ResMed, a global leader in digital health with many cloud-connected devices such as ventilators and bilevel respiratory devices, recently stated that there could not be a clearer case for the use of digital health tools than in the ongoing COVID-19 crisis. However, the company has always maintained that patient privacy is critically important while using these technologies. With reference to the recent IMA protest against the proposed National Digital Health Mission in India, Seema Arora ResMed India’s National Marketing Head said that there should be strict data protection laws in place and only that will ensure that patient data is secured and protected when implementing digital health policies at the national level. Edited excerpts:
ResMed is an established player in the respiratory care segment, and caregivers would naturally expect more innovative solutions from your company to fight the COVID-19 pandemic. Do you think you has been able to rise up to such expectations?
ResMed has always been futuristic and proactive in adopting new technologies and solutions. Yes, there is a paradigm shift that has been observed globally in the immediate past, but we see multiple challenges in the adoption of these technologies in India, mainly due to low awareness. Our cloud care connective solutions for devices have been a step forward in this direction by enabling remote monitoring of patients and online consultations. In the recent past, the production of these cloud-care connected devices has gone up drastically, resulting in a surge in demand across the globe. Apart from products, we have used technology extensively to leverage our expertise and information for handling these crises by giving online advice and by giving ventilator training to our health care professionals through these virtual tools.
Cloud-connected platforms are key enablers of digitisation in healthcare. But resource separation failure, privilege abuse and other privacy issues remain a big challenge. As a platform provider, how do you perceive and address these issues?
Our strict protection policy ensures that patient data is always secured and protected with us. So, as soon as a patient buys a device, he has to sign a written consent for submitting data to ResMed. During therapy also, if he wishes not to send any data, he can do that by simply putting the machine on airplane mode. Data at our server location is always stored in an encrypted format and for that reason, all those who are working on this data never get to know the real identity of the patient. So, I think we have a strict data policy that’s being accepted worldwide.
What are the different services that you provide apart from the cloud-connected respiratory devices?
We have connected devices both for respiratory care as well as sleep care. Sleep care is basically [treating] obstructive sleep apnea and respiratory care is mainly handling COPD patients. Apart from this, we do a lot of initiatives for driving awareness among doctors as well as patients. A recent initiative, #WakeUpToGoodSleep, is mainly to educate our doctors as well as our patients to understand the importance of the quality of sleep and the issues they are facing and manage those issues well. So, these are various initiatives that we are working on in India on the importance of sleep as well as respiratory medicine.
In India, a doctors’ body has strongly opposed the National Digital Health Commission proposal released last year. Do you think that is going to have any impact on the prospects of digital healthcare in the country?
One of the biggest concerns about digital healthcare in India is data security and patient privacy. I think, as far as health care is concerned, each and every piece of patient data has to be confidential and secure. New initiatives like NDHM give rise to a lot of logistical challenges and associated patient privacy issues if not implemented carefully. In this, the government will certainly collaborate with various hospitals—public as well as private, insurance companies, perhaps pharmacies and laboratories too. So, there is a greater chance of exposing the patient data at large to the risk of hacking or maybe commercial misuse even.
Currently, NDHM is a voluntary exercise, like Aadhar was at the beginning. But it could become mandatory for availing of government health benefits, etc. So, I think patient privacy and data protection is of paramount importance. Before we make it a pan-India affair, I think the technical and implementation-based deficiencies need to be sorted out and the government needs to gain the confidence of all stakeholders, including civil rights bodies. There are also many questions that one has to answer, like who will manage and maintain the repository of such huge health data, and on whether the source or the individuals have rights to eradicate or erase some of the old health records, etc. I think those need to be addressed. But with strict data protection policy, we are positive [about this] and we believe that we can act as a catalyst to generate records for the government with individual consent.
Though home care is picking up globally, India as a market hasn’t seen much momentum in this area. What is ResMed’s experience as a home care solutions maker? Why has the shift been slow in India?
Globally, we have seen that a digitally-enabled healthcare pathway takes the centre stage when it comes to handling a crisis situation like COVID-19, which also accelerates the adoption of digital health technologies that ResMed is offering. It ensures out-of-hospital care for patients, optimising services and better patient outcomes. But we have a long way to go in this regard in India, mainly due to low awareness and less interest from doctors considering the cost as well as apprehensions from patients. We try to create awareness among doctors and patients through our communication initiatives about the positive aspects of homecare, like fewer readmissions and a better quality of life, etc.
I also see only a handful of insurance companies providing reimbursement or support to home care or even for medical devices used by patients. I think more awareness needs to be created to improve patients’ acceptance, which can also increase affordability.
Karexpert is a recently launched digital health care platform with built-in electronic health records, promising to take hospitals paperless in the future. Does ResMed have services similar to this?
No, we don’t have such associations or the model available in India. We are basically focusing on the devices sector, involving respiratory devices and home care.
How has been the market response to the home sleep test introduced by ResMed?
There has been mixed review and acceptance of the home sleep test. But during the pandemic, people have started realising the importance of this, as it is accessible anywhere. ResMed’s home sleep test ApneaLink Air has been an effective tool for diagnosing obstructive sleep apnea in the comfort of your home. You need not have to visit any sleep lab or sleep clinic. With a potential sleep apnea population of four million, there are I think a handful of sleep labs here that will not be able to take the disease burden. So, the home sleep test has become critically important.
We are also soon launching India’s first disposable home sleep test in the market called One Sleep Test. It is simple, safe and can accurately diagnose obstructive sleep apnea from the comfort of your home. It is a one-time use device. After you open the device you need to download the app and the device has to sync with that app. When you use the device, the information from the app goes to a cloud-connected software that can be accessed by a sleep specialist. The specialist can then go through the report and send the information and the test report to the patient’s email directly.
What are the new areas that you are exploring in technology-led healthcare?
We are optimising a lot of our cloud-connected devices technology.
Many are yet to come in the market. I will not be able to comment much on it.
Sleep apnea is something that may still not be familiar to many people, especially in India. People don’t think much about how they’re sleeping or why they might be snoring? But nowadays it’s getting highlighted via awareness programmes. So, what all technologies do ResMed as an expert in this area provide, to help people realise and tackle this condition?
A lot of people who have potential symptoms of snoring and daytime sleepiness are not aware that this could be an indication of a medical condition called obstructive sleep apnea. The first and foremost thing is to make them understand. So, we have a lot of screening tools which are all digitally enabled and through which people can feed in their answers and make out whether they are suffering from such a medical condition.
Once they understand the condition and want to go for a sleep test, then we have devices like the one sleep test. We also have a ResMed ApneaLink test that is also cloud-connected so they can diagnose their sleep and understand that this condition is actually obstructive sleep apnea. After that, we give them a trial of the devices that are again cloud-connected to our air-view platform where we manage your speech therapy and tell them how their quality is of sleep every day.
Based on the interaction through our coaches, patients understand the importance of CPAP therapy in their life and then they can finally go and purchase the products. So, right from the screening to the diagnosis to the trial, we have sleep coaches who help them to understand this issue better and get them into therapy. From a respiratory care perspective, we have our bilevels that are available for home-care use and to some extent available for hospital use as well. Soon, we will be launching an updated platform for these connected devices in the bilevel segment.