Interview

The challenge is to create an architecture that allows seamless information flow : Manish Gupta, CIO, Fortis Healthcare

What has been your vision and approach in building up the IT strategy of Fortis?
At Fortis, we are rolling out a centralized system that�s patient-centric, scalable and clinically very adaptive. Any such system requires standardization of data and processes across our hospitals and other allied facilities. By the way, deviations from standardization can result from exceptions or innovations!

Our IT strategy is driven broadly by business, clinical and societal requirements. Business needs are around administrative work, financial and procurement and such things that are common to all organizations. Apart from the usual applications, we are working on a group wide employee portal as well.

Clinical and social needs are quite specific to our industry. For example, our customers will be glad to access their health records, get reminders, be advised by doctors even when mobile. I am looking towards launching this patient portal for Fortis and then invite other healthcare providers.

What according to you are potential improvement areas in your existing systems and how do you plan to take the IT capacity in Fortis to the next level?
Scalability matters in an explosively growing public company like Fortis. Our biggest improvement stems from our ability to deliver standard clinical pathways across all our facilities. Centralized EPR or Electronic Patient Records will automatically derive there from.

We want to capture data at source, whether from doctor�s written/spoken word or from equipment at our hospitals or even at patients’ home. That�s the ideal scenario for input. On the output end, we want to disseminate portable health information to our patients’ families and their general physicians if needed.

What are the various back end, front-end, integration platforms and technologies that are in use in Fortis?
These are aligned with our Hub and Spoke business model. We use web-based Trak combined with our legacy Hospital Information System (HIS). We will migrate to a shared or centralized Trak system. We also leverage office tools and other collaborative applications of Microsoft. We also have financial, procurement and MIS systems in place.

Incidentally, we are the first among equals in India in initiatives such as web-centric and shared EPR, enterprise alliance with Microsoft and so on. We are also blueprinting SAP roll-out across our hospitals. Overall that means a single face to internal and external customers!

What is the practice at Fortis in terms of EMR & PACS?
Currently we are truly EMR-centric from admission to discharge across various patient episodes. To expand clinical usage, we continuously enhance system for Clinical Point of Entry (CPoE), that is, data entry at the time of doctor�s advice or prescription. In reality, we also have data entry operators to drive EMR.

PACS has a direct clinical impact but clinicians’ mindset has to adapt. At modern hospitals globally, doctors use 2D/3D imaging solutions and don�t want to use films. Once doctors know how PACS can help retrieve, analyse and prioritize images, I am sure they will ignore other perceptions. At Fortis, we are therefore deploying a centralized PACS solution. PACS is an initiative of our Clinical Technology team, wherein we invite IT savvy doctors and patient-facing users.

Fortis has also ventured into Telemedicine initiative for rural areas. What is the level of success in this initiative?
Telemedicine is great to make people health-aware, apart from benefits of clinical consults, marketing and indirect revenue. Currently, we run our locations on ISRO provided bandwidth as do other hospitals. With better network and hardware, we have planned out web-based solutions between our hospitals and also with remote internet connected locations.

Equitable sharing of medical, clinical and patient-specific data / information is crucial for seamless patient care. Yet there is no standard regulation on health information exchange and privacy issues. How much need is there for this in the industry?
Regulation exists but on paper, and not so much in action. Other regulations apart, information exchange standards are technically most important to save time and cost. There is a lot of hype around adopting HIPAA type portability in India but I think our healthcare sector is too different. We should localize every regulation that we want to emulate from the developed countries.

What is your opinion on Mobile and Wireless use in healthcare?
These have tremendous potential. In fact, leveraging mobile technology is the best thing that would happen. Almost all large private hospitals including us, use messaging to inform patients and doctors. We should now leverage mobile phones or bluetooth enabled devices to enter data. Imagine how this will save precious time of doctors and nurses! Further, let�s see in near future how mobile phones can read bar-coded tags or how patients can directly access a health portal on mobile, besides a PC can be very helpful, provided the patients and local doctors are IT savvy. Possibilities are endless – the only limit is how much benefit it brings to patient-doctor relationship.

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