September 2008

eHEALTH India 2008 Event Report

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And so it finally happened!
eINDIA 2008, India’s largest ICT event was held from 29th to 31st July 2008 at Pragati Maidan, New Delhi. As part of the seven tracks, ‘eHEALTH India 2008’ – presented by eHEALTH magazine provided a unique opportunity for healthcare industry players, policy makers, academicians, researchers, technology vendors and other stakeholders to come together on a common platform and share experiences, discuss pertinent issues and showcase innovations over three days of active conferencing and an exciting exhibition.

The eHEALTH track kicked off with an opening address by Dr. Rachel Jose, Additional Director General (Health Services), Directorate General of Health Services, Ministry of Health and Family Affairs. Dr. Jose highlighted the poor state of healthcare delivery in India. She went on to state how telemedicine is a possible solution to the healthcare crisis as by 2025, 65% of the Indians are likely to be literate. Emphasising the pioneering work done by the Indian Space Research Organisation on this front, she said that though e-health in the country is mostly restricted to medical transcription, there are more than 150 live telemedicine projects. The majority of these are funded by ISRO.

Speaking of the urgent need for automation, she said that ‘there is a need for automation of data because of the presence of health insurance’. Dr. Jose pointed out the main challenges to automation, including, shortage of reliable connections, the need for greater bandwidth, legal/ethical issues, complicated licensing procedure and data security issues.

Today we have several stand alone Electronic Medical Record (EMR) systems without interoperability. Dr. Bidhan Das, a member of the National Accreditation Board for Hospitals (NABH) introduced the pertinent issue of EMR. As of today, EMRs are an expensive option. Currently, no national standards exist and there is also minimal exchange of information between service providers. Dr. Das painted a picture of an ideal situation which healthcare service providers can aim for. This includes standardisation, integration, and seamless information exchange. He stressed the need for a well drawn out roadmap for health IT, which takes into account Integration, Automation and Accessibility. An important point raised at this time was the need for a standard tariff structure and increased insurance coverage. Automation can help to reduce the cost of administration as price falls. For this to happen, i.e. to push for wider use of automated systems, Dr. Das suggested that stringent action should be taken against defaulters.

People Speak

“It Was wonderful to be part of the mega event” – Dr. Sridhar Arunachalam, Manipal University.

“Please accept my congratulations for eHEALTH India 2008 conference. Unfortunately I could not attend the event because of my pre occupation with project related work. The conference was attended by my Principal Consultant from Infosys, who appreciated a lot about the sessions and speakers” – Dr Fahad Mustafa Khan,Business Analyst, Healthcare & Lifesciences Consulting, Infosys Technologies Ltd.

“Thanks for your great support” – Nikita Chavan, Business Development Manager, idhasoft

“The event was fantastic in terms of content and industry insight. Excellent platform to network with other healthcare players and exchange thoughts. Kudos to eHEALTH team for organiSing such a wonderfull conference. Wish you more and more success in future.” – A. Baskaran, Head-Strategic Business & Relations, Karishma Software

“It was a worthwhile event to attend. The coverage on eHEALTH is excellent and selection of topics and speakers was well thought out. I certainly enjoyed meeting and networking in this event and look forward to attending the one in Malaysia.” – Raghu Iyer, Founder & Chairman-Business Intelligence Technologies

“Great show. Truly phenomenal, the work that you guys have done. Well thought-out sessions, most informative. Overall, excellently managed. Cannot wait for 2009 and do keep up the good work!” – Dr. S. B. Bhattacharyya, VP (Clinical Services), Karishma Software lTD.Secretary, IAMI

“It was a good conference overall. However,the level of participation from the providers (doctors, hospitals) was not that high'” – Nagesh Srinivasan, Director, Marketing&Sales-Yos Technologies Private Limited.

There was a special address by Kerry Stratton of InterSystems and Dr. Hemant Kumar of the Microsoft Health Solutions Group. Kerry Stratton gave the audience a comparative overview of the national e-health policies of various countries (including India, China, UK, Sweden and Brasil). “Technology is not the issue today”, said Stratton. ” The problem is with fragmented systems.” Dr. Kumar provided an insight into the future of medicine. Dr. Kumar pointed out how Bumrungrad Hospital at Bangkok, Thailand increased its efficiency and output levels several fold by implementing a Microsoft system of automaton.

