Dr Vijith Gunasekera (MBBS MSc MEcon MD)
Visiting Academic/Research Fellow, Warwick Evidence
Warwick Medical School, University of Warwick, United Kingdom
(Former Director of National Blood Transfusion Service, Director Laboratory Services)
Healthcare technologies offer many benefits and have greatly enhanced the ability of health professionals to prevent, diagnose and treat diseases. Healthcare Technologies are key components of a well-performing health system as they are the most abundant and widely used medical products in practice. The quality of healthcare delivery can be assessed along the STEEEP criteria (Safe, Timely, Effective, Efficient, Equitable, and Patient-centered). However, many lower and lower middle income range countries in general face problems in satisfying these due to the unavailability, or limited availability of healthcare technologies.
Rapid advancement in healthcare technologies will be a major challenge in the era of 4th industrial revolution. In this era of information, many will be aware of available technologies elsewhere in the world and people will demand for such technologies as soon as they are available in the market. Acquisition of new technologies would be more challenging in our context as our health system is funded by a taxed based public financing mechanism. The Biggest challenge of such acquisition would be the cost of these health technologies and it will further burden the country’s health care budgets.
In this backdrop, the government needs to make rational decisions as to what technologies would be offered through the system and what mechanism of financing needs to be adapted. In the process, government needs to have the capacity to make evidence based decisions. UK National Institute for clinical and Care Excellence (NICE) is an example of such an organized system where those investment decisions are made through a comprehensive, in – depth analysis of the issue and solution. They mainly consider aspects of clinical effectiveness and cost effectiveness; that is patient benefits and cost benefits as country. Health technology assessment (HTA) play the key role in this regard in finding evidence and transforming them into decisions.
However, technology is not always costly as you may see it on the face of it. There can be interventions that would bring about more benefits in real terms by improving efficiency and patient benefits. Using Artificial Intelligence (AI) in health care would be such an advantageous consideration as many of our human tasks are now being replaced by machines. Healthcare is no exception to this rule.
Classic example of AI in health care in current context would be use of drone technology in healthcare delivery. Drones can do wonders in healthcare stings as they can be coupled with artificial Intelligence. Drones can be of help in many ways; particularly as a cost effective healthcare logistics solution.
Drones can deliver emergency blood, medicine and other urgent consumables to any designated location with minimal human involvement. These technologies are already successfully used in countries such as Rwanda and Ghana. The health authorities have been able to organize their distribution systems in a more centralized manner and by doing that, they have improved their efficiency almost to nil stock-outs, timely delivery, just in time – supply chain management and drastic reduction of wastage.
In the event of a disaster situation, where the accessibility would be the biggest challenge, (examples, Tsunami in 2004, Frequent Flood and land slide situations, frequent road traffic accidents and mass casualty situations) emergency deliveries of rare blood and urgent medicines and consumables could be done with the assistance of such technology with a marginal cost.
Apart from emergencies, many countries are looking at using drones and related AI technologies in routine health care delivery to improve accessibility in the rural settings for chronic disaster management, health promotion and prevention as well as other public health activities.
In summary, health care technologies are evolving and ever advancing. No country can evade such an advancement and rapid progression of the health care industry. People will be demanding cutting edge health technologies. It is the responsibility of the policy makers to invest on right technology at the right time that would bring about most benefits to the people through evidence synthesis through a process of Health Technology Assessment (HTA).