Leveraging Technology to Enable Effective Preventive Screening of NCDs at Population Scale: Initial Observations

Abstract

India is undergoing an epidemiological transition to non-communicable
diseases (NCDs), with NCDs contributing to nearly 60 percent
of all deaths in India. NCDs are challenging to manage given their silent
onset, low health awareness, significant informational asymmetry, and
low health-seeking behavior among the rural population and the poor in
India. The Ministry of Health and Family Welfare (MoHFW), Government
of India, launched Ayushman Bharat to move from a sectoral and segmented
approach of health service delivery to a more comprehensive
one. As part of this effort, a program was launched for population-based
screening (PBS) and management of five common NCDs—hypertension,
diabetes, oral, breast, and cervical cancers. The success of the
program, among other things, will be determined largely by the early
detection, timely treatment, and diligent follow-ups to manage the five
NCDs. In line with WHO’s Global action plan for the prevention and control
of NCDs 2013–2020, India is the first country to develop specific
national targets and indicators aimed at reducing the number of global
premature deaths from NCDs by 25% by 2025. However, challenges
like human resource shortfall, limited capacities of the health workers,
heavy burden of managing multiple health priorities, and poor utilization
of public health facilities may affect the outcomes of this ambitious
initiative Technology can serve as an enabler in solving some of these
problems. Dell Technologies and Tata Trusts have partnered with the
Ministry of Health and Family Welfare, Government of India, to develop
a technology solution for the PBS NCD initiative. It consists of a suite
of mobile and web apps on a cloud platform for health workers, doctors,
and health administrators to enable care delivery for people across
the country. The solution has been deployed in states across the country
with adoption gaining momentum amongst health care providers. While
early process indicators are encouraging, it is important to examine individual clinical outcomes, population outcomes and cost effectiveness
which are the primary objectives of such a program. The learnings from
this digital health program can then be transposed to similar healthcare
settings. The paper covers four challenges commonly encountered technology by health workers with low digital literacy, feasibility of running tech solutions in remote areas, value proposition of the solution for

users and finally the know-how on building and rolling-out technology at
scale to reach millions of people.