Hyderabad International Convention Centre, Hyderabad

eIndia 2009 was held during 25-27 August 2009 at the Hyderabad International Convention Centre, Hyderabad. eHealth India 2009 was one of the five tracks, at the event, that attracted participants and delegates including industry stalwarts, policy makers, academicians, researchers, technology vendors and stakeholders from India as well as overseas. The three day conference highlighted the key aspects in the health IT arena and proved to be an excellent platform for sharing knowledge and discussing pertinent issues.

Day 1

The opening address at the eHealth track, delivered by Dr. Ajit K Nagpal, Chairman-utive Council, Batra Hospital & Medical Research Institute, focused on “Transforming Healthcare Systems & Services: An ICT-centric Approach”. Dr. Nagpal stated that owing to the unique character of the healthcare industry, it is extremely challenging for IT industry to implement ICT technologies for the enhancement of technical efficiency, quality and delivery of healthcare. He highlighted certain challenges that the IT industry may face. These include: provision of fully functional clinical desktops for care providers, handsfree solutions, rules-driven user-interface, knowledge-based and protocol-driven clinical support system, appointment list on handheld devices, virtual and secure access of information, high speed internet connectivity and electronic records for secure access to information.

The opening address was followed by the first session of the conference, which was based on the theme Envisioning Healthcare Reforms Role of Information and Communication Technologies”. The speakers of this session made excellent presentations that were highly informative.

Dr. Girdhar J Gyani, Secretary General, Quality Council of India and CEO, NABH stated that ICT and accreditation are complimentary to each other. While accreditation for enhancement of quality is extremely important, the major challenge remains to design an appropriate IT platform for bringing in quality in healthcare procedures.

Dr. Shakti K Gupta, Professor and Head, Department of Hospital Administration, AIIMS, blamed the dearth of IT spending in the healthcare sector in India. Dr. Gupta stated that large corporate hospitals in India spend less that one percent on IT, while hospitals in the west spend somewhere around three percent. According to him the major challenges in the proliferation of ICT in India is the lack of enough government initiatives and spending and low computer-literacy in the government as well as private sector. Enhanced implementation will require continual incentives and benefits for the users.

Surgeon Rear Admiral (Retd.) Dr. VK Singh said that the need of the hour is to be able to provide quality healthcare at affordable cost and the battle is won if implementation of ICT helps in doing this. He pointed out several challenges to this such as trusted network, interactive systems and integration of different system components.

Importance of use of mobile technologies was another topic of discussion in the first session. Uday Bhaskarwar, Vice President of Infosys Technologies stressed on leveraging mobile technologies as mobile has always been the most pervasive medium of communication and the upcoming reliable 4G technology can be a very effective communication medium.

Dr. V Balusubramanyam, Domain Consultant-Medical E-Learning and Professor, Department of Anatomy, St. John’s Medical College, was of the view that resistance to change has impeded the proliferation of ICT in healthcare and doctors are probably the most resistant to change. While a change of mindset is required to make this happen, the new generation can be looked upon for bringing the IT revolution. The last presentation of this session was made by Dr. P K Amarnath Babu from HMIS Project, who spoke about the HMIS project and how it has overcome the challenges that were posed during its implementation. The session, overall, was able to put light on the key factors and challenges that need to be looked upon for implementation of ICT in the Indian healthcare sector.

An insight into the Aarogyasri Healthcare Trust was provided by Babu Ahmed who is the CEO of this program. One of the key programs launched by the Government, Aarogyasri implements IT in a big way to provide health services to several BPL families in Andhra Pradesh. He also stated that IT has to be a part of any mass scheme that is planned.

The second session comprised of speakers from the government as well as the private sector to discuss “Opportunities and Best Practices in eHealth Adoption � A Multi-stakeholder Perspective”.

Pravin Srivastava, Director (Stats), Ministry of Health and Family Welfare, Government of India, talked about the development of the portal www.nrhm-mis.nic.in, which is a dedicated web-based data capturing system. The portal has helped in completely eliminating paper reports under the NRHM and integrating health related information across various programs.

Dr. Balaji Utla, CEO, HMRI talked about HMRI’s service 104 Advice, which, with the implementation of IT, helps in providing crucial health information through phone to various people across the state of Andhra Pradesh.

Dr. K. Ganapathy put light on the initiatives of Apollo Telemedicine Networking Foundation, a private sector entity’s role in the provision of telemedicine services to the rural population. Highlighting the eHealth initiatives in India, Bhudeb Chakravarti, General Manager, National Institute of Smart Government, talked about the recent trends and key issues in the integration of IT and healthcare. Going forward, Dr. Sanjay Bijwe, Project Director and OSD (HMIS Project), Dept. of Medical Education and Drugs, Govt. of Maharashtra, talked about the HMIS project for medical colleges, which is currently being implemented and will be completed by 2010 end. Government of Maharashtra is coming up with several newer technologies in this domain, such as finger printing, PDA computer on wheels and so on.