The theme of the first session was ‘Public Health Transformation � Challenges, Success stories & Solutions’. The session saw a lively discussion and presentations by Dr. Ashok Kumar, Director, Central Bureau of Health Intelligence, Dr. Vijay Rai, CMO (NFSG) & Nodal officer (IT), Department of Health and Family Welfare, NCT, Dr. C. Raghavendra of the Indian Institute of Management, Bangalore, Joseph Amuzu of the Commonwealth Secretariat, UK and Dr. Tarek Badr, Project Manager of the Family Card Project, Government of Egypt.

Dr. Rai gave the audience an insight into the history of automation in the public health system in Delhi. He also discussed future plans for further improvement.

Dr. Raghavendra, who conducted a study of government health surveillance in Chittoor district of Nalgonda, Andhra Pradesh, shared with the audience her experience and analysis, pointing out that ‘Many IT projects remain pilots forever” and cautioned against the manipulation of health data. The situation across the Commonwealth of Nations with respect to IT and health varies widely, as was pointed out by Amuzu. He stressed the need for universal standards – for example, with respect to electronic signatures.

Automation within the public health system is a challenge throughout the world. The conference saw foreign participation through the participation of Tarek Saad Badr, who spoke about the Family Card Project of the Government of Egypt which uses smart cards. The project has been a success, even though Egypt faces problems like multiple legacy systems and reluctance to use technology on the part of users. An important point that Dr. Badr brought out was the need for citizen relations management, especially in transitional societies which lack IT-trained healthcare professionals. During the discussion which ensued, some participants brought up the question of whether the common man is ready for automation and digitisation.

People Speak

“eHEALTH India 2008 was a great success. Wish you all the best for future events.” – S.K.Meher, Medical Informatics Specialist, Department of  Computer Facility, AIIMS, New Delhi.

“It was good to be a part of eHEALTH India 2008. I wanted to congratulate you on a event well organised” – Alam Singh, Asst Managing Director, Milliman.

“Thanks for the opportunity to participate in eHEALTH India 2008. Though I was there only for a short period, I could feel the enthusiasm among participants” – A. Vijayrajan, CIO & CTO, Manipal Hospital, Bangalore.

“I would like to congratulate you for the great success of ‘eHEALTH India 2008’. The enthusiasm shown by the team members was great. It was indeed a good platform for sharing the innovative ideas. and it also motivated us to come out of our shell. The topics chosen for technical sessions were very relevant to the present scenario” – Sakhi John, Head – Medical Informatics, Majeedia Hospital, Hamdard University.

“Congratulations for a great show” – Dr Hemant Kumar, Director – Health Solutions Group, Microsoft India.

“Good show indeed and wonderfully organised. Congrats for showcasing it so well.” – Tapas Kar, CEO, Value Based Consulting.

“Congrats for excellent arrangement. The conference was very educative and informative.” – HNN Murthy, Head – IT & Healthcare, RGCIRC, New Delhi.

“All things considered, we had a great time at the event” – Anantharaman S Iyer, Regional Director (India), InterSystems.

“I must congratulate all of you for the wonderful job done in eHEALTH India 2008” – Indrajit Bhattacharya, Professor, IIHMR, New Delhi.

People Speak

The event was great and went well. I enjoyed it so much. But was disappointed with the chairing of the sessions. Speakers were allowed too much time to present. This dragged most of the sessions beyond the stipulated time, making participants to lose interest. I suggest all speakers are limited to 10 or 15 minutes and possibly presentations are vetted in advance and slides limited to 15 or less.” – Joseph Amuzu, Advisor, Social Transformation Programmes Division – Health Section, Commonwealth Secretariat

“I would like to congratulate your team for a successful completion of eHEALTH 2008. It was well conducted and the sessions were interesting. My only grouse was that the sessions were not keeping time. In fact we should have used an auto cut off device for those speakers who were continuing beyond their allotted time.I do not find any session taking things to a greater height, in fact no session went behind the present day realities except Mr. Bhaskaran, from Phillips.

It was an enlightening experience with his talk about the future.” – Dr. Satish Amarnath, Medical Director, Manipal Cure and Care Pvt Ltd.

