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The Teleradiology Opportunity in India Teleradiology in India today represents an idea whose time has come.

By Dr. Arjun Kalyanpur

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The healthcare industry in India is growing at a tremendous pace with increasing expenditure by public as well private players. During 2008-20, the market is expected to record a CAGR of 16.5 per cent. The total industry size is expected to touch $160 billion by 2017 and $280 billion by 2020. In other words, a healthcare investment in India today ought to be a slam dunk opportunity.

There's a significant catch however – namely, that the weakest link in the healthcare services chain today is specialized physician manpower. In other words, setting up or investing in a hospital or diagnostic center can, on paper follow a smooth course until it comes to recruiting, for example, radiologist staff. Due to a shortage in numbers of specialty training programs across the country, the total number of radiologists in India is in the approximate range of 10,000, which is woefully inadequate for a country with a population of a billion people.

Here's an example of the impact of the problem …

A patient arrives at the hospital casualtyat 3 AM with severe stomach pain and the Emergency Physician suspects a potentially life threatening finding namely a ruptured appendix. The key to its accurate diagnosis is a CT scan. The scan is immediately performed by a trained technologist who is present in the hospital overnight. However the key person required for the analysis of the scan is the radiologist. And the reality is that at the time the scan is performed there isn't one at the hospital. This is today an unfortunate reality in many parts of the world, not least of all in India. Does the patient suffer, undiagnosed and untreated, until the following day when the necessarystaff become available?

Not any more - out of the problem there has arisen an IT enabled solution titled teleradiology, namely using telecommunications and information technology to bring the images to the radiologist, who may be at home, across town, or in an office on the other side of the world. A number of benefits ensue – immediate access to specialist expertise in the emergency setting, greater access to quality diagnosis by small rural hospitals, increased radiologist efficiency and productivity, improved quality of reporting by bringing the complex cases to the most specialized radiologist etc etc.

In the past, challenges abounded that constrained teleradiology's growth, mostly of connectivity, infrastructure and simple ignorance that such a concept existed. However, in the last few years, the utilization of teleradiology by hospitals and diagnostic centers in India has seen a dramatic rise with telecommunications connectivity improving across the country.

Private hospitals and diagnostic centers, especially in smaller towns face challenges of being able to recruit and retain radiologists, who tend to prefer to live in metros where the opportunities and reimbursements are superior. Hence for these, teleradiology is an attractive proposition, as one can outsource low volumes on a per click basis without having high fixed salary costs.

Recognizing the importance of teleradiology in improving healthcare, the Indian Government has through its National Health Services Reseach Centre, conducted research projects establishing the value of teleradiology, on the heels of which several states have rolled out teleradiology tenders. Both public and private opportunities therefore now abound in this space.

From a technology standpoint as well, there is an opportunity. Niche technology products and platforms that enhance radiologist productivity and efficiency and even accuracy are all capable of generating paradigm shifts in a critical environment. And the telecom space also stands to benefit from the resulting growth in utilization. There is also an opportunity for e-learning and tele-education for those with the relevant skillsets, given the relative shortage of radiologist educators.

In India with its tradition of leapfrogging technologies (consider smartphone usage) the ability to digitize and transmit radiologic images can be extremely powerful as it can enable the technician in the smallest PHC to access the expertise of the most experienced radiologist in the largest tertiary care institute in the country.

Large imaging technology vendors also see teleradiology as a growth opportunity for them as sales of imaging equipment are today constrained by the lack of radiologist availability. Teleradiology allows them to fill that void and gives them the opportunity to sell more ultrasound, CT, MRI and PET scanners.

All of this translates into a significant business opportunity for healthcare professionals, especially radiologists and allied medical personnel, as also IT developers, telecommunication providers and secondarily, for healthcare investors and PE firms looking for a good investment opportunity.

Dr. Arjun Kalyanpur

CEO and founder of Teleradiology Solutions

Dr. Arjun Kalyanpur, is the CEO and founder of Teleradiology Solutions, also known as the ‘Chief Pusher’ at Teleradiology Solutions.

Dr. Kalyanpur was trained at AIIMS, New Delhi, Cornell University Medical Center and Yale University in the US. He is a visiting faculty at Yale University. He is an active contributor to scientific literature, has edited a radiology textbook, serves as a reviewer for several radiology journals and is on the editorial board of the Indian Journal of Radiology. He was awarded the Modern Medicare’s Entrepreneur of the year award in 2007, was named one of the 50 pathfinders in Healthcare in India in 2009 by Express Healthcare magazine and one of the 25 healthcare influencers by Healthcare Executive in 2015. Frost & Sulllivan’s Healthcare Entrepreneur of the Year award in 2015. Dr. Kalyanpur has been featured in Who’s Who in the World and in Medicine. He has also been covered extensively in the media, namely ABC, NBC, CBS, the New York Times and the New England Journal of Medicine as the path breaking pioneer of teleradiology services in Asia.

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