AI harnessed to help overcome doctor shortage in India
Artificial intelligence (AI) could be used to tackle India's doctor shortage. The nation's 1.3 billion population of largely working-age individuals has driven rapid economic growth but could also prove a healthcare time-bomb. The doctor-to-patient ratio is just 0.2 for every 1,000 individuals, compared with 1.1 in the US, and modern clinics tend to be concentrated in cities. AI can help address this by increasing access to existing resources. For example, Aindra Systems uses AI to increase the productivity of early-stage cervical cancer screening, while Tricog Health's mobile app helps increase access to cardiac care in remote locations.

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In a world with limited doctors, emerging diseases and superbugs, and sharply rising costs, how can we successfully tackle health care problems at scale? This is just one of the critical challenges India’s explosive startup community hopes to solve by implementing AI to serve the needs of the country’s 1,324 billion citizens. The result of this effort will have huge implications for the U.S. and other health care ecosystems around the globe.

To understand how dire the situation is, it’s worth considering India’s health paradox. The country’s deep demographic dividend — which occurs when the majority of a country’s population consists of working-age individuals — is driving rapid and unprecedented growth, but it is also a ticking time bomb. With an average age of 27, India has one of the youngest and most educated populations in the world. Since 1991, this phenomenon has fueled approximately 7 percent annual growth, produced new goods and services, and reduced dependents in the economy.

But in order to continue reaping the benefits of this dividend, India’s young population needs to have access to quality nutrition and health care. In addition, when the dividend declines (as we are witnessing in China), the country will need to have new infrastructure in place to care for its aging population. Unfortunately, the necessary infrastructure doesn’t exist today.

The doctor-to-patient ratio in India is one of the worst in the world, with just 0.2 doctors for every 1,000 Indians (by comparison, there are 1.1 doctors for every 1,000 Americans in the U.S.). Modern medical facilities — and as a result, doctors — are heavily concentrated in urban areas.

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India’s health care issues are primarily a problem of resource scarcity. The country needs more medical facilities and more medical expertise, and both of these require time and billions of dollars to develop. Such resources are not easily obtainable, so we must consider other ways to dramatically increase access to existing resources in an effective and inexpensive way.

This is where AI has the potential to reshape India’s health care industry. Manu Rekhi, managing director of Inventus, says: “Indian AI platform companies are building upon two decades of India’s IT industry expertise. They are supercharging how software and human intelligence can partner to create new human-in-the-loop AI systems for global markets, as well as the bottom of the pyramid.”

Indeed, a number of Indian startups have implemented deep AI expertise to move the needle on specific health conditions and diseases. Some of these companies offer technology and distribution opportunities that attract Fortune 500 partners for both the India market and globally.

One such company is Tricog Health, a startup handpicked by GE’s health care accelerator program for its cloud-based cardiac diagnosis platform. Coronary heart disease is increasingly prevalent in India, having escalated from causing 26 percent of adult deaths in 2003 to 32 percent in 2013. Tricog increases access to cardiac care across 340 cities in 23 states, including in some of the most remote locations in India. The company’s platform collects physiological data and ECGs from medical devices in the field and then uses specialized AI to process the data in real time and give the cardiologist a diagnosis.The cardiologist then reviews the diagnosis and recommends next steps to the GP or nurse in the field instantaneously using the Tricog mobile app. By using Tricog’s AI engine, a few specialists can diagnose over 20,000 patients.

Another startup, Bengaluru-based Aindra Systems, is using AI to tackle cervical cancer, which is the second most common cancer among Indian women between the ages of 15 and 60. In fact, India represents a whopping one-third of the total global incidences of cervical cancer. Aindra’s solution can detect cervical cancer in its early stages and measurably increase the odds of survival. The company increases the productivity of the pathologists screening cervical cancer samples, who otherwise typically need to manually examine each sample and flag cases with a high cancer probability to an oncologist for further review.

Adarsh Natarajan, founder and CEO of Aindra Systems, says: “Our vision is to implement mass cervical cancer screening using AI, and help the 330 million Indian women in the at-risk age bracket. With early detection, up to 90 percent of deaths can be avoided with appropriate treatment. Aindra’s computational pathology platform includes an affordable and portable point-of-care cervical cancer screening device to automate deep learning analysis and bring down the screening time significantly to help detect cancer at an early stage.”

The AI boom in health care is just starting, and the up-and-coming list of players is endless. Niramai is working on early detection of breast cancer. Ten3T is providing remote health monitoring services via AI to detect anomalies and alert the patient’s doctor. HealthifyMe, a Bangalore startup, is working on lifestyle diseases like obesity, hypertension, and diabetes. With its AI-enabled nutrition coach, Ria, HealthifyMe brings the best of elite nutrition expertise with AI in the loop.

And, of course, global corporate leaders like Google are bringing their AI capabilities to India, as well. Google recently partnered with Aravind Eye Hospitals to use image recognition algorithms to detect early signs of diabetic retinopathy, an eye disease that can cause blindness in diabetics if not treated early. Aravind Eye Hospitals is the largest eye care group in the world, having treated 32 million patients and performed 4 million surgeries. The hospital has provided 128,000 retinal images to Google that have been invaluable for the application of AI to detect diabetic retinopathy in 415 million at-risk diabetic patients worldwide.

With a bevy of AI-fueled solutions in the works, India is poised to leapfrog over some of the key barriers to conventional health care. Of course, this has profound implications for health care delivery in other countries, including the U.S. With rising health care costs and unfavorable government policies, an increasing number of people in the U.S. are being priced out of access. The burden on emergency rooms across the country is increasing as more people are unable to afford preventative care at primary care centers. AI-assisted technologies could reduce health care costs in the U.S. using the same mechanisms being implemented in India to affordably scale access to millions of people.

These startup-driven innovations and global platforms are just the tip of the iceberg. AI can ultimately become a force multiplier in bringing preventative health care to everyone, rather than just those in urban or affluent communities. As you’ll often hear AI experts say, “More data beats better algorithms.” In other words, simpler algorithms only need a larger training dataset to generate accurate, valuable predictions for both payers and providers. With 1.3 billion citizens, India has the potential to provide the vast amounts of data needed to improve the accuracy and precision of these algorithms and empower both startups and large companies to help solve health care problems around the world.

Pranav Deshpande is a product marketer at Twilio in San Francisco and a volunteer with Startup Bridge at Stanford, an annual conference that connects leading technology innovators in the US and India to build new relationships for tomorrow’s moonshots.