The three day event from 4-6 August, 2010 was aimed at providing a unique platform for knowledge sharing and discussing emerging issues in depth in the areas of IT and technology in the healthcare services sector. Sangita Ghosh De of eHealth reports.

eHealth India 2010, being one of the six thematic tracks of eINDIA 2010, hosted policy makers, academicians, researchers, technology vendors as participants and delegates from across India as well as overseas.

The 6th eINDIA 2010, the three-day international conference and exhibition, was held at Hyderabad International Convention Centre, Hyderabad during 4-6 August 2010.

eINDIA  aimed at providing a unique platform for knowledge sharing in different domains of ICT for development and facilitates multi-stakeholder partnerships and networking among government, industry, academia and civil society organisations. This year eINDIA was even more focussed with six thematic tracks namely  eGov, eHealth, digitalLEARNING, Telecentre, eAgriculture and Municipal IT.

Conceived and produced by Centre for Science, Development and Media Studies (CSDMS) and Elets Technomedia, eINDIA 2010 was co-organised by Department of Information Technology, Ministry of Communications & IT, Government of India, Unique Identification Authority of India, Directorate General of Employment & Training (DGET), Ministry of Labour & Employment, Government of India and National eGovernance Plan (NeGP).

Department of IT & Communication, Government of Andhra Pradesh was the ‘Host State Partner’ for this event, while Sri Lanka was the official ‘Country Partner’.

eHealth India 2010, being one of the six thematic tracks, hosted policy makers, academicians, researchers, technology vendors as participants and delegates from across India as well as overseas. The three-day long conference threw light in the areas of  IT and technology in the health sector, while providing a successful platform for sharing knowledge and discussing emerging issues in depth.

Day One

Public healthcare – vision to transform

The first session of day one of eHealth track started with the vision address delivered by J Satyanarayana, Special Chief Secretary, Department of Health and Family Welfare, Government of Andhra Pradesh on ‘Transforming public healthcare through technology.’ According to him, transformation is a radical and fundamental change and therefore, transformation in public healthcare also needs to go through the path of radical changes pertinent to the necessity of the rules and tools of the sector. The target areas of the sector are very sensitive and large in numbers, where focus needs to be on specific needful areas in achieving success. It is now proved that technology in primary healthcare is different from technology in secondary or tertiary care. Therefore it is more wise to concentrate on Public Private Partnership (PPP) mode, opined Shri Satyanarayana. With the availability of proper opportunity of management in human resource, healthcare is a suitable area for IT development provided with optimal infrastructure. Besides, in the sector with IT, medical technology has also going through a meaningful phase of development. All these developments result into a proper management of delivery of services in manpower, funding, logistics, and procurement as well with requirement of trained manpower. In this scenario, Aarogyasri is one of the successful paperless projects, he mentioned.

The vision address was followed by the first keynote address delivered by Sangita Reddy, utive Director, Apollo Hospitals on ‘Envisioning hospital of the future – putting technology at the heart of care’. In her address Reddy makes an excellent presentation that was focussed on Hospital Information System (HIS). According to her, appropriate application of technology in every step of healthcare needs innovation and proper flow of information enabling it more acceptable, sustainable, affordable, patient centric and efficient.

Following to her presentation, Dr Karanvir Singh, Head-Medical Informatics, Sir Ganga Ram Hospital, Delhi delivered the second keynote address with focus on ‘Implementing an electronic medical record system’ in hospital. “We have been having Hospital Information System (HIS) in Gangaram hospital since 2005. Our experience says that a proper HIS includes an effective usage of Enterprise Resource Planning (ERP)  solutions and a successful Electronic Medical Record (EMR) system. Now implementation of a proper and smooth running EMR is really critical and an expert’s job as it involves entering crucial data correctly and timely,” says Dr Singh. If a hospital needs to run uninterruptedly and effectively with the support of HIS, EMR has to be uted accurately, he voiced.

The first session of day I ended with a special address by Miles Ayling, Director of Service Design, Commissioning and System Management Directorate, Department of Health, United Kingdom.

