Generative AI is Undoubtedly the Innovation that Stands Out for Me: Shuvankar Pramanick, DCIO, Manipal Health Enterprises

In an exclusive and insightful interview with Shuvankar Pramanick, Deputy Chief Information Officer, Manipal Health Enterprises, we explore the organisation’s pioneering efforts in leveraging technology to redefine healthcare. This conversation sheds light on their comprehensive technology strategy, covering vital aspects like cloud computing, artificial intelligence, generative AI, machine learning, and emerging technologies, all aimed at enhancing patient experiences and transforming healthcare processes.

Can you describe your overall technology strategy for Manipal Health Enterprises, including your approach to cloud computing, artificial intelligence, machine learning, and other emerging technologies?

So now, in the healthcare industry, the business has evolved. It is no longer just about conventional disease management systems; Manipal is leading the charge by embracing technology as the way forward. Everything is digital now, almost everything, to be precise. Looking at it from a business perspective, the main customer segment, or let us say the patients, are now receiving digital diagnoses, reports, and connecting with specific consultants and hospitals.

The adoption of digital tools is a necessity for any organisation in healthcare, or at least for most organisations. A few years ago, even before COVID, some healthcare institutions were a bit hesitant to fully embrace cloud technology and high-tech solutions, especially when the consultants were not too tech-savvy. There was some apprehension about how well these technologies would work and their accuracy in diagnosing and delivering results.

However, technologists consistently reassured the consultants that they were not here to replace any medical professionals or systems; they were meant to complement the existing processes. Consultants could suggest and get the most out of these technologies. This significantly reduced the time spent with patients while providing valuable insights and suggestions.
Manipal is not falling behind other hospital organisations in the healthcare sector. They are well-versed in regulations and have embraced various technologies, including AI/ML and cloud solutions.

Do you think the pandemic accelerated the pace of digital adoption?

Definitely it accelerated the adoption of technology. COVID has set the stage for change. When COVID initially emerged, it became a litmus test for our conditions, highlighting their resilience. It presented a myriad of challenges for patients in terms of how they approached healthcare and how healthcare organisations adapted to generate new business opportunities in the market. This unique situation prompted us to rethink our approach and swiftly adopt new technology.

What digital transformation initiatives has Manipal Health Enterprises undertaken to improve patient experiences and streamline healthcare processes?

So, the patient’s past experiences have always been shaped by the quality of services provided. We can dissect this in two main dimensions. First, there is your internal ecosystem, encompassing how you manage healthcare processes, your feedback mechanisms, and how effectively you respond to that feedback. Your internal ecosystem deals with how patients check-in, check-out, the services they receive, and the efficiency of payment and benefits. These components are all intricately connected to your internal operations. This is one facet of digital transformation, involving processes automation and feedback mechanisms, as well as interactions with patients through advanced CRMs, even after they have left the hospital.

The second dimension involves the external ecosystem, specifically, how you attract patients. This is more closely related to your overall business model. It is not a one-size-fits-all approach, I must emphasise. Instead, it is about targeting segmented customer groups, particularly those who are tech-savvy. A prime example would be corporate patients who often lack the time to physically visit hospitals and prefer instant service. This is where a business-to-customer (B2C) approach comes into play. Your business must reach out to serve the customer directly.

To achieve this, various apps and services have emerged. For instance, homecare agencies and platforms for online appointments and consultations, as well as teleradiology services. These have been successfully implemented at Manipal, extending healthcare services right to the customer’s doorstep. This constitutes the external facet of the healthcare ecosystem.

Generative AI, particularly in medical image analysis and diagnostics, has been a hot topic. Is Manipal Health Enterprises currently leveraging generative AI?

Not so, but we are contemplating its utilisation at some point. We currently offer X-ray and ultrasound imaging services, and we are exploring the possibility of expanding into genome sequencing with a few potential tech and business partners. However, I must emphasise that we have not commenced these initiatives yet.

There is undoubtedly substantial potential in this direction. Generative AI in the field of medical imaging has been around for quite some time. Initially, its outcomes were far from perfect. However, recent advancements have brought about near-perfect results, and clinicians are increasingly placing trust in this technology. This transformation is not limited to imaging; it extends to various diagnostic areas. For instance, in specialties like automatic sensing, the technology analyses data and offers predictive analytics. These models are data-driven, which historically posed a challenge in healthcare due to a lack of high-quality data.

Fortunately, we are now witnessing significant changes in this regard. Governments are taking proactive steps and initiatives to capture and maintain quality healthcare data. In fact, the introduction of the Digital Personal Data Protection Act mandates the storage of such data within healthcare systems. This shift towards high-quality data is a pivotal development across the industry.

In the era of increased cyber threats, how is Manipal Health Enterprises ensuring the security of patient data and maintaining robust data privacy practices?

Even just four or five years ago, the healthcare landscape seemed considerably more volatile. Today, that volatility still persists, especially when it comes to numerous systems beyond the borders of the units. I will refrain from delving specifically into Manipal’s situation, but speaking broadly, there are concerning issues that need to be addressed.

For instance, consider the process of giving your prescription to a local pharmacist; this action inadvertently leads to a breach of data, where your sensitive information is exposed externally. To tackle these issues, we must take a multifaceted approach. While within our multiple ecosystems, we can employ technology such as firewalls and various cybersecurity tools to protect data accessibility and integrity. However, we must acknowledge that once data leaves our immediate environment, we lose control. It becomes part of the broader market.

