Besides expanding the applications of AI in healthcare – from clinical decision support to personalised medicine, hospitals in India look to test and adopt other types of emerging technologies this year. 

Prashant Singh, CIO of Max Hospitals, and JP Dwivedi, CIO of Rajiv Gandhi Cancer Institute, discussed with Healthcare IT News some continuing and emerging trends in health IT this 2024. 

For one, robotic solutions for surgeries are expected to take more space, not just in big, private chains but also in smaller, public hospitals as costs become more competitive with the arrival of domestic alternatives. 

A particular form of AI, generative AI, which grew in popularity last year, will stay in demand as hospitals seek more efficient tools to spend more time with their patients than doing menial administrative work. Voice AI like Augnito is also catching attention with the discovery of voice biomarkers indicative of various diseases, especially pulmonary and even neurological ones. 

While there is sustained enthusiasm among hospitals to be deemed as "technology champions," investing in new technologies is not met without resistance.

Q: Which trend in health technology in India do you see continuing in 2024? How about new trends to expect in the new year?

Dwivedi, Rajiv Gandhi Cancer Institute: Hospitals have always embraced medtech. In Radiology, there are digital X-rays, filmless images, high-precision CT, MRI, and PET-CT. Haematology and Biochemistry laboratories have analysers, which are now integrated into Hospital Information Systems. Automation has also come to Microbiology and Histopathology, while hospital investments in molecular laboratories and genome sequencing have grown in recent years. Now we are going for AI in both Radiology and Pathology; 2024 will see the continuation of this trend. 

With the emergence of more and more sophisticated modalities in Radiology and heavy demand for radiologists, it is imperative that we do some sort of triage to separate absolutely normal images from the images that need particular attention of a professional. The use of AI/ML has already enabled that. We see a number of AI/ML-enabled products learning the art of diagnosis alongside radiologists. After learning the analysis of 100-200 normal images and 100-200 abnormal images, the software can step in to sort these images and present only abnormal or potentially abnormal images to the radiologist. It saves significant time and effort. AI is also able to detect nodules that are not visible through the naked eye and suggest a closer look by a professional, and thus avoid a false negative. In Pathology, high-precision cameras enable the [preservation of] digital images rather than glass slides that are very difficult to handle, store, and transport. These images could be stored digitally and analysed by AI/ML-enabled products in the same way in radiology imaging. 

In our institute, we have been working on digital pathology and the use of AI/ML-enabled technology [tools] in detecting prostate cancer. The results so far have been very encouraging. We will soon expand it to detect many other types of cancer. The next technology intervention area is putting it to therapeutic use. 

Robotic Surgery has been in existence for more than a decade and is proven to prevent blood loss, increase the precision of surgery, and minimise the length of hospital stay. Until very recently, such robots were very expensive and training was available only in a select few places in the West. With the arrival of a domestic robot called SSI Mantra, the cost has been significantly reduced. We will see more and more robotic solutions coming in the near future.

Other examples of technology interventions are Radiofrequency Ablation (RFA), Trans Arterial Chemo Embolization (TACE), Trans Arterial Radiation Embolization (TARE) and High-Intensity Focused Ultrasound (HIFU). All these have been effectively used in oncology over the past few years to improve precision and minimise intervention. We shall witness the rapid expansion of these technologies in healthcare in 2024 and many years to come.

Aside from a few large hospital chains, hospitals traditionally have been myopic about using IT until 2020 when COVID-19 struck. The onslaught of COVID-19 changed the mindset of healthcare providers in many ways. For the first time, doctors preferred providing opinions remotely (telemedicine) and using computers to check patient records (EHR) more than referring to paper files that could carry the deadly COVID-19 virus. This trend continued thereafter as patients are able to book appointments and see their complete medical history using apps, while doctors are finding it easy to view medical history on a single screen rather than flipping through several pages of a bulky paper file.

However, there are several challenges in the adoption of EHR, and these are faced by clinicians worldwide. Doctors find it useful to retrieve the records but are not comfortable entering the notes, orders, and prescriptions online. Hospitals are looking for dependable technologies that can help in the creation of medical records in the background while doctors are interacting with and examining their patients. The next best could be handwriting or voice recognition technologies. A lot of promises are coming but nothing has been successfully proven other than a few specific areas like dictating radiology and pathology reports. This problem is more acute when a doctor is making rounds and is made to stay in the ward to enter progress notes, prescriptions, and diagnostic orders on the computer. The year 2024 will see some promise in this direction. 

As more and more patient data is becoming available online, the data security risk has increased manifold. Cybersecurity technology is emerging and will see a marked improvement in 2024 and beyond.

Singh, Max Hospitals: In my view, AI/gen AI will continue in 2024 in various healthcare use cases, specifically case summarisation and disease prediction.

Q: How receptive are hospitals in India to new technologies being offered in the market? Are you seeing hospital budgets aligned to testing/introducing new technologies in 2024? 

Dwivedi, Rajiv Gandhi Cancer Institute: Hospitals have always been receptive to medical technologies but are now opening up to IT as well. Governments are encouraging [the] use of IT in hospitals in many ways. Patients are also aware of the benefits of patient health records, telemedicine, online appointments and many other facilities [that] opened up with the help of IT, and they are able to differentiate technologically advanced hospitals from others. Technology is also helping [improve] patient safety, reducing cost, and enhancing patient experience. Hospital budgets are getting aligned with not only testing but putting these technologies to effective use and they want to project themselves as technology champions rather than being stamped as laggards.

Singh, Max Hospitals: Corporate/bigger hospitals are very much receptive to newer technologies but the allocation of sufficient budget still faces some resistance even now.

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The interviewees' answers have been edited for brevity and clarity.