Day 2

Divya Sehgal, Chief Operating Officer, Apollo Health Street Ltd., delivered a special address on “ICT best practices for excellence in modern hospital operations”. Talking about innovation as the immediate need, Divya stressed on limitation of infrastructure, access, affordability, quality and research, manpower and demand management as the major factors curtailing growth. Apollo’s initiative, The Health Hiway platform, aims to have a centralised patient-centric architecture and become the main platform for the industry. The platform uses SaaS to capture most electronic transactions and sets uniform standards.

The first session on day two, was chaired by Surgeon Rear Admiral (Retd.) Dr. VK Singh and focused on “Technologies for Clinical Excellence and Business Efficiency of Hospitals”. The key speakers of this session included: Dr. Karanvir Singh, Consultant Surgeon and Head-Medical Informatics, Sir Ganga Ram Hospital; Dr. Srinivas K Iyengar, Vice President, Care Hospitals; and Rahul Chatterjee, Head-Healthcare Vertical, Siemens Information Systems Ltd. The discussions focused on implementation of IT at the hospital level. Dr. Karanvir Singh and Dr. Iyenger talked about the implementation of TrakCare system and Karishma Software’s HIS system respectively at their hospitals to bring in the IT component for automation of various procedures.

Being a vendor of the technology, Rahul Chatterjee, presented a case study of deployment of Siemens’ IT solutions at MedCentral in the USA. A special keynote address was delivered by
Iain Bray from the strategic planning group of InterSystems Corporation. He compared various systems installed at Sweden, Brazil and Chile and highlighted the benefits of all these systems. He also talked about the core eHealth policies of these countries. Technologies for clinical excellence and business efficiency of hospitals were discussed by the vendor community including Srikanth Muthya, General Manager (Healthcare IT), GE Healthcare; Satish Kini, Chief Mentor, 21st Century Healthcare Management Solutions; and Dr. Suman Bhusan Bhattacharya, VP-Clinical Services, Karishma Software.

Srikanth Muthya talked about providing solutions for eHealth and how can technology serve for clinical excellence and business efficiency of hospitals. According to him, the two areas of expertise that can help in doing this include intra-operability and evidence-based medicine.

Satish Kini highlighted three major factors-technology, processes and people and said that the much needed efficiencies in healthcare require innovative approach and technologies.

Dr. SB Bhattacharyya said that technologies for clinical excellence and business efficiencies of hospitals has mainly two takeaways: dashboard and requirement management. According to him, the latest innovation in clinical IT is clinical transformation, which is not a technology based tool but involves implementation management.

Setting an excellent example, UK Ananthapadmanabhan, President of the Kovai Medical Centre and Hospital (KMCH), Coimbatore, talked about the integration of technology in various processes at KMCH and how it has invariably helped them in improving efficiency and quality of their services. The third session of the day was an interactive session on “Health IT Leaders’ Forum�Mainstreaming IT in Indian Hospitals”. In addition to the moderator, Sandeep Sinha, Deputy Director-Healthcare (South Asia & ME), Frost and Sullivan, the discussion comprised of eight other speakers�Dr. Karanvir Singh; UK Ananthapadmanabhan; Dr. Srinivas K Iyenger; Manish Gupta, CIO, HCG Enterprises; Vishnu Gupta, CIO, Calcutta Medical Research Institute; Dr. M Venugopal, SDN Hospital; and BS Ganesh Babu, Aravind Eye Care System. With all these dignitaries on the dais the discussion successfully brought out the main bottlenecks in the proliferation of IT in the healthcare sector in India and the most probable solutions for these.

Manish Gupta was of the view that there can mainly be two approaches for mainstreaming IT budget in hospitals. First is to keep the baseline budget lean and utilize the extra finances for new initiatives. Another approach is to first build a P&L and keep IT as a component in it.

The last keynote address of the day was delivered by Wg. Cdr. (Dr.) Sanjeev Sood, Sr. Medical Officer and Aviation Medicine Specialist, Indian Air Force.

Talking about computerised physician order entry (CPOE), Dr. Sood highlighted the various benefits of installing a CPOE system, which include�prevention of medication errors, reduction of prescription dosage errors and keeping physicians updated. He also discussed several other major advantages of CPOE such as increasing efficiency, reducing practice variations, giving clinicians a broad access to clinical literature and reducing the length of stay of the patient in the hospital, among others.

Chaired by A Vijayrajan, Chief utive Officer, Clinitics, the last session of the day focused on standards, best practices and solutions in creating a seamless healthcare ecosystem. Eminent speakers of the session�Dr. Dinesh Jain, Medical Informatics Specialist, Max Healthcare; Vamsi C Kasivajalla, utive Director-Healthcare, Sobha Renaissance IT; Inderjith Davalur, CEO, Aosta Software Technologies; Prasenjit Kundu, COO, Health Hiway and Subramaniam, Director, ezEMRx, brought forward the most viable solutions to create a healthcare ecosystem in India.

