We built capacity by coupling digital with physical

According to Arvind Sivaramakrishnan, Chief Information Officer, Karkinos Healthcare: Medicine is art. Digital is science. When we couple all of these, we find that these are complementary skills. One is feeding the other. This is not either. Edited excerpts from a video interview…

Did the healthcare industry upgrade itself during the pandemic?

Yes. But more than that I would say is that the realization of digital transformation took place. A lot of these solutions, particularly the biggest one that everybody spoke of, teleconsulting, existed for the last many years. There was always a high degree of scepticism on it. There was a feeling of how can healthcare be delivered without the touch and feel and physical presence? That’s one aspect from the consumer side.

From the provider side, the maturity of providing it as real as the physical was lacking. There was a lack of sophistication on both sides. The pandemic forced a situation where we didn’t have an option. There was that immediate race of getting it all perfected. Perfected also from a legal standpoint, thanks to the government.

Looking at the healthcare institutions and delivery sector, one realized that by coupling digital with physical, there was that ability for building capacity that did not exist in the physical world. The next aspect was the need to perfect operations so that physical and digital are one and the same. One is not less than the other. Take either one depending on the best fit for the presentation of the clinical condition.

Then comes in the sophistication of the bandwidth and the tools that are used. For example, when we are talking, we cannot have something blurred, break in voice or signal distortions. Because this is not a social encounter but a clinical encounter where a certain amount of looking and perceiving is equally important. Comes with it the tools and techniques that are used to record these encounters and thereby a better understanding and realization of electronic medical records.

With all of this, trying to figure out during the pandemic what was going on and what was working, that brought into perspective capturing data in the right aspect at the right point. And the appreciation for turning that data into insights and decision making. That’s why I call it the realization of the potential of digital and thereby each of us had to upgrade, align and rewire ourselves. We had to learn and unlearn some of our past practices. Above all we had the realization of ensuring that the high degree of clinical quality was not compromised. A slow healthcare industry leapfrogged, before which other industries were way ahead on digital transformation.

Which technologies are better and can help in reaching universal healthcare?

Any technology that you can use to solve a problem. It is not about the perceived notion of superiority of a particular technology. Obviously, mobile phones are far reaching and important. Then comes the advancement of the computing technologies, whether it is hybrid or cloud. There are efficiencies in which the computing technology is aiding that aspect of it.

Social Media coupled with the right level of verified information can give the right information about healthcare. This also comes under “delivery of healthcare”, it’s not just about hospitalization and visits. It’s about educating people about the options that are there when faced with health problems.

Technologies such as Augmented Reality and Virtual Reality start bringing experience into perspective. They can train, build and orient the workforce. You can’t take everybody and get them into a physical location due to barriers and costs.

The larger aspect of this is all the work that we are doing on all of analytics. The curating of information, getting into prescriptive, predictive and cognitive analytics. The other aspect where I am mixing technology with biology is genomics. I think genomics is going to bring in a far better, deeper and precise manner in which we can approach a healthcare problem, understand the complexities of many non-communicable diseases that we are faced today for which we don’t know why it is happening. The biggest one being cancer.

Then there’s precision-based medicine and precision-based surgery. Better use of analytics and the discovery of information to drug discovery. For example, the vaccination, the speed in which it was all done as against what we are normally used to. All of these are technology enablers. I am not going to bet on one single technology, but a combination of all of this.

Medicine is an art. Digital is science. When we couple all of this, we find that these are complementary skills. One is feeding the other. This is not either or. A lot of people have asked questions like: With so much of technology, are we eliminating doctors and medicine? These are not valid questions. It’s not elimination, but augmentation.

What is the role of the CIO in the healthcare industry and how has it evolved?

The role has evolved from the traditional IT manager in the EDP section that typically used to report to finance. Handling governance and financial matters, supply chain, payroll and balance sheets. This was what the IT manager used to do to support the back office.

As and when we started realizing that the use of technology is a strong business enabler and consumer aligner; the use of technology brings that degree of surety to the business which the consumer is expecting, in blunt terms, a warranty and a guarantee. Immediately our friends in legal will say how are you saying these words and they are right.

But that is what the consumer is expecting. The consumer comes to the healthcare system and asks a very simple question: Will I get cured? And you are expected to give a yes/no answer. But forget all the legal terms and war over words. That is the expectation. That is why they are coming to the health system. And to be honest, that is what the health system is striving to provide also.

In all of this, the people providing this are human beings who are prone to mistakes because human beings are not entities that are at their best 24X7X365. That means the enabler or helper in this case is technology. And technology starts bringing in the element of discipline, rigour and governance. It is the virtual assistant to consult, and it doesn’t have mood swings or good days and bad days.

Businesses started realizing that technology is a business enabler. The CIO started becoming a person who is the conduit between business and technology; business and growth; business and revenue generation; business and operational excellence, the conduit for enabling service excellence and the conduit for ensuring governance and financial excellence.

Using all these technologies and trying to ensure patient safety, clinical quality and excellence, and striving toward higher and higher degrees of outcomes. So today the CIO is able to translate the art of possible technology to the reality of the want of business.

We have embarked upon a very ambitious India2047 programme. Are the HealthTech startups, pharma, diagnostics, industry along with the government synced up for our India2047 goals?

I wouldn’t say synced up as a full stop. I think the process is well done. The maturity of this is well understood. The various aspects of law, business enablement in terms of funding, the alignment between industry and healthcare; tech and trials; tech, business and execution, all of these are understood. The promise is well understood.

The difficulty is being absorbed. The understanding of the complexity is now there. We still need to mature. But we are on the right path to achieve that maturity, and excellence, in time and in scale. It’s a journey. We are on the right path at the right speed. I am very optimistic.

(Catch the complete interview on the YouTube CyberMedia Series channel)

Arvind Sivaramakrishnan

Chief Information Officer, Karkinos Healthcare

sunilr@cybermedia.co.in