Known for its prowess in the global IT industry, Infosys has slowly and steadily developed a strong practice and a full range of solutions and services for catering to healthcare organisations. Dr Pankaj Gupta, Principal-eHealth and Clinical Practice (New Markets), Infosys, in a candid interview with eHEALTH.

What are the most common IT challenges faced by healthcare industry?

IT challenges faced by healthcare industry are identified as in the following –

1. Lack of EMR adoption by physicians: This is the single largest IT challenge faced by healthcare organisations at present. Changing physician approach towards using technology is a key focus for most CIO.
2. Extreme heterogeneity of IT environments: Data lives in silos separated by individual systems or paper based processes. Managing, integrating and optimising these data sources, whether through updating technologies or implementing and managing interoperability platforms is a nightmare. E.g. doctors don’t think in terms of per disease episode, rather they treat the entire patient; therefore they want a comprehensive longitudinal record. Payers administering disease management programmes for preventive and wellness support, also need comprehensive medical records thus requiring smooth integration between multiple information silos
3. Improving operational efficiency and optimizing organizational performance: Finding out what to measure in order to optimise processes and improve outcomes is a challenge because a hospital is one of the most complex enterprises that anyone can imagine. Administrative processes are so tightly linked to clinical processes such that clinical knowledge is a pre-requisite in managing hospital administration in a patient centered manner. However, most clinicians do not have sufficient administrative experience or the  time and inclination to design corrective measures.
4. Lack of health IT experts and professionals: Shortage of trained and experienced IT manpower in healthcare result in inefficient, delayed and aborted IT projects, resulting in a high degree of distrust and loss of credibility for use of IT in hospitals.
5. Demonstrating a quantifiable ROI: This has always been a difficult question for healthcare CIOs and is often the basic source of conflict at the management level discussions on healthcare IT.
6. Increasingly sophisticated functional demands on claims processing and claims adjudication systems: With a large number of legacy systems in place, payer CIOs are struggling to keep pace with the need to enhance/modify/ replace these systems to manage areas like fraud detection, disease management and potentially competing with upcoming government insurance plans.

What range of solutions and services do you offer in the healthcare domain?

Infosys has a wide range of healthcare specific vertical solutions and services, as well as, horizontal technologies and platforms that can be used extremely effectively in the healthcare industry.

These offerings include:

1. HIS/EMR Centre of Excellence Implementation and maintenance of HIS and EMR for physicians and hospitals. Infosys has alliances with HIS/EMR product vendors globally, including India.
2. Infosys EHRS – to integrate various health IT applications for building a longitudinal medical record.
3. Healthcare Performance Management Platform Prebuilt solutions around Clinical Quality Management, Capacity Management and Revenue leakage management combining business process management, predictive modeling, data analytics, reporting and actionable real time KPI-Dashboards for process management and optimization
4. Healthcare Modernization Solution – for improving claims processing by payers.
5. Health Plan eConnect Solution – to help payers build physician and patient portals.
6. Healthcare consulting for business problems in payers, providers and pharma companies, where we suggest solutions and help them realize the ROI on their investments.
7. iTransform„ product suite a comprehensive tool kit, geared towards semi-automated remediation associated with HIPAA 5010 and ICD10 adoption in the health industry
8. Enterprise Applications Implementation, Maintenance and Support.
9. Complete IT Application Maintenance and BPO Management

Which are some of the landmark healthcare projects of Infosys across geographies?

Infosys has been doing business consulting, application development, maintenance, testing, IT support and a whole range of IT operations for health insurance companies, pharma and life sciences organisations. Recently, we have started entering the healthcare provider segment as well. Some of these engagements are multi-year, multimillion dollar deals spread across many geographies including North-America, Europe and APAC. Our India unit has been recently setup to focus on special needs of the Indian market.

How do analyse emerging opportunities in US, in wake of the government ambitious eHealth investment plans?

US is going through very exciting times in terms of healthcare transformation.

1. The Physician practices suddenly have become a very large Healthcare-IT market in USA! The power base has shifted. I remember the book Power Shift by Alvin Toffler.
2. Obama has put life back into Public Sector Health plans – Medicare and Medicaid!

So what is expected to change:

1. Pharma co: Physician reliance on pharma companies for drug education updates will reduce because they will get direct access to latest version of electronic drug databases in the EMR. Many EMR will have CPOE and Medication Management built into it, which will guard against unnecessary/ incorrect prescriptions. Crossselling and Up-selling of drugs will get minimized. However the drug compliance will go up in chronic disease management.
2. Insurance: Private sector Health Plans will have to compete with Public sector Health Plans for their bread-and-butter. US has a fairly large population that can fall under public health plans uninsured,underprivileged, and aged.
3. Hospitals: Will have to figure out how they can increase their practice on public health plans – Medicare and Medicaid. They will also have to depend more on Physicians that already have a greater mix of Medicare and Medicaid practice.
4. CDC: Public Health initiatives and Disease Surveillance will gain power because they will start getting valuable Public Healthdata through public health plans such as Medicare and Medicaid. So far private enterprises have been reluctant to share disease, prence and outcomes data.
5. Healthcare Economics: will shift towards measuring clinical outcomes rather than business value. Public Health, Disease Management and Preventive Medicine will gain.
6. M&A: New business models and major consolidations should be expected. I can see Pharma companies and Insurance companies buying out EMR/EHRS, Healthcare-IT companies [which one, I keep guessing..].

Infosys is watching the emerging changes and is prepared to offer solutions and services tailored for physicians, hospitals and payers, especially

1. EMR implementation and support,
2. Integration of EMR to enable record sharing (as and where appropriate)
3. Analytics and reporting for enabling meaningful use of EMR.

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