The Indian RAS market is at an evolutional stage now. All that the sector needs for further growth is the ecosystem to open up a bit more.The future of healthcare is shaping up in front of our very eyes with advances in digital healthcare technologies, such as robotics. The healthcare workers have to embrace emerging healthcare technologies in order to stay relevant in the coming years. In medicine and healthcare, digital technology could help transform unsustainable healthcare systems into sustainable ones, providing cheaper, faster and more effective solutions for diseases. In an exclusive conversation with Financial Express Online Mandeep Kumar Singh, VP&GM, Intuitive India talked about the state of medical technology in India, robotics-assisted surgery and more. Excerpts:
What is the current scenario of medical technology in India?
Over the last 5 years, there has been a significant interest in developing solutions related to ‘preventive care’, ‘curative care’, and ‘well-being’ in the country. This includes innovations associated with diagnostic tools, ventilators, medical and surgical devices that support better patient outcomes and improved operational efficiency for healthcare administration in hospitals.
More specialised surgical technology including high-end innovation and research facilities have also evolved over the last two decades. For instance, surgical robots that support surgeons in specific procedures are now gaining increased traction in Tier 1 tertiary care hospitals. While developed countries are leading the innovation in this space, the products and solutions are also finding acceptance in India over the past decade, given the quality of surgeon training and their willingness to adopt new technologies. Currently, the penetration of these technologies is largely limited to urban cities that have a network of robust healthcare providers.
As healthcare providers invest more in technology to improve operational efficiencies and more surgeons are looking at broadening their skills in using the latest technology, procedures such as Robotic-assisted surgeries (RAS) are finding more traction, especially in oncology surgeries in the field of gynaecology, urology, and general surgery. According to a Research and Markets report, the Indian robotic-assisted surgical market is predicted to reach Rs.26 billion in 2024, expanding at a CAGR of 19.8%.
Does India have enough resources and talent equipped to make use of these technologies? How is Intuitive helping the surgeon community in terms of training and upskilling to enable them to use the latest in surgical technology?
If I talk about robotic-assisted surgeries (RAS), India currently has around 500 trained surgeons who are adept in RAS surgeries in their respective therapy areas. No doubt there is a lot of room for increased adoption. Along with the programs and solutions we provide to our customers, we also aim to provide the best-in-class training and support to surgeons in India throughout their careers – from initial exposure to the technology to progressing to advanced training, ensuring that they have the skill and experience necessary to perform procedures using the da Vinci Surgical System. However, we train only on the usage of the da Vinci surgical system, not medical knowledge to perform the procedure.
Mandeep Kumar Singh, VP&GM, Intuitive IndiaWe currently have three training centres in India: Kochi – Mangalore, and Bangalore. We have also started an industry-academia partnership called I-ROPE (Intuitive Robotic Onboarding Program), where we collaborate with top government medical institutions to expose resident surgeons to Robotic-Assisted Surgery. Through this initiative, we aim to familiarize these resident surgeons with robotic-assisted surgery, its technology, clinical applications, and its benefits.As a pilot, AIIMS Delhi ran this program in their Oncology divisions. Based on the surgical students’ feedback, we extended this program to other specialities and institutions across India. Currently, around 250 resident surgeons are going through this program across institutions such as RMLH Delhi, Armed Force Medical College- Pune, and AIIMS Bhubaneswar. We are planning to further expand this program to more institutions across India in the coming months.
Given the pandemic situation, what is the role of the technology led innovation in strengthening Indian healthcare system?
At a national scale, there has been an unprecedented push towards digitisation during the pandemic. While the process had started earlier, the pandemic has helped accelerate tech-led innovation in the healthcare industry to meet the demands that came with the pandemic. The pandemic has witnessed the birth of several frugal state-of-the-art innovations associated with touch-less diagnostic tools, ventilators, medical and surgical devices that support better patient outcomes.
In the case of surgical technology, we receive regular feedback from surgeons in private and government establishments that RAS supports ensuring better patient care, minimal duration of hospitalisation, and faster recovery from the surgery. According to the Association of Surgeons of India (ASI) many hospitals with robotics programs have resumed operations and successfully carried out a number of surgeries.
