India’s health care story is often told through the expansion of hospitals, medical colleges, imaging centres, laboratories and diagnostic packages. More tests are available today than ever before. Blood investigations can be booked from home, scans can be scheduled through an app, and advanced molecular and imaging technologies are reaching an increasing number of patients. But healthcare cannot be transformed simply by increasing the number of tests. India now needs something more fundamental: A diagnostic quality revolution.
Diagnostics has become central to modern health care. Industry data indicates that diagnostics contribute to more than 70% of clinical decision making, while accounting for only around 6% of total health care spending. India’s diagnostics market was estimated at about $12 billion in FY2024, with substantial room for further expansion.
In recent reporting related to health care diagnostic, it has been highlighted that India has around three lakh diagnostic laboratories and only 2,165 were reported to be accredited with NABL in March 2026. This highlights the gap between the unorganised and accredited diagnostic ecosystem.
The diagnostic test has to go through various steps before getting the final result and one of the important steps is that sample collection must be correct. The patient must receive appropriate preparation instructions. The sample must be correctly identified, stored and transported. Equipment needs calibration and maintenance. Reagents need appropriate storage. Internal quality controls must be monitored. Skilled professionals must interpret results correctly. High end sophisticated machines can not compensate for the wrong labelling or contaminated sample provided by the technician.
More tests can produce more borderline findings, incidental abnormalities and false positive results. Without proper clinical interpretation, patients may undergo repeated investigations or unnecessary treatment. The goal should, therefore, be appropriate testing, not maximum testing.
{{/usCountry}}More tests can produce more borderline findings, incidental abnormalities and false positive results. Without proper clinical interpretation, patients may undergo repeated investigations or unnecessary treatment. The goal should, therefore, be appropriate testing, not maximum testing.
{{/usCountry}}The future of Indian diagnostics should be built around the principle that the right patient receives the right test at the right time, followed by accurate interpretation and appropriate clinical action.
A diagnostic revolution that benefits only metropolitan hospitals will leave a large part of India behind. Rural and remote communities continue to face challenges involving laboratory infrastructure, trained personnel, sample transportation and access to specialised investigations.
Recent research examining tuberculosis diagnostic infrastructure found significant gaps. A 2026 study estimated that India had 97 culture and drug susceptibility testing laboratories against a benchmark requirement of 283, representing a shortfall of 186 laboratories. The same study identified shortages in TB units and inadequate access to molecular diagnostics in several regions.
Accreditation is important, but quality must extend beyond a certificate displayed on a laboratory wall. India needs stronger systems for internal quality control, external quality assessment, proficiency testing, staff training, equipment calibration, reagent management, sample transportation and reporting standards.
The National Quality Assurance Standards initiative is already moving in this direction. As of February 2025, 24,364 public health facilities had received NQAS certification, and specific NQAS standards for Integrated Public Health Laboratories were introduced to improve the accuracy and precision of testing processes and results.
A September 2026 analysis that covers nearly 795,000 digitised examinations from 33,244 diagnostic laboratories have reported an average of 24.8% disagreement on how results were classified normal and abnormal across laboratories. This is alarming and needs to be addressed and demonstrate why parameters like reference range, practice, analytical methods and all clinical interpretation of the results need standardisation. A diagnostic ecosystem cannot become truly data driven if the same result can be interpreted differently simply because it comes from a different laboratory.
India has demonstrated that it can expand health care infrastructure rapidly. But the challenge is to make the infrastructure dependable by focusing on priorities like skilled manpower, access to diagnostic tests, quality testing, standardisation and transparent reporting among the tests. Quality should be a priority and patients should not have to choose among quality and affordability. Reports should be always accurate, trustworthy and transparent on which doctors should be able to make decisions.
(The views expressed are personal)
This article is authored by Dr Sunita Kapoor, CEO & chief of pathology, City Imaging & Clinical Labs.