CXOToday has engaged in an exclusive interview with Dr. Sabahat S. Azim, the Founder and Chairman of Glocal Healthcare Systems
- Can you provide a brief overview of Glocal Healthcare Systems?
Glocal Healthcare Systems Private Limited (“Glocal”) is a social venture that seeks to bring state of the art healthcare to the underserved. Dr. Sabahat S. Azim, a medical doctor and ex-IAS officer, quit the IAS and founded Glocal with co-founders Richa Azim and Gautam Choudhury in 2010, to develop a technology and process-based healthcare system which is affordable, accessible and accountable for all. Glocal believes that (1) healthcare does not have to be expensive to be good and (2) the poor and underserved cannot be reached by inferior technology, but the best and most cutting edge one.
Glocal delivers healthcare to around 2.4 million patients in underserved areas annually through mobile applications, digital dispensaries and acute care multi-specialty hospitals. It has leveraged cutting-edge technologies like the Internet of Things (IoT), Point of Care (PoC) devices, and Artificial Intelligence (AI) enabled Clinical Decision Support System, to take quality healthcare to rural and remote areas. It is the largest provider of digital consultations in India.
It has built the least cost state-of- the-art health facilities in least time and offer healthcare at most affordable pricing in the organized industry. It has been contracted to set up and operate over 800 digital dispensaries across the country in the rural area in partnership with state governments of MP, Odisha, Gujarat, Chhattisgarh, Rajasthan and with PSUs like Coal India, BPCL, etc. It has built and operates eleven acute care hospitals in Tier 3 cities across West Bengal, Bihar, Odisha and UP. Glocal’s solutions have reached countries in Africa and Philippines.
- How has Glocal leveraged technology to ensure healthcare affordability without compromising on quality as a recognized low-cost private healthcare provider?
Healthcare is expensive as it is delivered in the age old tradition, by experts – doctors who are in short supply. The costs will not come down unless the delivery becomes process based, standardized and productized and then mass delivered in an assembly line approach. This will make healthcare affordable for the majority of the population, ensuring a standard quality.
Glocal has done this using cutting edge technology. Glocal has coded all the signs, symptoms and diseases, diagnostic test references, treatment protocols and pharmacopeia into a clinical decision support system with Machine Learning capability – LitmusDX. It titrates dosages as per age and weight and checks for drug and food interactions and contraindications to avoid medical errors. This is humanly impossible for a doctor to remember during every patient interaction. Litmus DX forms the base of our healthcare delivery.
Combining LitmusDX integrated with point of care and IoT devices for remotely examining patients and seamless data acquisition, instant tests and medicine dispensing, Glocal has created Digital Dispensaries, which can help doctors efficiently provide quality healthcare for majority of the cases even in areas where they cannot physically reach. Glocal is able to offer comprehensive primary care at the lowest cost in the organized industry.
Glocal adopted a zero-based approach to design and costing of hospitals. The focus was on reducing capital expenditure by focusing on most needed services and providing high clinical excellence in them. With iteration, we were able to build the lowest cost hospitals in least time in India. These hospitals are among the better designed hospitals in terms of efficiency and economy yet adhering to all quality parameters. The design effectively optimizes movement of man and material, thus maximizing efficiency and reducing costs by eliminating excess spaces in the buildings. Instead of being a doctor-driven model, Glocal aims to be a protocol and technology driven model facilitated by doctors. While good doctors are the core of any healthcare service, protocols allow for ensuring good quality care that is independent of the skills of the doctor.
- Considering the rise of AI in healthcare, how do you envision it reshaping the industry, and what challenges do you anticipate in its integration?
Artificial intelligence (AI) has the potential to transform healthcare. AI can help reduce costs, improve productivity and efficiency, speed medical research, and above all enhance access to healthcare services and improve outcomes.
Artificial Intelligence (AI) can help healthcare providers by automating administrative and communication processes, freeing up valuable time for clinical and patient-centric activities. AI can enable virtual triage, improve convenience and experience for both providers and patients. Chatbots and Generative AI are already extensively used in various industries. In diagnostic imaging analysis, AI applications enhance image recognition, expediting the diagnostic process and improving the accuracy of interpretations. AI-powered devices and applications already monitor patients and provide alerts and even medications based on real-time or predicted data.
Medical knowledge is vast and expanding with every passing day. It is humanly impossible for doctors to remember everything from years of rigorous study and be updated with every new development in their field. It is not an issue of competence but an issue of data processing capability. The doctor’s ability to memorize and effectively recall, not only affects the diagnosis and treatment, but a small error may have serious implications. In today’s hi-tech world, this is simply unwarranted. The doctor can be aided by AI enabled algorithm based clinical decision support system (CDSS), leading to efficiency, accurate diagnosis and adherence to most updated treatment protocols devoid of medical errors.
