India’s effort towards bridging the gap amongst various stakeholders of the national healthcare ecosystem through digital highways got underway in 2017 with the introduction of The National Health Policy. However, despite all efforts, improving public health infrastructure and availability along with capacity of healthcare professionals have posed major challenges in realising India’s health goals.

In addition to the critical factor of capacity expansion, healthcare organisations need to resolutely look at adapting new technologies in order to maximize available resources and reduce burden on the already exhausted physician workforce. Advanced technologies such as machine learning, computer vision, and robotics have the potential to play a catalyst in achieving inclusivity in healthcare services, making digital adoption an important factor for hospitals located in urban and rural areas.

Engineering Research & Development organisations have an important role to play here as their expertise in design, development, validation and rapid prototyping can accelerate breakthroughs in the medical domain, while new product development and adaptive intelligence solutions can help lower the barriers between hospitals and patients, particularity in tier 2 and 3 cities in India.

Rise of the machines in healthcare

Publicly available data shows that there is one doctor for every 1,445 Indians as per the country's current population estimate of 135 crore, which is lower than the WHO's prescribed norm of one doctor for 1,000 people. India also ranks amongst the lowest with regard to hospital beds according to a WHO report, with 0.7 beds per 1,000 people, far below the global average of 3.4. In addition to shortage of healthcare professionals, compared to urban areas, rural regions face high barriers to access healthcare facilities due to poor connectivity and limited supply of healthcare professionals.

But amid the challenges clouding the healthcare industry, there is a silver lining in the form of technology. India is among early adopters of digital health technology. According to Philip’s Future Health Index 2019 report, 76% of healthcare professionals in the country are already using digital health records. India also meets the 15-country average (46%) related to usage of A.I. within healthcare.

Delhi’s AIIMS hospital has a floor disinfectant and a humanoid robot in its Covid-19 wards and Fortis Hospital, Bengaluru is using an interactive robot to screen patients and medical staff at its entrance. Measures such as tele-monitored surgeries, tele-education, tele-medicine and video consultations with doctors has been used by medical professionals during the Covid-19 pandemic.

Most of the hurdles encountered by suburbs & tier 2 cities today would be neutralised through the shift of healthcare system towards collaborative and preventive healthcare. Although robotic technology is currently expensive for wider adoption across all types of healthcare settings, its adaptability specifically with reference to robotic assistants in surgery has already made in-roads in India. In addition, recently many hospitals had turned to robots as maintaining social distance became the norm due to the threat posed by Covid-19.

Robots may be utilised to bring safer specimen processing and diagnostic procedures with zero infection risk from remote areas which normally have lower technological levels compared to modern laboratory settings.

Robots on the surgical beat

India’s first robotic-assisted surgical procedure took place at a Delhi hospital in 2002. The world’s first heart surgery from a remote location was done in India in 2018, by Gujarat’s Dr. Tejas Patel, a cardiac surgeon, who with the help of advanced robotics, conducted the world’s first telerobotic surgery on a middle-aged women with blocked artery while sitting 32 kilometres away from the patient.

Over the years, robotic–assisted surgeries have made significant contributions to Indian Healthcare industry, with the growth of the Indian robotic-assisted surgical market expected to reach ₹2,600 crore by 2024 at a CAGR of 19.8%, as per a report by Research and Markets. Based on the findings of a symposium last year, almost 50% of all surgeries in India will be robot assisted by 2025. Concurrently, research and development in the fields of surgical systems, healthcare products and diagnostics will also see a marked uptick.

There are reports that over 500 robotic surgeons exist in India including deployment at government and private healthcare facilities. Due to shorter recovery period post-surgery, relatively less pain and blood loss, robotic assisted surgeries are considered to be a better alternative to open surgeries and laparoscopic surgeries.

Wider use of robotic technology shall enable Indians to save travelling and boarding costs over and above the usual hospitalisation costs. Specifically, in the case of medical surgery, robotics have been facilitating experts the majority of whom are concentrated in metropolitan areas and not available due to remote and inaccessible terrain for the tier 2 and 3 population.

Recently, the world’s first cost-effective robotic endo training kits had been developed in India in collaboration with the Republic of Korea. It is a surgical training robot, equipped to provide a high-definition observation of the patient’s anatomy. The live feed of the anatomy is broadcast on a screen which leverages virtual reality technology.

In addition to assisting surgeons, robots have been playing a critical role in training young medical professionals to become future surgeons. A cost effective robotic surgical training has become an ideal training model for young surgeons in tier 2 and tier 3 hospitals. It has accelerated the process of making young surgeons more skilled by reducing time and enhancing effectiveness.

Most of the hurdles encountered by suburbs & tier 2 cities today would be neutralised through the shift of healthcare system towards collaborative and preventive healthcare. Although robotic technology is currently expensive for wider adoption across all types of healthcare settings, its adaptability specifically with reference to robotic assistants in surgery has already made in-roads in India. In addition, recently many hospitals had turned to robots as maintaining social distance became the norm due to the threat posed by Covid-19.

Given the vast gap in the doctor-patient ratio, advance technologies such as AI and Robotics are expected to play a key role towards facilitating important medical services in the country especially in the middle of a pandemic. They not only lend support in hospitals and nursing homes, but also in the development, testing and production of medicine, vaccines and other medical devices and auxiliaries. Here are some fast-growing developments that will further shape the healthcare robotics industry in the year to come.

1. Nano robots set to dominate: With a microscopic virus holding humanity to ransom, the near future will surely see a proliferation of nanoscale robots who will traverse through the body to detect anomalies and irregularities. While the technology around nanoparticles is still developing, nanotechnology is a field which has the potential to revolutionise the future of healthcare and medicines.

2. Popularity of ‘rehabilitation robots’: With longevity on the rise and an expanded base of senior citizens in almost all large economies, the development of innovative rehabilitation robots is set to boom. Such robots will support an ageing population grappling with physical disabilities and support patients through the use of integrated sensors.

3. Surgical robotic systems: This is expected to be particularly relevant to hospitals that offer surgical procedures for complicated conditions. Moreover with enhancement of surgical systems being a pertinent need, it will drive the market for robotic services. Low cost innovations that assist robotic surgeries are expected to dominate the Indian market.

Training surgical specialists to become proficient in clinical robotics is a welcome trend that is sharply on the rise. Advances in surgical platforms and innovations propelled by VR/AR have the potential to address the needs of the fast-growing clinical robotic sector and usher in a new era of robot-assisted medical care for the masses. The journey of robotics from industrial assembly lines to suburban and small town clinics promises to be an exciting one.

Views are personal. The author is deputy CEO and member of the board, L&T Technology Services.

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