December 2012

IT for Healthcare Delivery

When the Prime Minister announced,in his Independence Day address of 2011, that health would be among the foremost priorities of the 12th Five-Year Plan (2012-17), it was both an admission that health has been hitherto an area of great neglect and a promise that policy would now accord it the priority it deserved. Are we now on that path? And how technology can come handy in taking us on that path, heres a report!

dIgitalhealth

Vision for all inclusive healthcare
Charles J Antony
Former MD & CEO, TATA,
Council Member & Educator,
Gerson & Lehrman Group

If you look at todays standards, India will equate its healthcare professional ratio to the number of patient in year 2022. Hospitals to fulfill this demand is impossible because the demand is too much than supply. The geographical and rural footprint for healthcare is not adequate. 70 percent of the population in India is rural and there is no way of reaching doctors who are living in urban areas. So a sector of population in India do not get proper healthcare. Technology has to fill this gap especially in large private hospitals. So far, they all have failed due to non capability to capitalise the opportunities, poor quality of healthcare and non-transparent pricing. In last 50 some years, the big private hospitals could not able to rise up the challenges or create some regulations and standards. Nowadays, hospitals are forced to optimise their operations for profitability and customer satisfaction for survival. There are lots of push and pull in the whole landscape where we have to perform like any other corporation. The growth of specialised healthcare facilities, as retail healthcare is booming in India. There are lots of hospitals that are coming up with 100 beds, 200 beds or 75 beds all are specialty centers. So lots of specialised healthcare is coming. Consumer empowerment is now the trend among the masses as everybody has access to a smart phone, ipads for maintaining their health record, blood sugar level, stress level and self monitoring.
The Integrated healthcare eco-system is now cloud based. This is a much untapped green field where the major IT companies are not able to capture big private hospitals. Government is struggling on their own way, so there is a need
to open the doors for small players to get into the market and optimise. The biggest challenge is the enormous data that comes from various different sources. People do not want to spend unnecessary money,but they want access to anywhere anytime at optimal cost. There are 3G, broadband, Internet; social media etc which are playing very active role to move forward that something you cannot avoid. So now these elements like cloud computing, social media, smart consumer access are coming together and completely changing the landscape and this brings to us as an interconnected world. In the next few months we will play a very active role how to change the landscape and take it to next level. TATA launched Pan India, mHealth pan for 150 million subscribers also done through 3G telemedicine phone once the need for the pan was generated.

Healthcare in Tamil Nadu

dIgitalhealth

Pankaj Kumar Bansal
Mission Director.
State Health Society & Project Direct
Reproductive & Child Health Project,
Tamil Nadu

ICT department in the healthcare sector of Government of Tamil Nadu runs 18 Government colleges with 41 hospitals, 267 secondary care Government hospitals and 1600 plus primary health centre. All these are managed by the different directorate. We are having 32 revenue districts but we have made 42 health districts. We are running 17 verticals in the health department where the different directorates take care of the different departments. If you see the vital statistics of Tamil Nadu as on today we are among the bigger states standing second in all data after Kerala. Our IMR is 22, MMR is 72 and TFR is 1.7 only. We are processing six initiatives taken by the Government of Tamil Nadu. First five are already implemented and 6th is in the process.
The other part is Mother and Child Tracking System (MCTS) we started it with name called (PICME) Pregnancy and Infant Cohort Monitoring and u-ation and it started in 2008 in Tamil Nadu till date we have registered 35 lakh mothers into this system. Just by entering the PICME number you will find all the details available within the system. Monitoring System(MRMBS) under this for each pregnant mother Rs 12000 is provided as a maternity fee and this is totally a paperless system. We have received Rs 660 Crores transaction online during 2011-12 in maternity benefits scheme. The next is Chief Ministers Comprehensive Health Insurance Scheme and our budget is around 750 crores. It is a smart card based which has 64kb storage capacity and Scostas specification for the card. If we see today 179000 claims has been processed and Rs 416 crores has been transacted through this system is totally paperless.Finally we are going to establish our State ealth Data Resource Center (SHDRC) with the support of ICMR, World Bank, NRHM and state government this system analyse the data, process the data which will help at state level in policy formulation, policy changer and intervention on day to day basis all details will be available here.

