By Arindam Haldar  

Healthcare industry landscape is shifting, and we have seen a shift in mindsets from ‘curative’ to ‘preventive’, driven by awareness of rising prevalence of non-communicable diseases (NCD) like cardiovascular diseases, diabetes, chronic respiratory diseases and cancer that account for three of every five deaths—an alarming number given that NCDs are largely preventable and need only lifestyle changes. NCDs are typically present in people aged 55 years or older in developed countries, but their onset in India is happening earlier, at about 45 years of age. Cardiovascular diseases—ischaemic heart disease, stroke—made the largest contribution to total burden of mortality in India in 2016, at 28.1%, and diabetes contributed 3.1%. Compounding this problem is infectious diseases that pose a huge challenge to the health system, resulting in a double burden of having to deal with both NCDs and communicable diseases.

However, awareness is growing fast. A recent survey on diagnostic test results for diabetes found that amongst the working-age population under 40, while the rising trend of diabetes diagnosis had been muted in the last year, the number of people getting regularly tested had risen significantly at 32% annually. This shows that people are being armed with knowledge of diabetes and are working towards ensuring their blood sugar levels stay in control.

Consider cervical cancer. In the US, the incidence of cervical cancer decreased by 54% during 1973-2007, following implementation of a widespread screening programme. In India also, despite having a patchy screening programme, age-standardised incidence of cervical cancer has decreased by 39.7% from 1990 to 2016. This gives us a glimpse of what a robust preventive healthcare mindset can achieve.
This shift places a responsibility on the diagnostics sector that has to improve its services both while front-facing consumers as well as in the laboratory. Last year, diagnostics companies ramped up home collection capabilities in a bid to improve reach. They are also introducing customised tests and technological innovations.

Artificial intelligence

AI can make healthcare system smoother, personalised and more efficient. With heaps of data being accumulated, these systems are goldmines of information for developing AI solutions. Microsoft India and SRL Diagnostics have partnered to expand the AI network for healthcare to pathology. By increasing efficiency in the histopathological analysis of human samples through artificial neural networks, it will be possible for a laboratory to cut down on manual errors and process more samples in a day with higher levels of accuracy. Similar AI technologies have enabled interpretation of complex genomic test results and arriving at a personalised treatment plan easier.

With more importance being given to preventive healthcare, it is expected that the pressure on secondary and tertiary healthcare systems will significantly come down. The biggest advantage of moving towards a preventive, rather than a curative, healthcare mindset is that NCDs are invariably tackled first, and these have a better chance of reversal if detected and managed early.

This year and beyond, for diagnostic labs the main drivers will be continued focus on preventive healthcare, shorter turnaround time through automation, next-gen logistics network, value-added services like AI for personalising test packages and qualifying lab reports, home collection of samples, and establishing connect with customers through handheld devices.

An issue that needs to be addressed is regulation and standardisation. Mid-sized and small labs dominate the industry in India, holding 85% of the market—unlike in most markets globally, where the industry is dominated by large organised chains. As the sector evolves, quality and customer service will become more important and a wave of consolidation in the industry will follow. So, it is imperative the government brings in a regulatory regime and stipulates standardisation principles of diagnostic tests. This will not only ensure a healthier and more productive India, but also remove fraudulent fly-by-night operators from the market.