He spoke about the innovations and implementation of HIS and technology in National Health Service (NHS) started in 1948 in United Kingdom and the new organisation, a part of NHS called NHS Global that is aimed at partnering with healthcare systems overseas. NHS is publicly funded, third largest organisation in the world, a three tier system and its services are free with a annual budget of USD165 billion. According to him, while reaping the opportunities in improving the healthcare system currently, one has to face the challenges as well. NHS has a record of 1 million patients contact every 30 seconds that really shows its vastness and the nature of complexity that it has. It is a highly dense network of thousands of hospitals, community centres and general practitioners, where only technology has helped in delivering seamless services to its patients facing a lot of challenges though. To overcome the challenges funding had increased three to four times more for the past few decades and clearly focused on increasing quality, innovation and productivity continuously which could be the part of learning curve for anybody.

Reform, Transform, Perform: Charting blueprint of the future healthcare

Session two of day one started with the discussion on ‘Reform, Transform, Perform – charting blueprint of the future of healthcare in India’ moderated by Dr Ashok Kumar, DDG & Director, Central Bureau of Health Intelligence, Ministry of Health & Family Welfare (MoHFW), Government of India.

ICT has brought in revolution, across all departments in the government including healthcare, commented Dr Kumar, while moderating the session. “In India ICT in healthcare still needs more attention as the service needs to percolate at the bottom of the society, therefore spurring demand more into primary healthcare and subsequently moving upwards to secondary and tertiary healthcare systems. The country needs the most effective and successful healthcare system but with a major transformation to meet the challenges,” he added.

According Dr Ajit K Nagpal, Chairman Healthcare Advisory Council, Feedback Ventures & Convener Task Force on Health Sector Reforms, J&K State, the transformation highly demand the PPP mode. “We need strong public policies to foster the PPP mode for quality but affordable and of course accessible healthcare in our country. As reformation and transformation has many challenges in itself,  implementation of ICT in healthcare needs more attention of the experts and policy makers to make it scalable and available,” he observed.

In the session, Dr B K Rana, Dy Director, NABH, Quality Council of India was of the opinion that for a hassle free delivery of services the system needs a successful and productive coordination, where data needs to be protected at the most.

Therein, Dr Mahesh Reddy, utive Director, Nova Medical Centres Pvt Ltd commented that to provide medical facilities at par across the country, provision of health insurance should be made mandatory and for the matter government should facilitate the process of decentralisation of its accessibility at the earliest.

Dr V Balasubramanyam, Domain Consultant-Medical E-learning & Professor, Department of Anatomy, St. John’s Medical College, Bangalore said, “As per my understanding and experience, we need to understand technology and try to apply it meaningfully so that the patient is comfortable. Let’s not follow implementing technology blindly.”

Following to his remarks, Dr P S Ramkumar, Adjunct Professor – Information Sciences, Manipal University commented that there are gaps in the process of implementing ICT in healthcare which has resulted enough wastages of resources. The best thing can be done is bridging the gap and benefit from the best of the product.

The session ended with the observation from Dr Ramchandra Lele, Director-Nuclear Medicine, Jaslok Hospital and Research Centre, Mumbai, which said that India’s priority is delivering its best for the primary healthcare whatsoever the situation is.

Day Two

Day two started with the keynote address delivered by U K Ananthapadmanabhan, President, Kovai Medical Centre & Hospital, Coimbatore on ‘Harnessing technology for hospital mordernisation – new paradigm in care management.’ The major observation in his presentation was pointed towards the transformation of technology that is changing the scenario completely. “I felt exciting when networking through computers started that changed the work process flow in the hospitals. A lot has been changed in the past few years. As I foresee now, following to the early stage of development, there should be a team of vendors who would develop customised software for specific needs,” Ananthapadmanabhan quoted, while delivering his lecture.

IT in modern healthcare: Best practices and solutions

The keynote address was followed by a round of experts discussion on “IT in modern healthcare organisations – best practices & solutions,” chaired by U K Ananthapadmanabhan.

In the discussion, Amod Kumar, Director, Maternal & Newborn Health Project, Intra Health International Inc. informed that in Uttar Pradesh in the next five years with National Rural Health Mission (NHRM), the monitoring system in healthcare services is going to see an overall change. Therefore, in the scenario the process of hospital modernisation is utmost important and for that the PPP mode is the best policy. Also Rashtriya Swasthya Bima Yojna (RSBY) should be implemented on an urgent basis to improve the healthcare scenario at the earliest.

