What are your thoughts on the medical device market in India today, and how is Infosys leveraging the same? 

India is a rapidly growing market for medical devices with approximately 30% growth rate. About 70% of this need is met through import from US, China, and Germany. Currently, medical devices are not regulated in India except for a few critical devices as defined by Central Drugs Standard Control Organization (CDSCO). Most local companies are manufacturing medical devices with only the CE mark and thus face competition from FDA approved imported devices which are considered to be of better quality due to stricter quality controls and approvals process.

Infosys is working with some of the leading multinational companies in helping them develop affordable medical devices for emerging economies through Value Engineering. Infosys is collaborating with several hospitals like PGIMER Chandigarh to create solutions for better patient outcomes. Infosys built an anesthesia management solution for use in operation theatres which collects patient data from connected vital sign monitor, infusion pumps and anesthesia machine and keeps an electronic record of the same. The data collected is used to study issues and patterns and has been used for publishing research papers. In addition, remote monitoring of patients from multiple OTs on single screen helps in using anesthesia staff more efficiently. As devices become more regulated, the systems to receive submissions, review them, and approve them need to mature. There is a need for developing structures that enable this smoothly, while also providing quality metrics and assuring safety.

Can you discuss how AI plays a key role in enabling the medical devices market? How are such emerging technologies catalyzing the wearable tech ecosystem? 

AI and IoT are starting to play a key role in early detection of diseases, more accurate diagnosis of patient conditions, improved patient care continuum by remotely monitoring patients between visits providing precise on-time interventions through condition monitoring for improved outcomes. It is also helping in optimizing the cost of manufacturing and maintenance of medical devices.

Emerging technologies have significantly expanded the scope and impact of wearables there by driving up the adoption. Wearables are being increasingly leveraged in enabling home care and remote monitoring of patients due to high quality connectivity solutions and smart sensors and AI-driven predictive capabilities. Some of the wellness devices such as Apple Watches have medical grade ECG and SPO2 measurements that are FDA approved leading to improved patient awareness of the conditions, enhanced ability to predict critical events ahead of time and enabling timely care for the patients (E.g. Continuous glucose monitoring devices can alert well in advance if sugar levels cross a predefined upper or lower limits). We have seen significant increase in telehealth in the last 18 months due to COVID and we will see a lot more of these technologies in action in the near future.

AI applied outside therapeutics themselves can aid companies in developing the correct drug or drug delivery system for a given disease state. Better data analytics, leveraging AI/ML can increase the speed at which molecules are developed, leading to faster and more targeted therapies. The same can be done by mining the data already being generated by medical systems for higher quality care without increasing the cost of that care.

What are your thoughts on the adoption and usage of robotics to augment the existing medical infrastructure?  

Surgical robots initially slowed the workflow in the OR. As surgeons and their teams have gained more expertise, faster operative times with reduced variability can be expected. As operating rooms are fixed costs units in hospitals improved throughput improves the bottom line. Surgical robots improve the most precious of OR infrastructure – the surgeon. Whether increasing length of career, allowing more precise procedures in a minimally invasive environment or enhancing decision making, the surgeon’s powers are improved.

The data acquisition capability of digitizing surgical procedures is only just emerging. Performance and quality measures, teaching opportunities, documentation, and cost information is now readily available. Applying AI/ML across a healthcare system’s surgical robots will likely improve system OR quality metrics.

Leveraging autonomous systems that can read/screen CT scans, which are validated by a radiologist can significantly increase the throughput, speed up diagnosis and reduce costs. Leveraging robots for screening in ER waiting areas can triage more effectively and begin work-up queuing.

Could you elaborate on the role of technologies like IoT, 5G, and AI in enabling remote care? 

The Internet of Medical Things (IoMT) enables collection of clinical data and vitals such as heart rate, SPO2, blood glucose levels in near real time and improved diagnosis, helps in tracking patient between visits and post-op scenarios avoiding loss of critical information leading to accurate and timely interventions. AI in conjunction with the data from the devices improves the ability to predict critical events well before they happen and also enables early detection of diseases including neurocognitive diseases. The availability of 5G has created tremendous opportunities for telehealth using video and also enables remote medical procedures with high volume data exchange in real time. Robots, AIs, and more connected devices will severely strain the existing bandwidth infrastructure. 5G will be part of that solution to enable better and faster data transfers. Connecting medical systems will require investments in Edge AI to push the computing power to the point-of-care level for better patient, physician experience. Ensuring that these technologies work in sync will be critical to high-quality and reliable care.

What are the challenges in the adoption of connected medical devices in the healthcare industry today and how can they be addressed? Specifically, what challenges can you see when it comes to data analytics and AI adoption?

While we have seen reasonable adoption of connected medical devices, some of the key challenges for adoption are 

• Patient Information security
• Cybersecurity risks
• The regulatory framework which is yet to evolve for AI enabled devices and concerns of patient safety from failure of technology or lack of efficacy. 
• In developing markets like India, infrastructure may pose additional challenges to reach under-developed areas.

For the regulatory framework, the medical devices companies, technology providers, academia and the regulatory bodies need to work closely to define the standards for technology adoption and the framework for clinical trials and approvals of these devices and digital solutions. 

On the Patient Information Security, while there are robust regulatory frameworks for patient data privacy, the technology providers have to work together to define strong controls for the ethical use of data and compliance to comply with country-specific privacy regulations.

How has COVID19 has changed the dynamics of medical devices today? Do you see any new opportunities for medical tech guided by AI and with connected medical devices enabling increase in connectivity? 

COVID has shown the vulnerability of healthcare infrastructure in developing and developed markets. Because of the strain on the healthcare infrastructure and regulatory authorities, there has been a slowdown in clinical trials, approvals, reduction in demand for devices for non-critical procedures and impact on supply chain. On the positive side, it has accelerated the adoption of digital technologies and the awareness of technologies across the spectrum of businesses. COVID has accelerated the usage of telehealth, increased use of basic diagnostic devices at home (like pulse oximeter, Digital Thermometers, BP meter, Glucometers, etc.) and also established the value of remote monitoring of patients through connected devices. As a result, we will see increase in investments and adoption in the connected medical devices remote monitoring, telehealth, and AI.