We need to build sensitive healthcare institution
Fr Ferdinand Peter
Director,
Bishop Benziger Hospital

The Benziger Hospital was established in 1948. Our hospital is the very first private hospital in Qulin, Missouri. Today it has grown to become a 600 bedded
multi and super-specialty hospital having all the major departments, modern equipments, facilities, eminent doctors and efficient paramedical staff. It is a venture aiming at the integral development of the people who live in the neighboring villages. Community radio is the latest of the many innovative initiatives of Bishop Benziger hospital in its constant attempt to reach out to the community around it. It is hoped that this new venture will complete and complement the already existing services rendered by the hospital through its community health centres.
A community radio is a platform to voice the common issues of a particular community living in a specified geographical area irrespective of religion, caste, community, colour, age, education, or profession. Bishop Benziger was responsible for introducing professional nursing in the hospitals of Kerala. When opportunities became open for the private sector to start radio stations, Bishop Benziger hospital found a long awaited opportunity to fill in a lacuna i.e. a communication component in its development projects. Hence community radio became complementary in the efforts of Bishop Benziger Hospital.
Radio Benziger was awarded second place at the national level by the ministry of information and broadcasting in the category of community engagement, In less than two years of broadcasting history, nearly 2,50,00 people have participated in the radio programmes.This is the first radio in India to broadcast marine weather and marine safety tips on a daily basis in association with INCOIS,Hyderabad. The radio programmes succeeded in building awareness among the public about pollution control, waste management, traffic safety, pulse polio, TB Filariasis etc. We feel a healthcare institution is able to be sensitive to the needs of people only through feedbacks.

A cross sectional descriptive study in District General Hospital Trincomalee in Sri Lanka

Dr Ayanthi Jayawardena
Medical Suprintendent,
Base Hospital Deniyaya,
Sri Lanka

The Epidemiology Unit in Sri Lanka with the collaboration of WHO initiated Electronic Hospital Information System (EHIS) in 2005 in several Base Hospitals. Under this project, new software and system hardware has been installed but it was complex, was not popular among hospital staff that led to failure of the system. The new software was introduced to the hospitals in Northern and Eastern provinces called Multi Disease Surveillance System (MDS).
As the country is aiming towards eHealth and paperless hospital information system it is important to study the system to understand why it has succeeded while others failed. It was completely a paperless system running at the OPD. This system was password protected. Each member of the staff of the DGH Trincomalee was given a password to enter into the system. After this initial step of registration at the OPD, the hospital Patient Identification (PID) number was automatically generated. This PID number was used in subsequent visits of the patient to retrieve previous records. Medical officers have full access to the system. The OPD computers were directly connected with the main laboratory, therefore prevented duplicating laboratory reports on the same patient. At the pharmacy, a pharmacist/ dispenser issued drugs according to the prescription and automatically stock balance of a particular drug appeared. A competent doctor who is familiar with the system can enter details of the patient within ½-1 minutes. It takes longer for examination of the patient and then doctor can spend the saved time with patient.

Ergonomic technologies for healthcare practices

Pradeep Balachandran
Health Informatics, C-DAC,
Thiruvananthapuram

We are trying to leverage the potential of automatic speech recognisation. Here, technology like Voice Interface Systems can act as an alternative input modality to existing system. If we apply the conventional input modality systems like voice Interface, where automatically speech converted to text and get suppose to the database. There are special context where doctors need an area to fit in descriptive text. Core technology is the Automatic Speech Recognition if we skip the technology part, the Auto-matic Speech Recognition (ASR) is being formulated as a supervise pattern. There are two parameters- Word Accuracy or Word Error Rate and Response Time. So what is the essential ingredient for that? It is the data. So if there is the facility you can plug in to ease the flow of data and given such technologies which can positively play role then it should be appreciated. So the greater goal is to promote wider adoption of electronic health record with the use of ergonomic technologies.

Implementing IT is very important

Dr Parvez Ahmad
Group Medical Director, Rainbow
Group of Hospitals, Hyderabad

IT helps a patient before he/she steps in the hospital and when steps out too. For driving better healthcare services, six parameters that include quality, safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity is important. Wide role of IT is implemented in front office, inventory, human resource, application management, finance and budgeting, life science, clinical management and ancillary modules. Now mHealth is coming very aggressively. The top five mHealth areas of applications are appointment scheduling, patient information, tracking the patient, patient records and patient monitoring. We have designed Centralised Telephone Based Appointment System at Rainbow Hospitals. When a patient schedules the appointment, the system generates an SMS automatically. Video conferencing system plays a major role in medical consultation, treatment, meetings, trainings and demonstration of live surgeries.

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