Sanjay Singh, Head of Department of Information Technology, Sir Ganga Ram Hospital stated in his presentation on ‘Wired Network Security – Best Practices’ that in the modern hospital environment where information is running and being stored in bits and bytes, the underlying wired network infrastructure becomes the ‘nervous system’ of daily operations and must be secured to insure day to day normal operations. While implementing technology, if the wired network in today’s hospital environment is compromised and becomes inaccessible, every aspect of hospital operations is at risk and patient lives may be at jeopardy.

Further to that, in a presentation, Aniruddha Nene, Principal Consultant & Director, 21st Century Health Management Solution focussed on ‘IT in modern healthcare organisations – best practices & solutions,’ where he depicted that the solution has to work on patients sensitivity. With the entry of ICT, the work flows system and services in healthcare system has changed a lot. But the challenges remained in the uncertainty, delays and errors and in information gap. To meet the need, the challenges have to be met individually.

Clinical excellence and business efficiency in healthcare through IT

Session two started with the keynote presentation by Dr Thanga Prabhu, Clinical Director-HCIT, Wipro GE Healthcare. Dr Thanga Prabhu pointed towards the challenges in clinical care, where medical domain knowledge has been doubled over the past eight years. Besides, unnecessary overloading of digital data, and variations in clinical practices have complicated the process. Only a proper implementation of IT can become the core tool in solving these problems. Following to the keynote address, there was a panel discussion on ‘Achieving clinical excellence and business efficiency in healthcare organisations – possibilities through IT,’ moderated by Dr Karanvir Singh.

In his presentation Inderjith Davalur, CEO, Aosta Software analysed that the quality of being exceptionally good of its kind deliberates to fineness, superbness, and of course superiority. In the areas for clinical excellence in healthcare, a special feature or quality that confers superiority comprises beauty, distinction, merit, perfection, and virtue. In a measure of productivity that compares output to inputs, efficiency in healthcare is measured with the number of minutes required to process a patient admission.

Further to the presentation, Om Manchanda, CEO, Dr Lal Path Labs in his presentation on ‘Achieving Clinical Excellence and Business Efficiency’ stated that ICT provides efficiency and scalability in business and healthcare being very much consumer driven fall in the same path.

Going deeper into the discussion, Alam Singh, Assistant Managing Director, Milliman India delivered his presentation on ‘Clinical Protocols and Pathways: integrating into HIMS’ stating that it is very important to integrate logic, knowledge and intelligence for an efficient IT management system to gain the most of  the productivity.

The session ended with a presentation by Dr Uma Nambiar, CEO, S L Raheja Hospital, Mumbai on ‘Clinical excellence & business efficiency in HCO – possibilities through IT,’ where she mentioned that challenges in clinical excellence need to organise the data and categorise them for fruitful usage, India has to go a long way to achieve the system, though.

Strengthening through innovations in policy, processes and technology

Session three of day two started with the keynote presentation by Satya Gottumukkala, Vice President,  Healthcare and Life Sciences, Religare Technologies. “As healthcare is booming in the country, we need to pull in maximum resources and for that IT can be leveraged the most. Currently cloud computing is in to perform on top of that,” pointed out Gottumukkala in his presentation.

Following to his presentation started a panel discussion on ‘Health systems strengthening – innovations in policy, processes and technology’ moderated by Vijaylaxmi Joshi, Principal Secretary (Health) & Commissioner Health, Government of Gujarat. “In the morning session I was listening to a presentation on ERP, I think to match up to the current pace of IT revolution and to look into the future further, healthcare services need to bank on ERP at the most,” she commented.

According to Dr S Vijaya Kumar, Special Secretary, Department of Health & Family Welfare, Government of Tamil Nadu, as far as the initiatives at the government level are concerned, one of the most important steps of Tamil Nadu healthcare services is that its decision to go for a successful PPP mode.

Dr Iyyanki Murali Krishna, Adjunct Professor, Asian Institute of Technology, Thailand defined a case study in his presentation on ‘Studying diseases patterns, hotspots and diffusion in Chiang Mai province, Thailand.’

The main objective of this study is to apply the spatial epidemiology approaches for studying diseases patterns, hotspots and diffusion in Chiang Mai province, Thailand, he pointed out.

“In India it is very hard to retrieve data of healthcare status of the country in the government sector. Had it possible, it could have done wonder,” commented Bhudeb Chakravarti, General Manager, National Institute of Smart Government, while delivering his lecture in the session.

Following to his comments, Anju Sharma, MD, NRHM, Gujarat assured while saying that in the changing scenario, the government is now able to serve the most updated version of services to the patients. “We have started e-mamta in Gujarat to build a database of the mother and child to track the service by the name of the patients,” she added.