This is precisely why we need to emphasise the security of our patient data. There are multiple dimensions to this concern. In the larger picture, we cannot confidently assert that data is entirely secure, especially when it leaves our ecosystem and becomes accessible to pharmacists and potentially others, who might inadvertently gain access to your prescription information.

What recommendations do you have for strengthening cybersecurity within India’s healthcare sector to address the growing need for heightened security measures?

It necessitates a substantial infrastructure framework. I say this because, outside of India, it has become standard practice that prescriptions cannot be fulfilled without a GP’s prescription. Everything is interconnected. It is an impressive system that revolves around patient-centred care and security.

The governing body, in this case, has the responsibility of ensuring that medicines are only provided upon the presentation of an online GP’s prescription. Patients have the full authority to share these prescriptions as it is their data. Patient-centred care means they have the rights to disseminate this information. However, service providers must not share this data without proper consent.

Patients have the flexibility to carry their prescriptions on various digital platforms, be it mobile devices, email, or any other means. The key is to maintain a unified ecosystem. For example, if Manipal issues a prescription, that prescription should be stored securely within the system. Patients can then share it with their chosen pharmacist, who can access this data from a designated portal, ensuring that patient data remains protected within the larger ecosystem.

What are the key challenges that Manipal Health Enterprises faces in its technology and digital endeavours, and how is the organisation addressing them?

We do not really have any such challenges in our technological setup. Manipal is currently expanding its physical presence by acquiring many more hospitals. However, when we acquire other hospitals, we encounter a distinct infrastructure and different technology setups. Merging these two sets of technologies and ensuring the security of data on both sides presents a substantial challenge.

For instance, when we acquire a hospital chain with a completely different infrastructure from our own, the process of integrating these technologies becomes a significant challenge. It needs to be swift and efficient to ensure that our policies and processes can be rapidly implemented within these new hospital entities.

These challenges emerge not due to technological limitations but from the practical intricacies of merging healthcare technologies. It is essential to consider that, although it may sound straightforward in theory, acquainting another hospital might not have reached the same level of technological advancement. As we navigate this process, we must think of it as redecorating a house, ensuring that everything is in its proper place.

Could you share some examples of successful innovation and collaboration initiatives that have contributed to the organisation’s growth and development?

We have introduced a pharmacy module that is primarily tailored for Manipal. Within this module, we facilitate the delivery of medications right to the patients’ doorstep, eliminating the need for physical visits to the pharmacy. Additionally, we have made significant strides in telemedicine. Our telemedicine solution is user-friendly, eliminating the need for downloading any applications or medical software. Patients can simply call our dedicated call centre, and they will receive a unique URL to commence their consultations. This means there is no need for downloading apps or complicated setups.

We are also in the process of developing a comprehensive homecare solution. While various homecare services are available through different applications, we are working on consolidating these services into a single application. This centralised homecare application will encompass a wide range of services, including nursing and ambulatory care, providing patients with a one-stop solution for their homecare needs.

For instance, when a patient is not located near the hospital’s physical location, perhaps in a city or a small town where the hospital is not present, are they still able to access the same benefits of E-pharmacy?

As of now, this service is not available at all locations. However, within our hospitals, wherever they are located, we can efficiently dispense medications using our software. For example, patients who were initially admitted to Manipal Hospital on Old Airport Road and are now traveling to Jaipur, our Jaipur hospital can still receive their prescribed medicines and dispense it accordingly. In this context, the service is indeed available.

Can you provide insights into some of the notable technology and digital initiatives currently in progress or planned for the near future within Manipal Health Enterprises?

When it comes to patient experience, we are actively developing AI-driven insights tailored to various medical specialties. We are also in the process of transforming our call centre to operate with an approach similar to bot-based call centres commonly found in the banking industry. As part of this initiative, we have already released some features through WhatsApp bots, and we are currently working on strengthening and expanding our presence on WhatsApp. These are the key areas on which we are currently focusing.

If you are implementing a bot-based customer service system, will there still be human oversight? Especially for handling specific and potentially complex queries related to individual patients, as there can be unique situations where the bot may require human intervention?

Certainly, human intelligence will still play a significant role, particularly as we move beyond the basics. While for straightforward tasks, we are streamlining the process with reduced manpower.

What are your predictions for the future of healthcare technology, and how do you envision Manipal Health Enterprises positioning itself in this evolving landscape?

Future predictions indicate a much more integrated and interoperable healthcare ecosystem in India. The Digital Personal Data Protection (DPDP) Act marks the first step, and within the next one to two years, we are looking at achieving a fully integrated healthcare ecosystem in India, where Manipal plays a vital role in these initiatives.

As we move forward, we anticipate that the developed features will become more sophisticated and realistic. This means that cognitive applications, teleconsultations, and teleradiology services will evolve into more than just technology-enabled services. The goal is to create a seamless experience for patients, much like when you enter a new hospital and wait in a queue, reading materials, and then consulting with a healthcare professional. The aim is to replicate this filling factor in teleradiology and teleconsultation setups. The login process will be streamlined, and in the Indian context, where doctors’ time is precious, we expect a significant improvement in disease management discussions. While it may be facilitated through artificial means, the patient experience will feel as if you are sitting in the doctor’s office, not at home.

Before we conclude, I would like to ask one final question. As both an individual and Deputy CIO, can you share the one healthcare innovation that you are particularly proud of?

Generative AI is undoubtedly the innovation that stands out for me. The ability to generate multiple models and algorithms using data is incredibly appealing. It is something I aspire to work on in the future.