Using Technology To Facilitate Access To Healthcare | PwC India

We helped a client develop a smartphone-based solution that enables cataract screening for the elderly at near zero cost. The ability to conduct doorstep screening makes it possible to cover vast, remote areas and detect cataracts early. The potential outcome is reduced blindness rates and a much improved quality of life for many.

Together, we build a robust future.

Cataracts are the world’s leading cause of treatable blindness and severe visual impairment, especially affecting people aged 50 or over. They are a particularly serious problem in India, and studies have shown that about 4.8 million people become blind due to cataracts each year. Unfortunately, India has an insufficient number of cataract screening centers, and many elderly people in India find it difficult to travel to be tested. As a result, many cataract cases are not detected in time.

To address this problem, a team in PwC India, worked with a client and developed an AI solution which was integrated with the client's smartphone application.

The solution can detect the presence of a cataract by analyzing the picture of an eye captured using phone camera. The app then alerts the user if a cataract has been found. It is convenient for any volunteer with a smartphone to use this application for door-to-door screening of the elderly. People who are found to have advanced cataracts can then be referred to local health officials for further treatment. The development and implementation of our smartphone-based cataract detection solution involved interdisciplinary collaboration between medical professionals, engineers and researchers. Further, the solution underwent rigorous testing and validation to ensure its safety, reliability and effectiveness.

Benefits of the solution

Accessibility and affordability: This is a near-zero-cost solution that is not intended to generate revenue, and hence aligns with PwC’s purpose of building trust in society and solving important problems.
Convenience of doorstep screening: Elderly individuals often face challenges in accessing healthcare services, particularly in remote areas or if they have limited mobility. Moreover, someone must accompany them and thus bear an economic cost in terms of, for instance, the loss of a day’s wages. Door-to-door screening eliminates the need for elderly individuals to travel to a healthcare facility and related dependencies.
Enhanced coverage of remote areas: Health volunteers who are already embedded within local communities can visit individuals in remote areas, capturing eye images or videos with the app and inputting basic patient information.

Our impact

The solution can detect cataracts with >95% sensitivity and specificity, which is equivalent to the accuracy of a trained ophthalmologist.
Ophthalmologists use specialist and expensive equipment to screen for cataracts. The app enables anyone with a smartphone and basic education to screen the elderly for cataracts at near zero cost.
In India, the ophthalmologist to population ratio is 1:1,00,000, while that of health volunteers (such as ASHA) to the population is 1:1,000. With health volunteers using this app, cataract screening capacity can be boosted by 100x.
The average Indian travels 4.9 km to reach the nearest healthcare facility. By enabling door-to-door screening, the app allows senior citizens to save both time and money.

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AI based Cataract Screening for the elderly.

Industry

Citizen Services - Health

Our role

Develop an AI solution which can empower health volunteers to screen for early detection of cataracts and help control preventable blindness in the elderly.

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Artificial Intelligence (AI)

Situation

Cataracts are the world’s leading cause of treatable blindness and severe visual impairment, and especially affect people aged 50 or over. They are a particular problem in India where several studies - including from The British Journal of Ophthalmology - state that about 4.8 million people become blind from cataracts each year. Unfortunately, India has an insufficient number of cataract screening centers, and many elderly people in India find it difficult to travel to be tested, so many cataract cases are not detected in time.

The Solution

To address this problem, a team in PwC India has helped a client to develop an AI-powered solution, deployable on mobile applications, that can detect the presence of a cataract by analyzing the picture of the eye captured on smartphone. The app will then alert the user if a cataract has been found. Any volunteer with a smartphone can use this application to go door-to-door screening the elderly, in their homes. Anyone who is found to have advanced cataracts can then be referred to health officials who can arrange further treatment.

The following are the factors that define the impact of this solution.

Accessibility and Affordability
Door-Step Screening Convenience
Enhanced Coverage of Remote Areas
Rigorous testing and validation

Accessibility and Affordability

This is a near zero cost solution and not intended to generate revenue. It aligns with the PwC purpose to build trust in society and solve important problems. The only cost incurred would be of running the application on cloud. So, this solution comes at a very low cost and can scale up rapidly.

Door-Step Screening Convenience

Elderly individuals often face challenges in accessing healthcare services, particularly in remote areas or if they have limited mobility. Moreover, someone must accompany them and must bear the economic cost, which may include loss of wages for at least one more person for a day. Door-to-door screening eliminates the need for elderly individuals to travel to a healthcare facility which eliminates dependencies and barriers in accessibility.

Enhanced Coverage of Remote Areas

Health volunteers, who are already embedded within local communities can visit individuals in remote areas, capturing eye images or videos with the app, and inputting basic patient information. By leveraging the capabilities of Health volunteers and providing them with an AI-based cataract screening app, it becomes possible to extend eye care services to remote areas.

Rigorous testing and validation

It is important to note that the development and implementation of smartphone-based cataract detection solutions involves interdisciplinary collaboration between medical professionals, engineers, and researchers. The solution has undergone rigorous testing and validation to ensure their safety, reliability, and effectiveness.

Results

The solution can detect cataract with >95% sensitivity and specificity which is equivalent to trained Ophthalmologist.
Ophthalmologists use specialist equipment to screen for cataract and it costs approximately INR 50,000 for the equipment. Now with the app, anyone with a smart phone and basic education can click the picture of the eye of elderly and screen for cataract at near zero cost.
In India, ophthalmologist to population ratio is 1:1,00,000 and health volunteers (such as ASHA) to population is 1:1000. With health volunteers using this app for cataract screening, we can increase the cataract screening capacity by 100X.
Average Indian travels 4.9 Kms to nearest healthcare facility. With the capability to go for door-to-door screening, the travel costs are zero and saves time for citizens.

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