According to Inderjit Davalur, as of today, USA is the only country that takes medical care to a more aggressive level and India also needs to gear up now. Therefore it has become imperative for all organizations to have a proper system in place.

Vamsi Kasivajalla was of the view that a huge amount of duplication is happening in the healthcare industry because of non-implementation of IT in the maintainence of reports and urged the government officials to come out with a policy and create some standards that can help prevent this.

Prasenjit Kundu gave a patient-centric view of the ecosystem, which respects the privacy of the patient and is streamlined cost-effective and efficient at the same time. He said that the patient’s journey on the health highway goes through various aspects of the ecosystem leading to multiplicity of data residing in disparate areas.

Subramaniam identified the health ecosystem and the needs of various stakeholders in this ecosystem. Talking about IT as an enabler, Subramanian explained various health information technology systems such as EMR/EHR, LIS/RIS, drug information systems, health management systems etc.

Day 3

Day three, began with an interesting keynote address, delivered by Dr. Rathan Kelkar, Director, Kerala IT Mission, Govt. of Kerala. Dr. Kelkar focused on the ‘Dr. SMS’ program, an mHealth application initiated by the Kerala state IT mission for providing assistance in healthcare. Looking at the rapid evolution of mobile technologies, Dr. Kelkar said that the high penetration and scope for development of mTechnology in health application and health services cannot be ignored. ‘Dr. SMS’ is a round-the-clock service, which acts as a central repository and provides health information through SMS and portal to the people in Kerala.

Going forward on the same lines, the first session of day three also focused on exploring new technologies, service channels and business models for online and mobile applications in healthcare. Some interesting statistics were provided by Rajendra P Gupta, the chairman of the session, such as the number of mobile users in India increasing to about 470 million. Also, compared to internet density of 7 percent, the teledensity is greater than 40 percent, which in itself highlights the huge penetration of mobile services in the country. Speakers from various backgrounds including Nivedan Sahani, VP, Enterprise Services, Bharti-Airtel Ltd., KVRK Rao, VP-Strategic Initiatives and Business Intelligence, SG Technologies; Dr. Ruchi Dass, Business Head, Kayaguru Health Solutions; Dr. Shabbir S Abdul, Researcher, National Yang Ming University, Taiwan, and Dinusha Vatsalan from School of Computing, University of Colombo, Sri Lanka; came together and discussed about mHealth’s penetration into the healthcare industry and the change, it has brought about, in the way health services are being offered.

“Considering that Government of India allots 5 percent of GDP for the health sector, there are several opportunities for private players to invest in different areas. Information technology is a major sectors that can attract investments and provide fruitful returns.”

Nivedan Sahani said that there are four aspects to a health ecosystem, which include: the enabler, the government, the doctor and the patient. Focusing on mHealth, he talked about Airtel’s solution Health MATE deployed under the Aaganvadi Project.

Dr. Rana Mehta, VP-Healthcare Practice, Technopak Advisors, presented his keynote address in the post tea-break session. His presentation revolved around the funding landscapes in the emerging Indian healthcare industry. Considering that Government of India allots 5 percent of GDP for the health sector, there are several opportunities for private players to invest in different areas including super-specialty hospitals, community hospitals, diagnostic centres and day care surgery centres, among others. Information technology, medical equipment, consumables, training/education, medical waste management and hospital architecture and facilities management are all major sectors that can attract investments and provide fruitful returns.

Following the keynote address, was the venture capitalists’ and PE investors’ forum. Vikram Gupta, COO, India Ventures; Manish Gupta; Sateesh Andara, Venture Partner, Draper Fisher Jurvetson; Yash Shenoy from Invascent; and Monica S Shah from Acumen Fund participated in this session. The discussions in this session centred around appraising investment worthiness among healthcare providers and technology players.

Following the focus of the session, Vikram Gupta talked about India Ventures, which is a Piramal Group funded organisation focusing on healthcare and lifesciences investments across the entire healthcare and lifesciences sector.

A very interesting, post-lunch keynote address by Venkat Changavalli, CEO, GVK-EMRI, kept the conference alive. Highlighting the example of EMRI, Venkat Changavalli talked about how technology can be leveraged for emergency management and healthcare delivery in India.

The developments and best practices for universalising healthcare through technology was the focus of the last session of the conference. Various Indian as well as international speakers including Lt. Col. (Dr.) Salil Garg, Senior Cardiologist at Command Hospital, Pune; Dr. Pradeep Bhardwaj, COO, Ojjus Medicare Group; SG Prasad, Chief of Telemedicine at Care Foundation; Dr. PC Jain, Professor and Head of C-DAC, Noida; and Holger Monnich from university of Karlsruhe, Germany participated in this session and highlighted the technological aspects in the dissemination of health services.

Geared for excellent growth, the future of health IT in India seems to be extremely bright and the eHealth India, every year, is committed to deliver the best platform for knowledge sharing on key aspects in this arena. With the same motive eHealth will be showcasing eHealth Asia 2009 in Colombo, Sri Lanka from 2-4 December, this year. We hope to see you there!

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