The other areas that have improved significantly is the identification of gaps in the healthcare system and filling up the voids to prevent further deterioration. Some of these areas involved public-private partnerships for providing technical and manpower solutions towards faster triage, 24/7 call centres for supporting state and central governments to manage patients and resources towards accepted patient care, logistical solutions including cold chain strengthening across the country, applications developed to support vaccination drives, etc. Overall, the changes this will bring about to the future of healthcare in the country will be unprecedented.
Does the Industry have the support required from the Government in enabling the advancement?
The Medtech industry has been receiving support from the government. However, there are more areas where further support is needed, like a decrease in import duties for specialised medical technology products, which could result in increased patient access to the latest in surgical technology.
The other area could be the inclusion of the latest surgical procedures like RAS into all insurance solutions that are provided to the masses. This will help ensure that in the coming months and years, modern healthcare and treatment methods can reach their full potential in India, resulting in a more innovative healthcare system and the country’s population in better health.
How is the Robotic-Assisted Market evolving in India, and what is the support the sector needs for further growth?
The Indian RAS market is at an evolutional stage now. All that the sector needs for further growth is the ecosystem to open up a bit more. From including RAS in medical insurances, to more surgeons up-skilling themselves with the latest that global medical technology can offer, we still have a lot of ground to cover before RAS can become widely adopted.
Currently, we have a higher penetration in metro cities where Tier 1 healthcare providers have a presence. In the recent past we have installed our systems in institutions such as AIIMS Jodhpur, AIIMS Rishikesh, and private centers in Tier 2 cities and while it shows the growing appetite in Tier 2 markets and beyond, there is a need for better healthcare infrastructure in these markets. Most importantly, surgeons in these markets should be willing to adapt and get trained in using the latest technology.
Intuitive has been in space for more than two decades. What has been Intuitive’s contribution in terms of surgical technology in India?
We are happy that we could immensely contribute to the transformation of surgical technology in India over the last two decades. Though we established a direct presence in India in 2018 only, we spent a number of years before that in India through a distributor by providing Indian hospitals, surgeons, and patients with access to robotic-assisted surgery.
Currently, India has over 500 robotic-assisted trained surgeons and more than 75 da Vinci robotic-assisted surgical systems across major private and government hospitals. Our products are constantly evolving with the feedback of top surgeons, the early adopters of RAS , who have been using our systems since two decades. I would say that our major contribution to the Indian MedTech market is the fact that we could introduce Minimal Invasive Surgery (MIS) with the use of robotic assisted surgery, that supports improved patient outcomes.
What are the innovations Intuitive is bringing in the Robotic Assisted Surgery space? Do these innovations help in bringing down the expense of robotic-assisted surgeries for patients?
At Intuitive, we want to expand the potential of physicians to heal without constraints with the support of intelligent technology. We are driven by the Quadruple aim for our customers- better clinical outcomes, better patient experience, better care team experience, and lower total cost to treat.We have a host of new technology offerings lined up this year, and we are hopeful that the post-pandemic era of healthcare will be a technology-led one.
Recently, we introduced our ‘Extended Use Program’ (EUP) in India in an effort to offer additional value to our customers through product innovation within their robotics program. With this EUP initiative, we have extended the usability of many of our instruments through innovation and design improvements within its 4th generation technology, without compromising on its performance.
This apart, we are also soon launching India’s first robotic stapling technology, which can provide autonomy to the surgeon during surgery through intelligent feedback and utilizes a greater range of motion than the human hand. All these innovations, while aimed at empowering surgeons, also can impact patient outcomes and economic value.
Additionally, as a customer service innovation, we have launched da Vinci OnSite, a service feature that allows the da Vinci Surgery Technical Assistance Team (dVSTAT®) to remotely access the system status for real-time diagnostic feedback and troubleshooting.
Do you think the technology led innovations will be the mainstay of future healthcare in India? Why
Yes, technology-led innovations will be the mainstay of future healthcare in India. This is primarily because we are a vast country with growing healthcare needs and limited healthcare facilities which will take time to scale. However, with the help of medical technology, it is not only for people to access healthcare remotely but also because it can improve clinical outcomes making it easy for the existing healthcare infrastructure to service more people in less time while providing them with the best possible care.
As medical technologies keep advancing, the primary driving force behind newer inventions will be focused at minimising hospital stay and associated costs while ensuring the least amount of post-care complications so that people can get better sooner.
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