Advent of Blockchain and Data Analytics in Healthcare
Health Insurance is based on similar principles of insurance where the community pools in its risks as well as its resources to face any risk or disease. The Health Insurance sector in India has grown in the past five years. It may not be at par with the world standards where more than 60 percent of the population is covered under Insurance. Currently, the State run employee benefit Insurance (like ECHS, ESI etc) cover about 6 percent of the population and State sponsored Health Schemes (like Arogyashree, MaaYojna, Bhamashah etc.) cover about 25 percent of the population. The private sector Insurance barely covers about 5 percent of the population which includes private sector employees through TPAs and retail insurance. Of the 37 percent of population currently covered under Health Insurance, majority is under State sponsored scheme and the private sector insurance has a long way to go. The Govt. of India envisages 50 percent Indian population covered under Health Insurance by 2025. This will help in addressing three vital aspects:
• The burgeoning burden of disease in the population
• The productivity of people will improve with improved healthcare facilities (reducing disability with timely treatment)
• Reduce the Economic Cost to the country (decrease in loss of manhours) by introducing healthcare policy reforms and resource management
The growth for private sector Health Insurance was mired with challenges of high rates of insurance premium and a lot of exclusions in policies. The policies were neither updated to include the emerging newer diseases and their trends. The claim processing time and payouts to clients was equally slow.
Over the past few years, the Indian Healthcare sector has seen a surge of investment from Private Equity and FIIs. This has catalyzed the availability (better equipped hospitals and clinicians) and accessibility to better clinical care for patients. This has also attracted investment in the Private Insurance sector which facilitates affordability for patients. Technology tools like Data analytics, Artificial Intelligence and Big Data with personalized predictive diagnosis have provided new insights into customer preferences and emerging disease patterns. Private Insurers are using these tools to innovate and customize specific Health Insurance Plans(e.g. Cancer Insurance, Heart Insurance Plan etc.) at affordable premiums. They have also upgraded their services with faster claim processing time and web enabled platforms to improve customer experience. Based on customer behavioural pattern, insurance companies are rewarding their customers with lower premiums or free annual health check-up packages. Promoting lifestyle modification and healthy living habits (e.g. lucrative Gym Packages) helps private insurers pre-empt disease save on hospitalization costs and earn better profits.
The era of predictive healthcare
A synergetic alliance between technology and healthcare is revolutionizing the face of health insurance too. As data analytics provides tons of data on disease, customer behaviour and treatment costs, the consumer and service providers explore the balance between the cost and optimal outcome. AI usage has already been initiated in some of the radiological and diagnostic tests where the results have been very encouraging.AI tools have been able to shorten the time taken to read X-Rays, analyse more number of reports in the same time, reduce manual errors and improve overall efficiency thousand folds. IOT is being used in managing remote healthcare facilities and individuals’ data. It ranges from tele medicine to preventive care. E-ICUs, OT management etc. are areas where IoT is being currently deployed.
The current interest in Block Chain is being explored for managing patient profile and his health journey. This will help Insurance companies and healthcare facilities to predict disease burden within community as well as medical record track patients. It will also serve as a predictive tool for monitoring outcomes as well as clinical journey of patients. The customers will gain transparency with regards to the quality, expertise and cost of treatment. Block Chain would also be useful as an intervention tool to introduce lifestyle modifications in a timely manner so that a healthy pool of productive population exists in the society, contributing to the economic growth.
As these advances are churning the healthcare ocean, some interesting work is happening in the provider market. One of the bigger questions which is emerging is who will be the controller for this knowledge pool? Will it be the customer or the data storage agencies or the analytics provider? Individual healthcare organizations may use tools to focus on business strategies, but it seems that data assimilating corporates will be the major players. Apple and Amazon are already possessing huge data regarding disease and consumer behavior and drug utilization. They have already acquired enough data through usage of various healthcare apps - data on BP, Pulse, Blood Sugar, Heart Rate, exercise, medicine purchases etc. They would be instrumental in recommending the health policy and treatments for specific health cohorts. They will provide innovative solutions to service providers for delivering affordable quality healthcare while the ultimate beneficiary will be the consumer.
The synergy between the health insurance sector and advance technologies is paving a path to accommodate better treatment modalities, cost-effective disease management and predictive disease burden. This will create a well-managed widespread health care delivery model. The age of predictive healthcare has arrived and health insurance companies are engaging judiciously by empowering the people with better healthcare options.