India is embarking on a great adventure. In order for India to realize its dream of improving health for all of its people, a massive new effort is underway to strengthen its existing health system so as to be appropriate for a New India.

India has seen huge improvements in other sectors of the economy which have benefited from the systematic, concentrated application of digital technologies. Agriculture has improved. Banking has flourished by applying new payment options. And even though there have also been some downsides, one must even admit that social media has contributed to the fiber of family life and social cohesiveness.

But alas, until now, health has been largely immune to these improvements. The situation has not been unique to India. The world’s health systems overall have been maddeningly slow to sip at the technological trough.

In a strange way, India might actually benefit from being late to the party. It can learn from the glaring mistakes of other countries such as the UK and the USA among others. These countries have tried but often been embarrassingly unsuccessful, at digitizing their health systems.

In the parlance of Silicon Valley, we call this phenomenon the vagaries of the “greenfield”. Starting at a lower entry point gives one the opportunity to “do it right!” without sacrificing huge sunk costs in already existing systems. And not-yet-obsolete systems can in fact often be “wrapped” in order to be salvaged and incorporated into a new architectural scheme. (We’ll save the technical jargon for another day!)

BUT and there is a big ‘but’ in this scenario – where is the talent and trained personnel going to come from to make this all possible? The kind of digital revolution envisioned by the National Digital Health Mission, recently announced by the Prime Minister, will take massive armies of new recruits, specially trained in health informatics and placed on a new career path which today is largely lacking in India.

Where are these people going to come from? Eager new students? Public Health experts? Clinical experts cross-trained in technology? Health Management experts? Technology experts cross-trained in clinical processes? The answer must be yes! To all of the above.

The strict divisions between these disciplines must melt away in favor of a cross-disciplinary approach. The technician must understand the clinical mind (the so-called mental model of healthcare delivery). The clinician must understand the opportunities (and limitations) of modern technology. No room for naiveté here. Well disciplined teams of cross-disciplinarians working together is the surest road to success.

So what are the Next Steps needed to get this ball rolling?

  1. India’s educational institutions, including, and especially, its valued Indian Institutes of Technology will need to adjust its curricula to this new world. The world marveled for decades at how successful these institutions were in bringing the first rounds of technological capacity to India. In fact, they became so successful that the diaspora ended up fueling the technology efforts of the entire world! Now the IITs have the opportunity to add a focus on today’s informatics, such as health informatics, and to thus offer high-paying, skilled, prestigious jobs to Indian students now.
  2. And it is not only the IITs who can reap the rewards here. The other highly prized institutions, including the All India Institute of Medical Sciences, and the Indian Institutes of Management, among others. There is room for all of them to address the likely need for at least 15 lakh new graduates in this field in the next decade.
  3. Beyond the students of today and tomorrow, the more immediate focus might be in cross-training clinicians, technicians, health managers, public health experts – offering them a “second career” in health informatics where they can actively contribute to the design, development, implementation, and sustainability of health information systems in almost every healthcare delivery point in India, whether in the public or the private sector.
  4. Finally, there is the need for government officials, parliamentarians, human resource professionals, patient advocates – well simply everybody! —to have some familiarity with health informatics. The pregnant woman in Uttar Pradesh, the diabetic patient in Assam, every district health officer in Gujarat – all will need to become aware of the impact these systems can have in improving their quality of life. And hopefully, in the process, become champions of the Digital Health efforts.

This challenge will not be easy. Frankly, it is daunting.It will require diligence and considerable resources. The roll-out of Digital Health across this vast nation will require more than a modicum of patience and perseverance. It will likely have setbacks as well as early successes. After all, this is the history of technology and its application.

But at the end of the day it is clear that India will be able to harness technology in its quest to improve and strengthen its health system. In fact, there is absolutely no reason why India could not become the world’s leader in this field.She has the talent, she has the need, she has the motivation. All she needs now is continued governmental concentration and the development of her real power, its trained people, to make it all happen.

Dr Dennis Streveler is Professor of Medical Informatics at the University of Hawaii. He is a global Digital Health expert, and currently “Digital Health Evangelist” at ACCESS Health International.

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