The current global pandemic has put a lot of stress on the already weak healthcare infrastructure of the country. Reports indicate that there is a shortage of beds in several towns and cities as well. The fragmented nature of the hospital locations do not help the situation. The lack of access to quality healthcare is especially evident in Tier 2 and Tier 3 cities. Even in the metros and Tier 1 cities, the lockdown has made it difficult for people to have convenient access to doctors for even non-COVID consultations.
Pre-empting the current healthcare crisis, Apollo 24/7 was launched on February 5, 2020. The platform, in the last five months, claims to have become India’s largest end-to-end omni-channel healthcare platform that enables users from any part of the country to use trusted Apollo services from their smartphones, at the click of a button.
Shobana Kamineni is the Executive Vice-Chairperson of the Apollo Group and has been past president of the Confederation of Indian Industry. In a freewheeling chat with TNM, she delved into various aspects including the work being done by Apollo 24/7 during the COVID-19 crisis, how tele-consultation services are being made accessible to people, maintaining privacy of patient records, the evolving COVID-19 situation in India and the efforts on getting a vaccine, among other things.
Here are excerpts from the interview.
What is Apollo 24/7? What is it aiming to do especially during the current COVID-19 crisis?
We believe that a group like Apollo has a unique opportunity. We are one of the few players around the world that is in every single touchpoint of a customer, of a person’s health journey. Having said that, we happen to be doing all this at scale. Almost all of Apollo’s services, we had a huge strategic thought, and we said let’s actually pivot the group to see how much healthcare we can deliver digitally. And I think no more time than this has the importance of being in the right place at the right time really shown up as this COVID-19 pandemic. If not for the fact that we had enabled all our digital systems, I think that many of the people that trust us would have suffered this pandemic much more. And I don’t say this lightly because during this time, by our ability to switch on digitally, we actually put 3000 Apollo doctors online, who were able to reach their patients and new patients were able to reach them. And this was I think one of the greatest services that we brought, the tele-consult to their homes.
How are you making tele-consultation services accessible to people, especially in rural areas, who may not have smartphones or internet connectivity?
For them, we actually work with the state governments. And I think this is something that has really happened more so after the pandemic, and this is more about non-profit, not to be confused with Apollo 24/7. We have done over 10 million tele-consults using the rural CSCs, the government has computer services in every village and we use that. So the highest and furthest points in India are all connected and those that have mobile phones, and more and more people will start having smartphones. About 400 million people have smartphones, that number will continue to grow and the scale of it.
An Apollo tele-consult is like you visiting your doctor. It has the same sanctity, it has the same legal framework around it and it is a paid service. I think that the trust and convenience factor has completely been opened.
How is Apollo 24/7 maintaining the privacy of the patients who opt for tele-consultation?
The good thing is that the PM is going to announce a national health stack and that health stack will actually have interoperability — from one institution to another, health records that are kept as a safe repository and I’m happy to say that Apollo has been in every part of that conversation because we have actually been following the highest of standards internationally available. For us, it’s not a new thing. We have 20 million digital records already of our customers and everything is anonymised, everything is completely safe. Happy to say that there’s never been a breach of privacy and the data is all housed on the cloud in India.
How do you see tele-consultation evolving in a country like India, especially with the rural-urban digital divide?
It’s very interesting. I think that whatever metric we’ve had earlier that you need one doctor for every 1000 people, all those metrics get smashed. There will be a new metric because now the doctors are way more productive. They are not limited by geography. So having said that, I think that once India starts recalculating based on the tele-consult and digital health platforms that are being built across the country, we will see that we can reach the sustainable development goals much easier. The outcomes, the number of people that can be reached, can be served by a smaller number of people. So this digital health revolution is actually going to change how conventional metrics were written in the past. We can’t do that with surgeries and some of the diagnostics, all those you still need to be live. But a lot of work can be removed through digital health.
Has India reached its peak of COVID-19 cases or could there be a second wave?
We have not even finished the first, there is no second that we are looking at. We have not done enough testing to tell us how much it is already there in the community so then we can predict. The answer that I would give you is we don’t have enough information based on testing but what’s going to happen is places that have had a surge, whether it is localities, whether it is municipalities, whether it is cities or towns, will see a decrease but that doesn’t mean with India being so spread out, it won’t now go into other places. So till we get a vaccine, this will continue to dampen society, it will continue to dampen the economy. However, there is a ray of hope that in India you are seeing a lot less mortality, and I think it comes from the fact that we are catching it early, that we have capacity and India has medicines that you can afford. And the government and the private sector together are working very, very hard to make sure that lives are not lost.
Do you think it’s a good statistic that our mortality rates are low but the total number of cases are quite high? How do you see this contrast?
I think it’s probably because our health system is somewhat working. And maybe Indians have better immunity. Definitely, we are a younger population than other populations that have been measured. So measure us against Italy, US which have high mortalities. We are a much younger population, so we are seeing that people in those are largely asymptomatic. Probably, we have a little more immunity, that has not been studied yet. Also in India, our medicines are priced so low that many people can afford it.
Does India have the infrastructure in terms of beds, testing facilities to deal with a rise in cases? What is lacking that you think needs to be done?
I think we should continue to test and testing will become a norm for even the future even after the vaccine comes. So whatever it is, I think India needs to invest in testing. In terms of number of beds, I think many of the cities like Maharashtra the cases are coming down, Delhi the cases are coming down. So we need to open it up for the other really sick people. There have been so many cancer cases that have not got care, so we need to work on that but having said that, I don’t think we have enough capacity in the rural areas. I really don’t know how that’s going to play out. So a big lesson from the pandemic is that we need to invest in our city infrastructure. I think that it’s a serious wake-up call and I certainly hope that we will move forward on healthcare infrastructure. I am optimistic that three years from now, the country’s health will be much stronger.
What is your opinion on instances of private hospitals overcharging patients? And do you agree with the government putting a price cap on treatment to curb overcharging?
Many in the government also don’t agree with the price cap. But what we have to do is I think that just as we don’t agree with people who were price gouging, but on both sides I have sympathy because for the hospitals that price gouge, you must understand that they had their beds empty for six months. They were desperate, they were paying nurses and doctors and they had no patients. So, what they did was completely wrong and I’m glad that the government stopped it but having said that, on the government’s side also, you can’t put a one-size-fits all because we’ve seen the way COVID-19 behaves, it’s the strangest of diseases. It’s just that both sides have correct points of view but you must look at it from a human point of view.
How do you see the COVID situation developing in India and the efforts on getting a vaccine?
If any developing country can get a vaccine, the first of the developing countries will be us. Because fortunately, that is one thing India did. We invested so well in medicines and in vaccines for the world. So hats off to those companies that did that. India will produce for the whole world and while producing for the whole world, we can keep a certain portion for ourselves. I have great hope that along with the US that is giving drug companies a billion dollars to produce vaccines, India just by virtue of them being here will have earlier access than other countries. In one way, we should all be happy that we are Indians. We will get it cheaper and we’ll get it fast.