January 2010

“We are moving towards a direct business model”

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InterSystems Corporation, one of the leading vendors in health information technology space, is dedicated to offering top notch innovative health IT products including TrakCare, CACHÉ, Ensemble, HealthShare, and DeepSee. In a chat with eHEALTH, Joerg Klingler, Group Director & Managing Director at InterSystems Corporation, talks about InterSystems’ growing presence in India and the world over.

Joerg Klingler
Group Director and Managing Director
InterSystems Corporation

What has been new in InterSystems in terms of business or geographical areas that you cover? What have been your major projects or achievements?

InterSystems is a very flat and functional organisation. Therefore we decided, that a two-step approach to enter new markets or market segments is what serves our customers best. Step one means to support each country, market and customer with all necessary resources. In a second step, we find the right people to provide each region with its own InterSystems team and senior management to develop and advance long-term business relations with our partners. As a company, we are very aware that people’s lives are depending on the performance and stability of our software. Therefore being able to address all upcoming issues immediately is a necessity. We strive constantly to live up to this responsibility.

The InterSystems healthcare portfolio offers a full range of software products, ranging from local in-patient and out-patient solutions to structures that are able to integrate and connect regional or even national health systems. To pass the challenge, that comes with all these obligations, we are currently in the final stage of changing and expanding our business model for InterSystems TrakCare, our health information system. We are now moving towards a direct business model, which is an important step for InterSystems and we pursue this approach with few exceptions currently worldwide.

One, if not the most exciting region for TrakCare is India. That’s why we have set up our own subsidiary in Gurgaon this year. India is one of the most active countries when it comes to developing and improving their healthcare systems and we, as a company, are growing tremendously being part of this process.

Two other areas, where InterSystems has been very successful in the last year, are the Middle East and China. In the UAE, we have recently signed our first direct customer, the Sharjah University Hospital. We will also soon be signing deals with some new hospitals in Saudi Arabia. China, where we started about two years ago, is developing nicely. Two examples there are United Family Hospitals and Clinics, a privately held hospital chain, with multiple facilities in  Beijing and Shanghai. There we are currently in the final stages of implementing TrakCare and interconnecting all those facilities. We have also signed up with the  biggest private hospital, Baptist Hospital in Hong Kong, where we have just started the process of implementation. So there is a lot  of activity going on in and around India.

Can you elaborate on the strategies and approach in the Indian market. Is there any customised approach?

We have so far signed five projects including Fortis and Manipal in India. Our most important objective is to complete the implementations in these hospital chains successfully. One interesting thing is that implementation in a chain of hospitals is quite different from implementation in a single hospital. There are, for example, issues pertaining to data security making data integration a very challenging topic. Therefore, implementation for institutions owning multiple sites requires a lot of work. On the other hand, there are tremendous opportunities in terms of increasing quality of healthcare, if you are able to compare the performance of two or more hospitals. It’s undoubtedly a way to run them more effectively. I see this as an opportunity to examine whether or not, we as a manufacturer, can really have an impact. So we are really excited about the opportunities to work with these hospitals.

The challenge for healthcare around the world is, that the demand is very high and still increasing, but the money to fulfil that demand is not always available. At least not, if we continue to provide this service the way we did in the past. To deliver more for less, forever is the challenge. I have always been excited about India and am very pleased now that  we have put in enough resources here. The task for us is to do even better in the future and to create a model that we can use all around the world.

What are the challenges faced by you?

There are very few companies in the world that are developing patientcentric, enterprise-class healthcare information systems. To have an integrated system working seamlessly  with every department is a tough task. In a fully integrated system you will have a look at your business, like you have never seen it before and you have to put pressure on certain people to behave in a way they never did before. So it comes with quite a lot of transformation. The true challenge is that, for implementation of such an approach, you really have to commit yourself. Without having the management backing up a process connected with so many changes, it’s an impossible task. It has also to be done in a reasonable way, integrating the input of the doctors, that have later to work with it, winning the nursing and administrational staff and have a real commitment from senior management. Part of what we did before we came to India, was to make sure that we have the maximum possible support from the owners of these organisations. They have to believe, that these systems will initiate a positive transformation and therefore show the commitment and the support for this transformation. That is something which is totally unique, because usually in the government there are only a few people who are willing to take this ”ownership”. Key is, that those in charge of healthcare need to have a vision for their business; an idea – how they would like to do it in the future. Therefore they need to have an understanding for and finally the trust into IT and software, that those implementations can help them achieve their goals.

Do you think that change has already occurred in India?

