Health technology

1. Scope and strategic significance

Health technology is broader than digital health. It covers pharmaceuticals, vaccines, diagnostic kits, implants, imaging equipment, assistive devices, surgical techniques and organisational systems supporting care. Digital health is the subset involving information and communication technologies, including electronic health records, telemedicine, clinical decision support and mobile health applications. Biotechnology contributes recombinant vaccines, monoclonal antibodies, molecular diagnostics and advanced cell and gene therapies.

India faces a simultaneous burden of infectious diseases, maternal and child health challenges, non-communicable diseases and population ageing. Technology can support prevention, early detection, continuity of care and rehabilitation. Portable ultrasound, point-of-care testing and remote specialist consultations can extend services beyond tertiary hospitals. However, a diagnostic result has limited value without confirmatory testing, appropriate treatment, counselling and referral facilities.

Health technology is also a strategic capability. Epidemics, disrupted supply chains and geopolitical restrictions can constrain access to active pharmaceutical ingredients, diagnostic reagents, equipment components and vaccines. Domestic research, manufacturing capacity, quality assurance and diversified sourcing improve resilience. Nevertheless, self-reliance should mean dependable access and competitive capability, not isolation from international science or acceptance of inferior products.

2. Major applications and emerging technologies

Diagnostics increasingly combine molecular biology, miniaturisation and automation. Reverse transcription polymerase chain reaction detects RNA targets after conversion to DNA, while antigen tests detect pathogen proteins. Genomic sequencing supports pathogen surveillance, identification of inherited disorders and selected cancer-treatment decisions. Test interpretation requires attention to sensitivity, specificity and disease prevalence: even a technically accurate test may produce many false positives when used indiscriminately in low-risk populations.

Artificial intelligence can assist radiology interpretation, tuberculosis screening, retinal-image analysis, triage and outbreak forecasting. Wearable sensors and connected devices enable monitoring of parameters such as heart rhythm and glucose. These tools can support clinicians but may fail when training data poorly represent local populations or when clinical conditions differ from validation settings. Prospective evaluation, human oversight and monitoring for performance deterioration remain essential.

Therapeutic advances include precision oncology, minimally invasive surgery, three-dimensional printing of prostheses and chimeric antigen receptor T-cell therapy. CAR-T treatment engineers a patient’s T cells to recognise specific cancer targets and is used for selected blood cancers; it is not a universal cancer cure. Advanced technologies can improve outcomes, but high prices, specialised infrastructure and serious adverse effects make patient selection and health-economic evaluation important.

3. India’s digital health architecture and delivery platforms

The Ayushman Bharat Digital Mission seeks an interoperable digital health ecosystem. Its building blocks include the Ayushman Bharat Health Account, or ABHA, the Healthcare Professionals Registry and the Health Facility Registry. An ABHA number supports identification and linking of health records; it is not health insurance. ABDM is distinct from Ayushman Bharat Pradhan Mantri Jan Arogya Yojana, which finances eligible hospitalisation services.

ABDM’s federated approach allows records to remain with participating providers and be exchanged through consent-based mechanisms rather than requiring every record to reside in one central database. Interoperability requires common standards for both data formats and clinical meaning. Consent must be understandable and purpose-specific; merely obtaining a digital approval does not ensure that a patient understands who will access sensitive information.

eSanjeevani supports provider-to-provider and patient-to-provider teleconsultation. CoWIN supported COVID-19 vaccination registration, appointment management and certification, illustrating population-scale digital service delivery. Such platforms can reduce travel and administrative costs, but weak connectivity, language barriers, disability and limited digital literacy can exclude vulnerable groups. Assisted access, offline alternatives and referral pathways should therefore accompany digital expansion. Teleconsultation cannot substitute for physical examination or emergency care when these are clinically necessary.

4. Regulation, ethics and assessment

The Central Drugs Standard Control Organisation and state regulators oversee relevant products under the Drugs and Cosmetics Act, 1940 and associated rules. The Medical Devices Rules, 2017 establish a risk-based framework: Class A represents low risk and Class D high risk. Regulatory requirements vary with device class and applicable exemptions. The New Drugs and Clinical Trials Rules, 2019 govern relevant clinical research and approvals, alongside ethical review and informed-consent requirements.

The Digital Personal Data Protection Act, 2023 provides a framework for processing digital personal data; organisations must track applicable commencement notifications and rules. Health datasets warrant strong safeguards because disclosure can cause stigma, discrimination or financial harm. Cybersecurity requires encryption, access controls, audit trails, backups and incident response. De-identification reduces risk but may not prevent re-identification, particularly when genomic or linked datasets are involved.

Health Technology Assessment in India, coordinated through HTAIn in the Department of Health Research, examines clinical effectiveness, safety, cost-effectiveness and relevant social and ethical implications. A technology can be cost-effective yet unaffordable at population scale, so budget impact also matters. Evaluation should consider the comparator, quality-adjusted life years where appropriate, uncertainty and distributional effects. Regulatory approval establishes specified standards; it does not automatically justify universal public procurement or reimbursement.

5. Challenges and a public-interest roadmap

The central challenge is converting technological capability into measurable health gains. Equipment may remain unused because electricity, consumables, trained technicians or maintenance services are unavailable. Proprietary systems can create vendor lock-in, while repeated pilot projects may never become sustainable services. Procurement should therefore consider lifecycle costs, calibration, repairability, interoperability and local operating conditions rather than only the purchase price.

Equity and trust require deliberate design. Algorithms should be evaluated across sex, age, geography and relevant population groups. Genomic testing needs counselling, clear handling of incidental findings and protection against misuse. Clinicians require training to question automated recommendations rather than accepting them uncritically. Patients need accessible grievance mechanisms and non-digital routes to essential care.

India should combine publicly funded research with transparent partnerships, clinical validation and quality-focused manufacturing. The National Medical Devices Policy, 2023 and production-linked incentive initiatives seek to strengthen the domestic ecosystem, but success should be judged by quality, affordability and dependable access as well as output. Priorities include district-level diagnostic capacity, biomedical engineering support, post-market surveillance and stronger primary care. Technology should augment the health workforce and universal health coverage, not become a substitute for either.

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