But in all the cases, whatever required should be met at the earliest because healthcare is for the people of the country, it is a public issue and therefore, not meant for profit, Dr Balaji Utla, CEO, Health Management & Research Institute, Hyderabad mentioned in his lecture.

CIO Conclave-mainstreaming IT in Indian hospitals

“We need to change our objectives in the healthcare sector. The role of the hospitals should be modified in changing their visions. The patients should be treated as customers as well and need to be served anywhere at anytime whenever they are required treated as emergency services,” commented Susheela Venkataraman, Managing Director, Internet Business Solutions Group, Cisco in her presentation in session four of day two.

The keynote presentation was followed by a panel discussion on ‘Hospital CIO Conclave-mainstreaming IT in Indian hospitals’ moderated by Indrajit Bhattacharya, Professor-Health Informatics, International Institute of Health Management Research (IIHMR), New Delhi. “Data mining is important and therefore, the software to manage data needs to be customised accordingly,” commented Dr Karanvir Singh at Sir Ganga Ram Hospital, Delhi in the session.

According to Dr Srinivas K Iyengar, Vice President, Care Hospitals the keyword is ‘change management ‘ and the challenge is to implement HIS individually in hospitals in that changing scenario.

While sharing her experiences of the IT implementation in Max Healthcare, Dr Neena Pahuja, CIO, Max Healthcare Group shared, “Max was one of the early service providers to go for a central database. We have chosen WorldVistA as it is the open source database. But for the successful usage of the software we go for a lot of data cleaning.”

But it has always been a challenge to track data, voiced Tim Ellis, Whole System LTC Demonstrator Programme Manager, Innovation & Service Improvement Division, Department of Health, United Kingdom. “We ran the software on 6,000 people at a stretch that also gave us the profile of the patients along with their lifestyle,” he clarified.

The problem lies elsewhere, mentioned Sandip Basu Thakur, Associate VP (IT), AMRI, Kolkata. “In healthcare there is no dearth of information but the challenge is feeding that data into the system correctly on time. It would be the best if the doctors take the responsibility,” he stressed upon.

Whereas Dr N K Thokchom, Group VP (IT, Telemedicine & Strategic Initiatives) informed that IT in global hospitals are now uated and reviewed as per its performance and how flexible it is to accommodate new technology.

The session was concluded with the comments of Group Capt (Dr) Sanjeev Sood, Indian Air Force Station, Jodhpur who said, “There are examples of projects which are successful and which are not. But that largely depends on the doctors who needs to overcome their protocols and limitations to learn and implement the language of technology. We also need to concentrate on patients safety and security.”

Day Three

Day three started with the keynote address on ‘Healthcare for the poor “serving bottom-of-the-pyramid population through efficient use of technology and service innovation’ by Babu Ahmed, CEO, Aarogyasri Health Care Trust, Government of Andhra Pradesh. In his presentation, Babu shared his experiences of Aarogyasri as a case study saying, “The challenges we faced is a bit difficult because we deal with the bottom of the pyramid “ primary healthcare in India. The volume and background of healthcare is critical in the country especially when it talks about the access of it. It is even more challenging in catastrophic condition in rural government health centres where bringing in experts is really tough leading to a situation where 30-40% of the posts are vacant.

Reforming health insurance through technology

The keynote address was followed by a panel discussion on ‘Reforming health insurance through technology’ chaired by Alam Singh, Assistant Managing Director, Milliman India. “We connect the consumer (the patients) and the service providers for cashless service in hospitals and other healthcare centres,” P Rammohan, Managing Director & Co-Founder, HealthSprint Networks informed in his presentation on ‘Health insurance data exchange to analytics – way forward.’

While sharing her experiences, Anjana Agrawal, CIO, Max Bupa mentioned that technology is very important for Max Bupa to access to the new market of healthcare which is growing leaps and bounds.

“We leverage on the maximum usage of Internet for networking especially to reach out to the places where health schemes are not sponsored,” said Sanjay Dutta, Head, Health Vertical, ICICI Lombard.

Third Party Administrator (TPA) being licensed by the Insurance Regulatory and Development Authority (IRDA) has now become a connecting bridge between the insurance companies and the customers and technology has open diversified ways to serve the best, Malti Jaswal, CEO, E-meditek TPA Services Ltd was quoted while saying.

