There has recently been a surge in the implementation of information and communication technologies in hospitals and healthcare facilities across the globe. In an effort to track this trend, eHEALTH brings you a comprehensive coverage of the extent of ICT usage in healthcare in its Health CIO Outlook 2010 report.
The aim of preparing this report was to capture the mindshare of CIOs and senior IT utives of India’s leading healthcare organisations. The CIOs shared their perspectives on issues pertaining to IT strategy, technology roadmap, purchasing trends, uation priorities and a host of related aspects that concern the modern healthcare industry.
The Health CIO Outlook 2010 Report comprises of the results of the responses received from CIOs of some of the leading hospitals in the country and provides an overview of the recent patterns in IT implementation in hospitals and healthcare facilities.
“A plethora of software options are available these days that add to the confusion of hospitals that have to choose the best solution that fulfils all their requirements. Given an option, almost 70 percent of hospitals would prefer a solution that is customized as well as a COTS software. “
All hospitals reported that through implementation of an IT solution in the hospital, they look for enhancement of overall quality and customer satisfaction. Seventy five percent of the hospitals follow the IT implementation approach to achieve standardization of their internal processes, while almost 60 percent reported that their ultimate objective is to achieve long term strategic value. Also, while choosing a vendor, more than 50 percent of the hospitals choose end-to-end deliverers, while none of the hospitals give cheaper solutions more preference. While choosing a software, the hospitals prefer a solution that is a mix of commercially available off-the-shelf software as well as a solution that is customized as per their needs. Interoperability with IT solutions in affiliated/partner hospitals is also a criterion. Although no standardization guidelines for health IT have been set, yet hospitals across the country are looking for solutions that are compliant with all.most common health IT standards laid internationally.
Macro Objectives of IT Implementation
On being asked to respond on their macro objectives for IT implementation, almost 60 percent of the hospitals look at achieving long-term strategic value, in contrast to the remaining 40 percent that are only aiming for short term departmental process improvement. This implies that a greater number of hospitals in the country are currently aiming at deploying IT solutions for achieving long-term benefits for their business.
Benefits of IT Implementation
In terms of the basic objective, 75 percent of hospitals deploy health IT solutions for standardization rather than flexibility. Most of them, hence believe that by achieving standardization, they will be able to extract most out of their health IT solution.
Basis for Choosing an IT Vendor
A number of vendors in India are offering varied health IT solutions to fulfil different needs within a healthcare facility. The products and solutions offered by them range from basic EHR/EMR solutions to more comprehensive and customized solutions that computerise the entire functioning of a hospital ranging from administration, laboratories to patient records and files. It is evident from our survey thatÂ 60 percent of the hospitals are looking for an end-to-end deliverer who is able to satisfy all their IT requirements, while almost 43 percent of hospitals have also expressed their interest in best quality providers.
A plethora of software options are available these days that add to the confusion of hospitals that have to choose the best solution that fulfils all their requirements. Given an option, almost 70 percent of hospitals would prefer a solution that customized as well as a COTS software. The remaining 30 percent would either opt only for a COTS software or a customized solution.
Preferred Level of Interoperability of the Software
While choosing an IT solution, a lot of importance is given to the interoperability of the solution whether with the existing IT solution, with the IT solution in affiliated/partner hospitals, or with an IT solution of all other hospitals. Most of the hospitals, replied that they would prefer a system that is able to interoperate with the IT solution deployed in other affiliated/partner hospitals. The rest, however, would either opt for a interoperability with an existing IT solution of with IT solutions in other hospitals.
Requirement for Standard-based Software
There are a variety of standardization protocols available for Information Technology solutions. These include-ICD, IHE, SNOMED, HL7 and DICOM. Seventy five percent of the users said they would prefer a software compliant to all or most common health IT standards, while some said they would be satisfied with only an ICD or HL7 compliant system.
Dr. Karanvir Singh
Head Â HIS Implementation,
Sir Ganga Ram Hospital, New Delhi
“Computerisation of Sir Ganga Ram hospital is aimed towards improving patient care by making the right information available to the right care providers at the right time, even though this may necessitate utilization of increased number of human resources and altered workflows. It is also aimed at improving hospital functioning through better management information of hospital functioning so that bottlenecks can be identified and utilization of resources optimized.”
CIO,Calcutta Medical Research Institute, Kolkata
“IT roadmap in healthcare information technology has evolved from being just a facilitator to an important driver of care and business. Health information technology is increasingly seen as a critical tool to help contain healthcare costs and improve administrative efficiency, while enhancing patient safety and quality. Hospitals can establish their IT roadmap through giving importance on specific areas like consumers (patients and doctors), pharmacy, behavioural health, long term care plan, and public health, etc.
