For some Integrated Diagnostics solutions

Communicable diseases such as tuberculosis prevailing over the long term, coupled with fast-growing Non-Communicable Diseases (NCDs) such as cardiovascular disease, diabetes, hypertension, stroke, and cancer, can be roadblocks for our economic growth.

The good news is that many diseases can be prevented, managed, and cured with a healthy lifestyle, regular check-ups, early diagnosis, and treatment. Technological advancements in all medical specialties have made early detection and prevention of diseases possible.

A case in point is the Covid-19 pandemic which affected millions worldwide. Accurate, early diagnosis and proper treatment required PCR tests on oropharyngeal swabs. This was needed to detect the presence of a virus, gene sequencing to identify the strain, blood tests, X-ray & CT chest scan.

These tests detected acute inflammatory markers and the severity of the disease.

In this context, diagnostic disciplines, namely laboratory medicine, radiology, diagnostic cardiology, neurology, respiratory medicines etc., require special mention. Diagnostics is essential for doctors to make correct clinical decisions and improve patient care and outcomes. In fact, it is claimed that 70% of clinical decisions rely on lab results. This is more so in present times of evidence-based, precise, and personalised medicine. When these disciplines operate in silos, clinicians have to depend on separate sets of information to arrive at a correct diagnosis. This delays treatment and makes the procedure costlier. The solution is Integrated Diagnostics (ID) which brings laboratory and radiology on a single platform.

This provides a unified interface for clinicians to access patient data and offer meaningful interactions and solutions. Take the example of Comprehensive Cardiac Screening (CCS). It includes tests such as ECG, ECHO, TMT, estimating blood levels of cardiac enzymes, heart failure markers, and coronary artery CT scan with calcium scoring. These tests provide a complete picture of the heart structure, the functioning of valves and heart muscles and coronary circulation. This helps a cardiologist diagnose an ailment correctly and initiate appropriate treatment. Likewise, many other tests such as MRI, CT Scan, PET CT, Gamma Camera, PFT, Mammography, blood tests etc., can be conducted at an Integrated Diagnostics facility. 

ID also helps patients take all tests and interact with radiologists, pathologists, microbiologists, biochemists, and doctors under one roof. It also saves time, money, and effort for patients eliminating the need to visit many centres.

In an ID, all disciplines, systems, and stakeholders of upstream and downstream health systems interact with each other. Upstream interventions are those that prevent health issues while downstream measures focus on treating existing health problems. An effective healthcare system is one that balances upstream and downstream efforts. This is vital for delivering the best patient-centric outcomes as opposed to disease-specific results.

There are, however, some bottlenecks that need to be fixed.

Highly fragmented &
under-penetrated: There are more than 1,00,000 laboratories and over 35,000 radiology centres in India. Around 48% of the market is dominated by standalone centres. 37% are located in hospitals. Regional and national diagnostic chains together make up for the balance 15% market share. ID combining multiple diagnostic modalities and data sources to some extent are found in major hospitals. However, the bulk of the stand-alone, regional and national chains do not have ID facilities.

Quality of centres and data: Only a mere 1-2% of centres in India are accredited by NABL (ISO 15189 standard).

Data disconnect: There is a lack of advanced IT architecture, curated data, and access to and exchange of data. This hinders the potential of Integrated Diagnostics to contribute to clinical best practices and research.

Technical & cost issues: Data privacy, integration, interoperability standards, and education of staff entail huge costs. Besides this, technical, political, and ethical challenges also pose grave challenges.

Artificial Intelligence (AI) and Machine Learning (ML) have the potential to revolutionalise the way diseases are detected and treated. They are useful in assessing diagnostic data objectively and generating meaningful clinical reports. 

The future of healthcare will see all streams of medicine benefit from Integrated Diagnostics. This is especially true for oncology, cardiovascular sciences, reproductive medicine, gastroenterology, respiratory medicine, and infectious diseases.

(The author is an entrepreneur who specialises in integrated diagnostics, laboratory services and preventive healthcare.)