India is among the few countries that has emerged as one of the fastest-growing digital economies over the past few years, characterised by 90% growth in terms of digital adoption index between 2014 and 2017. The Indian healthcare sector has adopted digital transformation to improve quality and accessibility. The digital healthcare market in India stood at US$ 116.61 billion in 2018 and is expected to increase at a CAGR of 27.41% to US$ 485.43 billion by 2024.
Digital Healthcare Landscape
The digital healthcare market is segmented into tele-health, mHealth, electronic health records/electronic medical records (EHR/EMR), and others (remote diagnostics and healthcare analytics). The mHealth segment is estimated to dominate the market (with 40% share) by 2024, as a greater number of people are likely to use health & fitness apps to track and monitor daily activities, thereby propelling market growth. This is followed by the tele-health segment. Enhanced accessibility and convenience will encourage patients to embrace mHealth services and solutions including healthcare apps and wearable devices.
Increasing importance of digital health and technologies has fuelled capital investments. In 2019, 53% angel investments were made in healthcare. In the first quarter of 2020, the healthcare sector witnessed a 50% increase in terms of volume (21 deals versus 14 deals in 2019) and 14% in terms of value (US$ 452 million versus US$ 398 million in the first quarter of 2019). Some of the notable deals were Curefit (US$ 111.5 million), Iora Health Inc. (US$ 126 million) and HealthCare Global Enterprise Ltd. ($119.7 million).
Launch of National Digital Health Mission
The biggest issue of patients in India is to find the best available doctor and services. In August 2020, the Ministry of Health and Family Welfare, Government of India, established the National Digital Health Mission (NDHM) with an aim to provide the necessary support for integration of digital health infrastructure in the country. Under the mission, a digital infrastructure comprising Health ID—an ID used to uniquely identify people, authenticate them and thread their health records; Digi-Doctor—a comprehensive repository of all doctors practicing or teaching modern/traditional systems of medicine, health facility registry and patient health records; and Electronic Medical Records—a digital version of a patient’s treatment history from a single facility. Amid government’s rollout of the National Digital Health Mission, private digital healthcare companies are making an entry into the sector. For instance, Medix Global, a London-based innovative digital health management solutions provider is setting up a pan-India digital infrastructure for tele-medicine and offline medical solutions including diagnosis and early disease detection services related to chronic diseases such as cardio-vascular, diabetes management, cancer and stroke. These also include health risk assessment, genetic testing, biomarker testing, personalised screening tests and personalised prevention plans. The company will also invest US$ 20-30 million in innovative medical tech start-ups with focus on India through Medix Ventures, a venture capital fund of the Medix Group to promote digital med-tech solutions.
The government has also developed a National Digital Health Blueprint (NDHB) to transition into integrated digital services in a comprehensive and holistic manner. The blueprint’s key features include a five-layered system of architectural building blocks, Unique Health Identification (UHID), privacy and consent management, national portability, EHR, applicable standards and regulations, health analytics, and multiple access channels such as a call centre, the Digital Health India portal and MyHealth App.
The Digital Healthcare Start-up Landscape in India
India has a rising burden of non-communicable diseases (NCD), with most Indian health-tech start-ups focussing in this area to leverage technological applications. Primarily, technology helps create the much-needed structured care continuum for the chronic patient pool by providing them an interface with the healthcare system 24/7 beyond doctor visits. This interface is typically a mobile application equipped to collect personal health data that is critical to monitor a disease. Start-ups such as NanoHealth and BeatO have been ensuring care for patients suffering from cardiovascular, hypertensive diseases and diabetes. On the other hand, companies such as 99DOTS use a cost-effective solution by asking patients to give a ‘missed call’, thereby tracking their adherence of tuberculosis (TB) patients. This system also improves the efficiency of healthcare providers who can track adherence data and respond appropriately to missed doses in real time.
Start-ups in the digital healthcare landscape largely work on technology-led service models. Companies such as Netmeds, 1MG and Myra play the role of pharmacists, threatening the removal of traditional pharmacists from the healthcare ecosystem. Start-ups such as ‘Healthcare at Home’ provide home-based healthcare services to patients who may be physically constrained in seeking hospital-based care such as terminally ill cancer patients or patients who need post-acute rehabilitation services.
While digital health start-ups primarily cater to patients in metro cities, a few start-ups look beyond metros and tier-1 cities. For instance, HealthPlix focusses on making convenient clinical practice by digitising instructions associated with prescriptions for patients. Another digital healthcare start-up, Karma Healthcare, is providing tele-medicine solutions by connecting patients in the remote parts of the country to physicians in urban areas. Start-ups such as Onco.com also provide services to international markets by connecting cancer patients to distant specialists and facilitating sharing of standardised reports between patients and oncologists.
Future of Digital Healthcare in India
Going forward, the global digital health market is expected to record a massive spike from both the demand and supply sides of the ecosystem. Focus on making a technology-enabled healthcare ecosystem as the backbone will benefit India in solving many existing challenges. An ecosystem of Health IoT, AI, 3D Printing and Robotics will help in solving intelligent patient monitoring, supply chain challenges, clinical inefficiency, claims settlements and patient safety.
While start-ups have shown early signs of success, they now must scale up solutions and demonstrate applicability of ICT solutions in the healthcare ecosystem. More investments in the health start-up ecosystem will require a stronger push towards scaling up digital efforts in the healthcare system.