Information and Communication Technologies (ICT) have become an essential part of modern healthcare delivery systems to gain greater efficiency, reduce overall healthcare costs and improve patient safety

By Sangita Ghosh De

Following to the necessity of the services, the adoption and acquisition of information technologies in the recent years by the healthcare sector has increased rapidly and substantially with an escalated spending of course but showing an upward tendency placing the industry as one to the major consumers of ICT products and services in India as well as global.

The healthcare organisations are investing in technology because it is now understood that technology is a key enabler and cannot be ignored if one has to scale up and manage up to a network of hospitals. The market for affordable healthcare in India is growing rapidly, say researchers and experts. The upwardly moving graphs show a very optimistic picture about this sector as an area for growth and investment opportunity as well as for the social impact that it could have on millions of lives in the country where affordable healthcare for the under privileged section is still inaccessible. Although it is said that affordable healthcare players in India are still testing various models to reach to the poor and rural segments of the population, a much needs to be done before one can say that affordable healthcare has figured out how to scale up, experts are upbeat about the segment, though. “There are challenges in implementing technology in hospitals. Inadequate computer knowledge at senior levels, large patient volume, focus on only clinical care and not teaching the needs of the patients and lack of training of medical staffs, accumulation of huge paper records and additional software and hardware costs are problems,” commented UK Ananthapadmanabhan, President, Kovai Medical Center & Hospital, Coimbatore.

Background and opportunity

Theoretically health information technology (HIT), in general increasingly viewed as the most promising tool for improving the overall quality, safety and efficiency of the health delivery system providing an umbrella framework to describe the comprehensive management of health information and its secure exchange between the stakeholders viz. patients as consumers, providers, government and quality entities, and insurers. A wide and consistent utilisation of HIT involves improved health care quality, prevents medical errors, reduces health care costs, increases administrative efficiencies, decreases paperwork, and expands access to affordable care.

According to Sangita Reddy, utive Director, Apollo Hospitals, “Appropriate application of technology in the form of Hospital Information System (HIS) in every step of healthcare needs innovation and proper flow of information enabling it more acceptable, sustainable, affordable, patient centric and efficient.”

Advancements in healthcare IT have also improved access to medical care, making high-end treatment and diagnosis more cost-effective to patients across hospitals globally. Applications like EMR, EHR, CPOE and physician practice management systems are used by both clinicians and larger healthcare providers to offer improved patient care. Imaging applications like PACS and RIS are used to manage images or patient scans. The implementation of radio frequency identification (RFID) is expected to drastically improve the healthcare IT scenario with access to medical record systems and files at any given time. Development in picture archive and communication systems (PACS) has been another essential clinical IT solution for delivering better patient care.

As per research analysis the implementation of interoperable health IT improves individual patient care, and results effectively in public health benefits including early detection of infectious disease outbreaks around the country, improved tracking of chronic disease management and uation of health care based on value enabled by the collection of de-identified price and quality information that can be compared. According to Sanjay Singh, Head -IT, Sir Ganga Ram Hospital, New Delhi, in the modern hospital environment where information is running and being stored in bits and bytes, the underlying technological infrastructure becomes the ‘nervous system’ of daily operations and must be secured to insure day to day normal operations.

Market analysis

According to a new report by MarketsandMarkets, a research and consulting firm, healthcare information technology systems market will be worth US $53.8 billion by 2014. According to the research, the healthcare information technology market is estimated to grow at a CAGR of 16.1%. The market is expected to grow because of the growing demand for general applications, which includes electronic medical records, electronic health records, computerised physician order entry system and non clinical systems. Also, it is expected that the market for general applications will rise at an overall CAGR of 13% from 2009 to 2014.

As per research analysis the implementation of interoperable health IT improves individual patient care, and results effectively in public health benefits including early detection of infectious disease outbreaks around the country

According to Frost & Sullivan’s estimate, the HIT market (by revenue) in 2008, in APAC (Southeast Asia, China, Japan and Australia) was close to US $5.04 billion with an annual growth rate (CAGR) of 11.8% from 2005-2008. Although the APAC HIT market represents currently only 2.1% of the total global healthcare market, it is very likely that the figure could double if not triple that in the next 10 years.