If you look at the progress regarding healthcare India made in the last 15 to 20 years, the country has gone through a tremendous transformation. It is successful and it is growing. Still, if you look at the private hospitals, there is an enormous lack of capacity. To deliver quality healthcare, India in general needs more beds and more doctors. So in a way it is more of a social responsibility to try and make a difference. Society in general also has to deal with something which is an absolute necessity. There are more and more people in this country, who can afford reasonable healthcare. If you have this kind of economic progress you need to give something back as well and I believe healthcare is one of those areas where it can easily be done. With the government stepping up and making investments in healthcare, I expect this industry grow very rapidly.

How soon do you expect the government sector in India to open up?

I believe it’s already happening. Healthcare is on the agenda of every single government in the world. There are some really dedicated people in every government, trying to make a difference.

Moreover, people are travelling and everybody is afraid of the pandemics, such as swine-flu. There is the possibility of an outbreak of some kind. People are connected and aware of the kind of delivery models which have worked in other places. A few years ago, there would not have been that level of knowledge, which is available today. Some governments have already made significant progress and recorded successes. For instance, the state of Andhra Pradesh is a positive example in healthcare in its decision for a public-private coordinated model. But it is important to keep in mind, that if one model is successful in one area, it may not be successful everywhere. Still it’s a fertile environment where a lot of smart people are coming up with new ideas and some of them do work. The great thing for healthcare in India is that, uniformly across hospitals, all CEOs believe that good care should be provided at affordable costs and that I think is phenomenal.

Are all these models based on public-private partnerships?

Public-private partnerships are everywhere nowadays. The difficulty with a pure private model is that sooner or later, people get greedy. So PPP is a good model and the government is proactively getting involved in it. In Hong Kong, for instance, private hospitals will take care for one part of all cases and the remaining part is taken care of by the government. In Chile, we are implementing TrakCare for primary care and there are 29 regions in Chile with only two possible suppliers on the panel. There we have signed with private hospitals, public hospitals, and primary care clinics. Chile has an incredibly innovative government and at the moment, the President of the country is a doctor and she is really pushing to put a proper healthcare model in place.

Do you think there is a sustainable growth potential in India compared to countries like Brazil and Chile?

Yes, the potential here is huge, particularly with 1.2 billion people needing medical care in all its various forms. Several governments in India are already providing funding. In Brazil there is a similar situation with every state/province making its own decision. Healthcare is anyway so diverse – doctor-to-doctor, site-tosite, country-to-country.

Is there a need for a body in India to set some kind of standards or policy for health IT?

Hospitals, at least the private chains, are all asking for standard based software and awareness about newer technologies. So, the need for standardization is high. Because it’s clear that there can not be one HIS system for everybody, a set of standards can be approved, to give a bird’s-eye view or a nation-wide/ group-wide view to make a wise decision. To be fair, the government is already aware of that and there is a lot of work underway in this arena.

Everybody knows the need for Healthcare IT standards, and a lot of people are working on it. There are standards which are needed to define which information can be stored, what people need to agree upon, what can be shared in these systems. Today, everybody feels in some way insecure about sharing information, even within the group.

If you don’t have someone to head this standardization topic, pushing international standards that have been created to provide a basis, becomes very difficult. For example, look how the UK government manages delivery of care by simply regulating the standards. All decisions that they have made apply to all citizens and not just a few. So, they make sure that
they can share all information. They have set up a network that makes use of resources wherever available to take care of patients in a timely manner. So, there are standards and I don’t think anybody is ignoring the need for them.

Are there any new technologies or applications from InterSystems in pipeline?

We are developing something new every day. We are continuing work to further improve the administrative capabilities of TrakCare and help hospitals better understand their business processes and create measures to improve efficiency. We are also focussed on driving clinical adoption, which is essential for hospitals to ensure high quality of care in the future and avoid clinical errors. In response to the universal need for reporting, business intelligence and analytics in today’s environment, we are enriching the functionality of ‘DeepSee’ – our realtime embedded business intelligence platform, and enhancing the Zen Reporting engine.

Given how our platforms are being used in mission-critical applications, in large (often nationwide) environments, we continue to focus our efforts on making all our platforms even more scalable, and easier to administer, while continuing to improve performance. For example, Ensemble – rated #1 interface engine in Healthcare by KLAS for 3 years running, now handles message processing approximately 30 percent faster than previously due to improvements in various areas including SOAP, XML and HL7 message processing.

When you work with our innovative software products – Cache, Ensemble, DeepSee, TrakCare and HealthShare – you’re working with the premier platforms for connected healthcare.

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