Understanding Digital Readiness of Small Healthcare Providers

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‘Digital health,’ the intersection between technology intervention and healthcare, has the potential to support equitable, affordable and effective healthcare systems. The Indian government is taking several steps toward the digitisation of the healthcare sector to enable the achievement of Universal Health Coverage (UHC). The Jan Dhan Yojana, Aadhaar and Mobile number (JAM) trinity and the National Broadband Mission form the backbone of these efforts, while the Ayushman Bharat Digital Mission (ABDM) aims to strengthen the emerging integrated digital health ecosystem for providers and citizens. 

The government’s commitment toward healthcare digitisation necessitates action from all healthcare providers, in particular private providers, as low-cost private hospitals and clinics constitute close to 70% of healthcare delivery. However, targeted efforts are needed to understand the status quo as well as the future requirements of private facilities to aid the transition. 

To understand the digital readiness of private sector hospitals, a dipstick survey was conducted with 45 respondents operating small-to-entry-level hospitals (about 50 beds) across Tier 1, Tier 2 and Tier 3 cities in Karnataka. The survey, along with in-depth interviews of 15 respondents out of the 45 survey respondents, set out to examine the providers’ attitudes toward digital adoption, measuring its present levels and their willingness to expand adoption, and identify the challenges they faced with digital adoption. 

Though the government continues to further its commitments, the survey results highlight an information gap due to a lack of comprehensive communication of the scheme provisions. While 26% of the respondents were registered under the Health Facility Registry (HFR), Key Informant Interviewees revealed that they were not fully aware of ABDM provisions and held misplaced notions of mandatory compliance with Ayushman Bharat-Pradhan Mantri Jan Arogya Yojna (AB-PMJAY). 

Nevertheless, digitisation efforts are underway in most facilities, with respondents claiming to leverage both hardware and software for basic operations and in select departments. For instance, digital tools are leveraged for operations such as billing (66.7%) and maintenance of records (60%). Only around 15% of the respondents claimed that all operations are digitised with nearly all staff members interacting via digital tools. All respondents, irrespective of digitisation status, continued to maintain paper-based records as a backup, while 16% of the respondents relied entirely on paper-based records.

While recognising the merit of advanced operations such as digital consultation, 70% of respondents still prefer to hold in-person consultations and follow-ups. At present, infrastructural issues such as network connectivity and the slow rate of adoption from the patient’s end slow the transition. The willingness to adopt further digitisation is inhibited by challenges such as associated costs, paucity of skilled employees to operate digital solutions and perform troubleshooting, and low availability of customisable software that addresses the needs of small-to-entry-level hospitals. 

Philanthropic organisations can play a critical role in systematically enabling this set of providers to better adopt digital tools by (1) facilitating the creation of a technologically skilled cadre of workers, (2) creating a cadre of digitally skilled professionals, (3) providing financial incentives for low-cost hospitals willing to digitise and, (4) generating awareness about government schemes that promote digitisation and increase willingness to adopt by successful demonstration of the value proposition.

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