According to Frost & Sullivan, HIT is here to stay with even more ubiquitous presence in all aspects of healthcare delivery systems. Moreover, it will be the main factor and driver in the transformation of healthcare industry towards translation care by providing common collaboration platform for information processing and exchange between related sciences and industries.
The implementation of HIT can improve the quality of care by providing better control which can come up to 80% because as per the industry rule healthcare services delivery organisation can become the subject of corporate negligence action if they violate the standard of care. But by allowing an electronic health record or other technology of its choosing as a part of HIT, these uncertainties can be avoided.

Healing touch

HIT is essential in dealing with the storage, retri, sharing, and use of health care information, data, and knowledge for communication and decision making that can be networked to build systems for moving health information. Therefore, informatics is yet another integral aspect of HIT. Broadly the key segments of the healthcare IT market are healthcare IT products like hardware, software, networks, radiology information system, PACS, healthcare IT applications like general applications, hospital applications, electronic prescribing system, ambulatory care management systems, laboratory applications, applications in clinical research, other related and supporting applications, and healthcare IT services that includes telemedicine, training services, implementation services, post-sales services, and consulting. “Clinical excellence and business efficiency in healthcare organisations show possibilities of growth only through IT as per current situations,” analysed Dr Uma Nambiar, CEO, SL Raheja Hospital in Mumbai.

In the United States, the Institute of Medicine’s (2001) call for the use of electronic prescribing systems in all healthcare organisations by 2010 heightened the urgency to accelerate all the US hospitals’ adoption of CPOE systems. In 2004, President George Bush signed an utive order titled the President’s Health Information Technology Plan, established a ten-year plan as this technology is essential to put the needs and the values of the patients first and gives patients information they need to make clinical and economic decisions. According to a study by RAND Health, the US healthcare system could save more than $81 billion annually, reduce adverse healthcare events and improve the quality of care if it were to widely adopt health information technology.

The classified applications for prescribing to include electronic medical records/ electronic health records (EMR/EHR), clinical decision support (CDS), and computerised physician order entry (CPOE). Applications for dispensing include bar-coding at medication dispensing (BarD), robot for medication dispensing (ROBOT), and automated dispensing machines (ADM), and defined tools for administration to include electronic medication administration records (EMAR) and bar-coding at medication administration (BarA). Healthcare IT solutions have primarily focused on addressing the administrative and financial processes of hospitals. However, adoption of IT by physicians is a challenge in the healthcare sector.

Healthcare providers are beginning to appreciate the role of IT in driving patient safety, quality of care and clinical outcomes, commented Rahul Chatterjee, Deputy General Manager & Head-Healthcare, Siemens Information Systems, India.

EMR/EHR has recently been centre point of discussion in almost all major medical issues in India. There is no doubt that it has to be implemented across all the verticals of healthcare service sectors but the debate remains in the timeline. The application, if implemented at large, will improve patient care, reduce healthcare expenses, and fundamentally change the way in which medicine is practiced in the country.

Scope ahead

The reason behind this is that the majority of software running in Indian hospitals does not have a useful EMR module. Either the EMR module is too rudimentary or is so user unfriendly that it is not practical to fill it for every patient. Also the incentive for entering data in an EMR is also very low, say the stakeholders. Its benefit to an organisation is low unless it also possesses means of extracting medical data in an analysable form. Very few EMRs have been designed to store data in a very granular fashion and very few organisations have the tools to extract the entered data in an analysable form, reviewed the users.

Liability related to the use of EHR could be prevented by the selection of an appropriate healthcare information system. Some other preventative measures include proper training of staff to ensure efficient use of system, documenting all information with justification, and preventing any further alteration to these records without proper documentation.

Nevertheless, experts expect cloud solutions to have a significant impact on health care organisations in the future -especially in a landscape in which 80% of IT organisations expect to increase spending on healthcare and clinical IT over the next five years.