April 2014

Quality Healthcare is High-Tech with Human Touch – Madhav Chablani, ISACAs External Advocacy Committee and India

Madhav Chablani, member of ISACAs External Advocacy Committee and India Task Force talks about the expanding role of IT in healthcare, and its aim of unifying all aspects of healthcare to serve the patient better


Growth of healthcare segment in the IT market
Information is a key resource for National Healthcare Service, and from the time it is created till it is destroyed, technology plays a significant role. Information technology has advanced and is at the forefront of technology adoption in hospitals for providing highest level of patient care and safety, healthcare delivery and quality information to patients as well as all concerned external and internal players.
With increasing information dependency and healthcare players not sharing information, the National Healthcare Service will be influential. Currently, all programs, directorates and states have their own IT solutions. These systems are not shared and complete information is fragmented. Coordination is lacking and is a major hurdle in providing quality information to improve decision making in healthcare sector. Standards for Information Architecture, Data Interoperability, National Disease and Service codes are lacking. Applications are not developed for National Healthcare Service but for the programs or enterprise.
While designing a healthcare architecture, the focus should be on information exchange which flows down to all programs, directorates and state initiatives and systems that comprise the health system. While capacity building for healthcare IT change management is limited, for IT processes improvement and transformation, it is either not done or limited. The industry players are striving hard to achieve their strategic goals and realize healthcare delivery benefits through effective and innovative use of IT, while achieving operational excellence through reliable and efficient use of technology, at the same timecontaining IT-related risksto an acceptable level, and optimizing the cost of IT services and technology, and complying with ever-increasing relevant laws, regulations, contractual agreements and policies. It is becoming pertinent for healthcare organizations, for their IT governance and management needs and value delivery, to adapt business framework like COBIT 5 from ISACA.

Hospitals going all-digital and installing RIS/PACS solutions
Technology is not a replacement for the human touch, but rather a powerful tool to increase quality and improve the patient care experience. Radiology has long deployed effective IT tools”RIS, PACS, voice recognition, 3D, enterprise storage and EMR” but now fiscal, political and demographic pressures are pushing departments, facilities and imaging centers to seamlessly integrate these technologies to maximize productivity and patient outcomes.
Another ingredient for thriving is a proactive technology vision and vigorous data mining and reporting. The epicenter is the radiologist, who needs the right information to flow instantly”as one open, unified,webbased view of the patient that includes images, relevant priors and current care data. But the whole operation must work with precision and speed. Ordering protocols must be set, scheduling must be efficient, patients need to move through the department quickly, comfortably and safely, and reports and images must be returned to referring physicians as quickly as possible. Tracking key metrics and adjusting to increase productivity and efficiency is becoming important. They are dissecting workflow, developing new processes and teaching employees to assist the department in reaching their productivity goals. Measure, learn, modify, and succeed.True, quality healthcare is high-tech with a human touch.

The role RIC/PACS plays in the transformation of healthcare
I believe there are three main areas of initiatives that can enable this next significant leap in productivity, viz, One Desktop, One Patient and One Community. This brings together the information, workflow, and tools to allow radiologists to continue to practice high-quality healthcare with speed and precision, and IT solutions are the enablers of this vision.
One Desktop means that the radiologists tools”RIS, PACS, voice recognition, enterprise storage, 3D and EMR”are seamlessly integrated so that the radiologist isnt logging-in multiple times, or re-identifying the patient, or dictating information the system already knows, or forwarding the images to multiple places. Also, the vendors product must be open to enable departments to plug in applications from other vendors or home grown applications seamlessly into it. It must be web-based, so that the radiologist can access his work from the hospital, home, imaging center, across town or across the world.
One Patient means that the radiologist sees the whole patient. Hospitals and imaging centers consolidate images and reports across institutions and medical record numbers to present to the radiologist. The time is ripe for image exchange and single patient-jacket type offerings to put an end to the DICOM CD. It also means full digitization of a patients images”currently radiology and cardiology, but soon digital pathology, visible light images, endoscopy movie files, all stored in a multi-purpose archive and plugged into the hospitals EMR.
One Community provides workflow tools to bring the healthcare community together. From the moment a physician orders an examination, the decision support that informs that order, the scheduling, the actual exam, the reporting system that effectively and quickly captures the radiologists diagnosis in text and discreet equality data using Natural Language Processing, and the channeling of the report, images, and any discrete results back into the originating physicians EMR. Community workflow must bring radiologists together as well. With sophisticated dynamic workload allocation, radiologists can form a virtual department that can read for many hospitals using sophisticated rules around turnaround time commitments, workload mix, specialty and credentials.
The One Desktop, One Patient, One Community vision bringstogether many technologies that already exist, but also many thathave yet to become mainstream. I am convinced that effectively delivering in these areas will double the productivity that the radiology community is depending on to stay ahead in the constant demand of imaging.


With increasing information dependency and healthcare players not sharing information, the National Healthcare Service will be influential

The future of healthcare IT market and growth contributors
Information is critical for informing the diagnosis and initiating therapy. We have to be ahead of the process and not behind it. We need to provide productivity and functionality that enable physicians to take care of patients in a very efficient manner.
Achieving maximum productivity among radiologists is a constant process that requires enterprises to juggle multiple inputs, include technology and processes. It is essential to plan each step and analyze its impact. A robust workflow image and information system portfolio provides a solid platform that not only provides features and functionality to maximize productivity, but also allows healthcare enterprises to further improve productivity
We see too many independent vendors selling products that lead to loss of productivity for the radiologist, either because they dont get integrated into the existing PACS or RIS, or require a different solution for almost every type of application.

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