In a large multi-layered hospital which devotes considerable emphasis on patient care. The short term objectives of the on-line computerised system are to reduce costs and improve the accuracy and timeliness of patient care, accounting and administration, record keeping, and management reporting. The long term goal is to build and maintain a patient database for analysis of data to facilitate clinical and non-clinical decision making process.
Since eHealth is a 21st century’s approach to healthcare deliverables, it’s the possibility of healthcare deliverables with minimal touch or minimal physical communication in a fast and effective way. Desired deliverables from eHealth in an organization are as following:
Increased efficiency and decrease costs by consolidation on various IT systems and bring them all on a more uniform platform.
Enhanced quality of care by providing best of IT support at points of care and sale.
Setting standards with information exchange and communication within organization.
Leaping out of the conventional boundaries of healthcare and set phase wise focus on aligning and implementing newer systems dedicated toward the approach of minimal touch.
Making e-health interventions more evidence based.
Empowerment of consumers and patients by making knowledge bases of medicine and personal electronic records accessible in electronic form.
Equality in health care at all levels.
The focus of IT is to now widen the scope of healthcare deliverables from Curative to Proactive wellness approach and to channelize the resources available with the healthcare delivery system towards the effective new approach wellness care.”
Manager – Systems,
Apollo Hospitals International Ltd., Ahmedabad
The information strategy is challenging. Our ability to work effectively is largely dependent on our information systems. We intend to sustain end-to-end collaborative information systems where all stake holders could create and access information.
Providing patient care is a complex endeavour that is highly dependent on information. To provide, coordinate and integrate services, healthcare organizations rely on information about the science of care, individual patients, care provided, results of care, and their own performance. Like human resource, material and financial resources, information is also a resource that must be managed effectively by the organization’s leaders.Â Every organization seeks to obtain, manage, and use information to improve patient outcomes and individual and overall organization performance.
Over time, organizations become more effective in:
Identifying information needs
Designing an information management system
Defining and capturing data and information
Analyzing data and transforming it into informatio
Transmitting and reporting data and information
Integrating and using information
Although computerization and other technologies improve efficiency, the principles of good information management apply to all methods, whether paper based or electronic. These standards are designed to be equally compatible with non-computerized systems and future technologies.
The information process in a healthcare delivery comprise of various components like, data captured from the patients, visitors, doctors observation, treatment and procedures done, result of various investigations, images, clips, audio etc. All these heterogeneous components culminate to a ‘Digital File’ (Patient Record) for a person or patient. Computerization is essential for any organization to effectively store and retrieve these digital files. In order to complement and support growth of the organization, MI division must have a definite structure and framework. The specific guide lines for functional components of the information system are made to avoid or minimize ambiguity.
Our strategic IT vision is to support growth challenges of the organization and to align with group IT initiatives.”
Head – IT,
Asian Institute of Medical Sciences, Faridabad
“Our vision is to try to provide a solution which will make the hospital 95% paperless and 10% manual dependent. Our strategy is to ensure the delivery of our vision to the organization.”
QRG Central Hospital and Research Centre, Faridabad
“I envisage IT to be an integral healthcare solution to the communities by interlinking all healthcare providers and the related government and non government agencies. It should encompass business intelligence for decision making based on the various quality and performance indicators, data analysis based strategy formulation, quality standardization to provide customer and employee satisfaction, compliant to all healthcare laws, bye laws and standards. The software should provide security and safety to the EMR/EHR. It should be user friendly and suggestive for process improvements. I wish that IT should be instrumental in hastening the service delivery and data recovery. The healthcare personnel and the patients should receive mobile alerts on their cell phones about the diagnosis and management of ailments. In general IT should be the breakthrough in providing healthcare anywhere by innovating and integrating all the related systems.”
“Our vision is to enable our internal customers to provide highest standards of medical service to patients. Towards this end, we have embarked on an ambitious project to provide an electronic health record system for standardization of care delivery and reducing medical errors.
Again, to be able to support such a critical and mammoth system, the infrastructure and support required is of a high order of magnitude. Therefore, we have taken a strategic decision to outsource IT service and delivery to our partners DELL Perot Systems as a long term relationship.
We wish to provide a seamless infrastructure across all our facilities, so as to ensure that there is a continuity of care for the patient, no matter which Max facility he/she visits. Therefore our systems and network are designed to provide a real time view of any Max patient record on demand.”