Digital health has emerged as a potential game-changer for enabling accessible, affordable, and quality health care for all. Globally, the digital health landscape is maturing rapidly, with investments in digital health reaching $57.2 billion in 2021.

India too is experiencing a rapid maturing of the digital health ecosystem and the launch of the Ayushman Bharat Digital Mission (ABDM) is a step toward the long-pending digital standardisation of the healthcare sector. Strong tailwinds, such as the changing patient and provider attitude toward digital solutions, burgeoning private sector investment, and an enabling environment created by government initiatives are helping Indian healthcare to move towards a strong digital revolution.

Digital solutions can help mitigate individual and nationwide health emergencies through information received from disease surveillance. With the help of public health data, disease outbreaks can also be predicted and stemmed preemptively. Digital health can increase access to care irrespective of location by leveraging interventions such as telemedicine, teleradiology, Tele-ICUs, connecting remote and rural regions to the healthcare network. This would enable early detection of risks and diseases through longitudinal health records, point of care devices and more.

Yet, the lack of digital literacy, limited Internet and Communication Technology penetration, affordability, gender biases, and age gaps, among other socioeconomic issues, limit the reach and acceptance of digital health solutions for a population that most needs them. Many digital health solutions in the market today are in English and this prevents many Indians from easily using them. In the healthcare provider ecosystem, while the large corporate hospital chains are moving to digitised operations, smaller setups such as clinics and low-cost nursing homes continue to lag behind. Change management costs such as the upgradation of existing hardware and software, training of staff, and the digital entry of data, apart from the other indirect costs, impact the adoption of digital health solutions among healthcare providers. Independent practitioners who run small clinics, especially in the rural areas of the country, still use traditional paper-based methods of storing data. For most of these professionals, the feasibility of adopting digital tools is very low. Although there is a growing interest in healthtech solutions, the number of solutions available for the underserved remains limited.

Many digital health solutions in the market today are in English and this prevents many Indians from easily using them. In the healthcare provider ecosystem, while the large corporate hospital chains are moving to digitised operations, smaller setups such as clinics and low-cost nursing homes continue to lag behind.

In order to ensure that these solutions are equitable and to boost the uptake and utilisation of these solutions, it is critical for philanthropic actors to work together with non-profits, government, and commercial sector entities to address three important areas.

First, driving digital healthcare adoption at the provider and citizen levels is crucial as sustained digital adoption can be achieved only if end-users perceive value in maintaining and improving their health. This can be done by creating system wide incentives and philanthropy can enable the same by innovating newer models of digital health that reduce the cost burden on both citizen and healthcare providers. Innovations could include low-cost health management information systems (HMIS), solutions customized to the need of specific healthcare facilities especially for private healthcare facilities serving the underserved markets, innovation in Outpatient Department (OPD) insurances and faster processing of e-claims over physical insurance claims.

Along with innovation in solution, it is imperative to also innovate newer business models that distribute the financial burden to incentivise adoption. Philanthropy can enable the identification of newer business models that reduce the cost burden on the citizens and smaller healthcare providers by taking care of the risk capital. Such innovations could include OPD-led insurance models, cross-subsidisation across various buyer profiles, and insurance payer-led models. Further, creating a common philanthropic fund pool to promote provider and citizen adoption, through free trials and subsidized payments of digital health solutions would give users enough time to understand the value proposition before complete adoption. Additionally to drive adoption at a citizen and healthcare provider level, philanthropy can invest in building in building digital literacy for frontline workers and citizens by partnering with academic institutions and local CSOs, to bridge the digital divide for last-mile adoption.

Second, reducing friction for solution providers to navigate system complexities is necessary. Philanthropic organisations can intervene to support digital health solution providers, as they navigate complex policy and regulatory systems. Since they have a shared resource pool of legal and technical advisors, they can mutually establish communication with policy and decision-makers, and create toolkits to build policy understanding. Additionally, collaboration with incubators, academic institutions and implementing organisations can provide a structured environment for solution creators to test their ideas and identify areas of convergence with the healthcare delivery system.

Lastly, there is a need to understand that self-sustaining solutions will have a higher chance of success. Therefore  creating an enabling environment that can address business model challenges is crucial. Mainstream capital providers and philanthropic funders could collaborate to identify innovative financial instruments, such as blended finance and outcome-based financing, to encourage start-ups to expand in underserved ecosystems. Self-sustaining solutions can be identified by bundling complementary solutions and novel financial mechanisms such as blended finance and outcome-based financing can be used to enable start-ups to expand in neglected ecosystems.

The digital health ecosystem in India is on the cusp of tremendous growth and has the potential to revolutionize healthcare for the underserved and marginalized populations. However, stakeholders must work together to align their goals, approaches, and financing models to realize this potential. Continuous engagement and convergence of initiatives are crucial in developing effective action plans that make digital health solutions widely accessible. With support from the philanthropic ecosystem and a shared commitment to improving healthcare outcomes, India can pave the way for a brighter, healthier future through digital health.

Dr. Arun Jose is Head of the BRIDGE Centre for Digital Health at the Centre for Chronic Disease Control.

Granthika Chatterjee is an Engagement Manager with the Sattva Knowledge Institute.