“We are a membership based, costless, not for profit organisation and highly technology based insurance company,” informed Steven Yeo, VP & utive Director, HIMSS AsiaPac following to Jaswal’s comments.The organisation is further involving in the medical banking sector to leverage maximum on cash to provide best of the service, he added further.

Technology: Bringing accessibility and affordability for masses

Session two of day three was started with the presentation of Venkat Changavalli, CEO, GVK-EMRI on ‘Leveraging Technology for Emergency Management & Healthcare Delivery’ as keynote presentation. His presentation was focused on innovative pro-poor PPP (Public Private not for Profit Partnership) service delivery model to improve quality and access to healthcare services across India.

Part two of session two was focussed on the discussion on ‘Technology enabled remote healthcare “ bringing accessibility and affordability for masses’ chaired by Dr B S Bedi, Advisor-Health  Informatics, C-DAC, Government of India. From very beginning of technology era in India, the government started to look into the possibilities of how much the social sector can get the benefit of it and health was no exception in that. The session portrayed a varied picture accumulating the facts from the speakers that was extremely rich with the experiences shared by them.

“It is very alarming to know that a major portion of doctors and medical practitioners are still unaware of the activity and success of tele-medicine in India. Nanavati Hospital has taken the risk of introducing tele-medicine as one of the early service providers in the sector and now we can say that we are much successful inspite of hurdles and obstacles that came across our ways,” shared Dr Pavan Kumar, Consultant Cardiac Surgeon & Head-Telemedicine Master Centre, Nanavati Hospital, Mumbai.

While Dr Sanjeev Sood delivered his presentation on ‘Transforming healthcare through technology-from innovation to ution’ that gave a productive scenario of the changing paradigm of the sector, M C Kartha, Project Manager, C-DAC, Trivandrum shared his experiences about usage of technology at its best in a project on ‘Cancer detection and cervical cancer treatment using Mobile Tele-medicine Unit’ in Kerala.

He was followed by his co-panelist Professor Dr  A K Azad Director, MIS, MOHFW, Government of Bangladesh who put forth the success story on ‘Remote Health Care – Initiatives of Ministry of Health of Bangladesh’. The project was an e-Health initiative under MOHFW, connected to ‘Digital Bangladesh Vision’ of the current government pertaining to a top development agenda in Bangladesh.

Online and mobile healthcare: Exploring services and business models

The third or the last session of day three started with the keynote presentation on ‘mHealth “ the reinvention of health care’ by Dr K Ganapathy, President, Apollo Telemedicine Network Foundation. Dr Ganapathy delivered his lecture on his research on ‘mHealth: A potential tool for healthcare delivery in India,’ that spoke the prolific future of mobile health in depth in healthcare service sector.

His lecture was also the part of the panel discussion on ‘Online and mobile healthcare “ exploring technologies, services and business models’ chaired by Dr Ruchi Dass, Vice President, Lifetime Wellness Rx International. “eHealth and mHealth are going to be the future of the growing health sector in India. But it is also true that technology has to be backwardly compatible otherwise the development would have a silo-base problem and will be soon dead or non-vital,” said Das, while delivering her introductory lecture about the session. According to Nitin Mathur, CEO, HealthPA.com, with the invent of technology, healthcare can now provide a multiple options of service providers, where the service is just a phone call away and therefore, the sector has become a bit complicated than the past few years.

IT involvement and operations in healthcare services industry is still in a developing stage in India. Dependence and expertise related to IT and technology will gain its own share of pace as par the growing momentum of time.

“We have started working on a project in 50 villages of Maharastra where mobile health devices have been regarded as the major tool to serve the rural population base. We have trained the doctors and other para medical staffs to gain maximum from the project,” stated B Girish Babu, Chief-Care Rural Health Mission, Care Foundation.
Smart card is one of the major tool in mobile devices in healthcare and it is slowly making its place, commented Vijaya Verma, Founder & CEO, Yos Technologies. “We are using these smart cards to record and preserve data of the newborns for future data base maintaining a individual calender in providing services on time. The cards can also be used in emergency care where critical health information can be delivered taking the help of these cards,” she informed.

“We still consider the IT involvement and operations in healthcare is in a developing stage in India. Dependence and expertise related to IT and technology will gain its own share of pace as par the growing momentum of time,” assured Anita Shet, CEO, pinkwhalehealthcare.com, while replying to a queries in the session.

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