“First of all I thanks eHEALTH for inviting me in the event. This was indeed a great event. We got lot of inputs from this event and came to know about what is the latest in health delivery where we stand and what all improvements we can do in our systems. Also I came to know about different clinical cutting-edge technologies, which can be embedded in our system. This I think builds a very healthy forum where we can all address our problems and probably come up with a solution.” – A. P. Singh, Deputy Manager IT, Fortis Hospital

What is a good HIS supposed to deliver? How does a hospital choose a good vendor? What do you do when faced with resistance to automation? These were some of the practical issues addressed by  hospitals MDs who took time out of their busy schedule to participate in eHEALTH India 2008. These included Dr. Karanvir Singh of Sir Ganga Ram Hospital, Dr. Nagpal of Batra Hospital and Dr. Suryanath of Care Hospital. Dr. Karanvir gave an insightful, first-hand account of how to go about the automation process in a facility. He cautioned CIOs against rolling out a Hospital Information System in a hurry and stressed the need for proper assessment of vendors and the needs to be met. “The implementer knows best”, he said, “not committees.” Dr. Karanvir also advised hospital administrators on how to manage resistance to automation, through a very well received address.

The session on ‘Improving Clinical Outcomes, Leveraging Business Performance’ had presenters like Mr. Anantpadmanabhan, President of the Kovai Medical Centre Hospital, Mr. Ashok Chandavarkar of Intel, Avinash Pandey of Crane Global Solutions and Satya Adhri of Idhasoft. Mr. Adhari gave an overview of electronic health infrastructure using the internet. According to Mr. Chandavarkar, there is an urgent need to use Mobile Point of Care (MPOC) as doctors and nurses can then be more efficient by spending less time on administrative tasks. Currently, a nurse spends most of his/her time on administrative work rather than with the patient. Another viable idea was that of hospitals sharing a central pharmacy.

The importance of integration in healthcare systems and within hospitals, was the main topic of discussion at the session on ‘EMR Best Practices and Information Sharing for Integrated Healthcare’. The session was chaired by Dr. S.B. Gogia, President of the Indian Association for Medical Informatics and Pradeep Saha of Max Healthcare, Ananthraman Iyer from InterSystems, Satish Kini of  21st Century, Alam Singh from Milliman and S.B. Bhattacharya from Karishma Software engaged the audience in a lively discussion afterward. Satish Kini, like most other speakers, sympathised with the doctor community when he spoke of implementing systems. “It is wrong to force our doctors in India who are overstretched.” he said, whilst stressing the need to reduce the workload of medical practitioners.

People Speak

“Thanks a lot for inviting us to participate in the eHEALTH conference… congratulations to the entire eHEALTH team for an excellent organisation and really insightful sessions. The conference was able to get participation from the entire who-is-who of the Indian healthcare industry. Such sessions prepare the industry for the future technology paradigm and are excellent learning while rolling them out to the mass market. I am sure, going forward, we shall see increased participation from ‘not-the-who-is-who’s of the healthcare industry the CIOs/ owners of <200 bed hospitals – who would tremendously benefit from keeping abreast with the healthcare ICT developments.”

Do keep up the good work !! – Vishal Ranjan, Director, Asclepius Consulting & Technologies Pvt Ltd.

eHealth India 2008 Awards

Best Government Initiative of the Year – National Population Stabilisation Fund:

In an effort to provide information to the public, the National Population Stabilisation Fund of India also called Jansankhya Sthirata Kosh (JSK), prepared State Level Health Facility maps for 19 states excluding one northern state (Himachal Pradesh) and North Eastern States from the datacollection – Survey of the India. Shailaja Chandra received the award on behalf of JSK. Three innovative strategic programmes have been initiated under this fund  Prerna, Santushi and a call centre. The Jansankhya Sthirata Kosh has a mandate to catalyse a movement in favour of population stabilisation and turn it into a people’s programme.

Best NGO Initiative of the Year – Emergency Management and Research Institute (EMRI):

EMRI is a non-profit organisation founded and funded by B Ramalinga Raju, chairman, Satyam Computers and his family. The institute, by partnering the state governments, offer professional emergency service through a call centre or response centre. EMRI, Secunderabad, received the eHEALTH India 2008 Award for Best NGO Initiative of the Year. It offers free emergency response service for medical, police and fire emergencies. The Karnataka government has recently signed a Memorandum of Understanding (MoU) with the organisation to roll out ‘Arogya Kavacha’, a scheme which provides free emergency services in the public private partnership (PPP) mode in rural and urban areas.