By processing and evaluating enormous amounts of historic and real-time data, AI can help medical professionals in chalking out a more evidence based and individualized treatment, forecast risk for individuals as well as populations and ensure proactive intervention. A CDSS, combining data science and evidence-based medicine, can help take healthcare to all the underserved population. In the next decade it is unlikely that patients will visit doctors or clinics for out-patient care. It will be completely virtual. It is possible that a lot of invasive and surgical procedures would be done in situ using nano bots or nano delivered precision medication.
All this requires an overhauling of our attitudes. I believe the patients’ health seeking behavior will be less of a challenge. The biggest challenge would be getting practitioners to use technology. This will also require serious investments and collaboration across firms, countries and governments in the coming decade. Then there is the challenge of right amount of regulation to protect citizens, while not nipping innovation in the bud.
- In light of the increasing significance of digital technologies in healthcare, how does Glocal embrace these advancements to enhance patient care and services?
Today 80% of the doctors live in urban areas catering to only one-third of the population in India. Digital health is the only viable alternative to taking modern healthcare to the remotest corners of the country, where internet is available. Glocal has successfully maximized the use of technologies like Internet of Things (IoT), Point of Care (PoC) devices and Artificial Intelligence (AI) to deliver comprehensive primary healthcare, including doctor consultation, diagnostic tests and medicines, from a single point called Digital Dispensaries, in underserved and remote. The Digital Dispensary includes innovations such as:
- LitmusMx, a healthcare terminal integrating IoT and Point of Care devices, which enables digital doctor consultations, remote patient examination and instant investigations.
- LitmusDX – a Semantic Algorithm based Clinical Decision Support System that helps doctors in differential diagnosis, interpret investigations real time, check for treatment protocols, titrate dosages, check drug / food / alcohol interactions and store EMRs.
- Hellolyf – a Telemedicine suite that connects doctors to patients through video conferencing.
- Litmus Rx – an optional automatic medicine dispensing unit
Glocal has cumulatively run more than 800 digital dispensaries. On an average, Glocal offers digital doctor consultations to more than 2 million patients in a year.
Glocal has extended the above digital healthcare solutions to support in-patient (hospital) care through:
- Digital protocol based critical care – results in one of the lowest ICU mortalities globally, in Glocal hospitals.
- HelloLyf PX – a pre-fabricated digital primary healthcare center or ePHC, which includes emergency care and beds for minor hospitalization. It leverages specialist and senior doctors digitally.
- HelloLyf HX – high end Acute Care Digital Hospitals with digital OPDs and e-ICUs, where patient monitors, injection syringe pumps and ventilators are all digitally connected for remote monitored leveraging experts from across the globe.
- What are Glocal’s upcoming strategies to expand healthcare accessibility in India, and are there specific projects in the pipeline?
Instead of the traditional understanding of segmenting healthcare across primary, secondary and higher categories, we would like to segment it in the following categories based on the patient’s needs and the way it is delivered:
- Out-patient care: Care which does not require any invasive procedure or hospitalization. This can be taken care by assisted digital healthcare using digital dispensaries (DD). We want to extend this model to more states in partnership with Health and Wellness Centers. The DDs are currently in a transitional stage. Eventually, with more automation and improving technology, this process can become completely virtual.
- Acute care: Ambulatory, specialized, emergency and critical care for patients requiring immediate intervention due to life or body part threatening conditions. These can be managed through our Acute Care Digital Hospitals – HelloLyf HX, which leverage digital connectivity and innovation. We want to set up hundreds of these hospitals in Tier 2 and tier 3 cities, where acute care services are lacking.
- Higher Level of Elective care: Some patients may require super specialized care such as heart surgery, advanced cancer treatment, organ transplant, etc., after their lives have been saved in an acute care facility. These facilities already exist in metros and larger cities. Glocal will currently not venture into this space.
We will complement our HelloLyf HX hospitals with ePHCs called HelloLyf PX, in locations around the hospital which are further off and do not have a viable option for emergency primary care and minor hospitalization.
Glocal is on the forefront of using technology in healthcare. We already use an AI enabled Clinical Decision Support System – Litmus DX as the backbone of our healthcare delivery. But our most ambitious project in AI and advanced analytics is codenamed “Galactus”, which will be based on huge quantum of diverse health data and is expected to:
- Enable differential diagnosis and treatment not only based on technicalities but focusing on outcomes
- Transition to a more evidence based individualized treatment from the current existing norms, which in some cases are quite arbitrary
- Not absorb and process the personal data of patients to provide complete patient data privacy