Best ICT Enabled Hospital of the Year:  Artemis Health Institute, Gurgaon

The hospital is equipped with the latest technology in predictive, diagnostic and therapeutic imaging, along with the highest levels of in-patient monitoring, and a paperless and film-less Hospital Information System. Artemis is the first installation in India to offer: Film-less and paperless environment (seamless integration with the Hospital Information System) where complete hospital workflow is done online. The HIS project has eliminated the need for large medical record charts as everything has been posted online. The project provides concise and easy to read summaries to the patients. Incidentally the project was implemented in a very short time of six months.

One of the main highlights of the event was the ‘Hospital CIO Conclave’. This saw 59 hospital CIO’s elucidate the challenges they had to face in each of their facilities and how they overcame them. On the stage were Vijayrajan A. from Manipal Hospital, Manish Gupta of Fortis Healthcare, Pradeep Saha, Max Healthcare U.K. Ananthpadmanabhan from KMCH,

Dr. R.S. Tyagi of the All India Institute of Medical Sciences, Dr. Suryanath of Care Hospital, Col. S. Patole from the Army Hospital Research and Referral Centre, Y. Srihari of Narayana Medical College & Hospitals and Dr. Rajesh K. Gupta from the Artemis Health Institute. Despite the space crunch at the dais, the discussion was fruitful in bringing out the complexities involved in data recording, sensitivity of patient information, motivation of staff to use new systems/software and working within limited budgets. Capturing patient data at source and in one go, it was agreed, is necessary.

Day 2 concluded with Dr. Ajit Nagpal, Chairman of Batra Hospital, chairing a lively discussion on ‘Connected Healthcare � network infrastructure, information access & remote service delivery’. Vijaya Verma, founder of Yos Technologies, stressed the need for consumer centric healthcare and and patient access to medical information. “How do you get a central repository in a multi-organisation set-up is a major question facing healthcare in the country”, said Dr. Nagpal.

According to the young entrepreneur Vishal Ranjan of Asclepius Consulting, it is a matter of grave concern that there are ‘minimal ICT solutions for more prevalent diseases.’ Treatment through ehealth requires strong protocol-based treatment and the support of multiple stakeholders, including the government. Manish Gupta shared his ideas on m-health, which he said has great potential through the use of mobile phones, smart cards and developments in mobile imaging. These are no longer front line technology, but are the most viable options for mass projects due to their common interface.

On Day 3, Dr. R.K. Mathur, Chief Radiologist, Max Healthcare, S.K. Meher of AIIMS, A. Nene from 21st Century Healthcare and Suresh Ranganathan of Agfa Healthcare gave an overview of the current use of medical imaging, Radiology Information Systems (RIS) and Picture Archiving and Communications Systems (PACS). “Filmlessness”, said Dr. Mathur, “will largely be driven by insurance in the coming years.”

The post tea-break session on the morning of the third day saw one of the most interesting presentations by Dr. Ajoy Kumar Ray, Head � School of Medical Science & Technology of IIT, Kharagpur.

Dr. Ray explained to the audience that image retrieval was as important as storing and transfer. Molecular imaging is the future of medical imaging, good quality of which is essential for pre-cancer detection.

The conference ended with the ‘Medical Technology Forum’ where a panel of Poornima from Texas Instruments, Kalyana Raman of Trivitron, Sumati Randeo of Abbott healthcare and A. Vijay Simha from BPL was chaired by Anjan Bose of Philips Electronics.

The discussions centred around a wide range of topics. From trying to find a solution to the eternal dilemma between placating multiple power centres and acting decisively on how important it is for a doctor to make eye-contact with a patient. During the networking breakfast, delegates and participants from all seven tracks got a chance to intermingle and share fresh ideas and learnings in a single space which proved to be an immensely enriching experience.

We at eHEALTH magazine hope that the lessons learnt and the knowledge shared will be taken back to workplaces, businesses, hospitals and classrooms and boardrooms. As societies develop and economies transform, we should be looking more at preventive rather than curative health. Better disease surveillance, data storage, data transfer, and generally improved access to technology is the future of health IT. In the years to come, we look forward to user-centric technology, greater mobility and very importantly, low-cost IT solutions.

We at eHEALTH hope to showcase the developments in these arena’s on a bigger scale at the eHEALTH Asia 2008 at Kuala Lumpur from 25-27 November and we hope to have you with us.

Like one of the speakers put it � ‘It has been a fascinating technological journey.’

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