Dr Amardeep Singh Kohli, Medical Superintendent, Medanta, in conversation with Shahid Akhter, ENN, discusses the IT solutions that finally culminate in improving patient care and clinical care
What are the challenges of Health Information technology?
It begins with high investment costs and concerns about revenue loss from lower productivity during the transition phase. Add to this consumer concerns about the privacy and security of their data and lack of uniform privacy laws and data disclosure requirements governing electronic information exchange across states and jurisdictions. There are variations in agreed-upon technical standards for interoperability, which provide a pathway for how to transmit and receive data between different HIT systems, and inconsist- ent implementation of standards by vendors and health systems.
What are the prime concerns about Privacy and Security in Health Information?
Some of the major concerns are rolebased security. Users should have different levels of security, based on their job function. It sounds intuitively obvious, but most medical practices â and most businesses â do not carfully control who has access to whatdata. It is relatively straightforward to do this right. However most Sys Admins dont, which jeopardizes the security of their system. In healthcare, and in business in general, it violates IT best practices.
Data backup plan. Here again, this sounds obvious to anyone. But many medical practices and many businesses â do not do this properly. We have seen backup systems that have been failing for months, backup systems that are not set up to back up allcritical data, and backup systems that overwrite the backup system every day. Data backup systems should be designed to periodically back up data to external media. The exact rotation (daily, weekly, monthly) depends on how frequently the data changes, and how much appetite the practice has for lost data since the last backup.
Strong user names and pass- words: Most people â both inside and outside of healthcare â use simple passwords that can be easily guessed,e.g. date of birth, etc. And because jobs are frequently shared by multiple part-time employees, and some- times to avoid licensing costs, many healthcare entities will use generic or shared user names, like Nurse Station or Billing. This is a no-no, especially in conjunction with easy to guess passwords. Passwords should have a minimum of 6 characters, and should be a combination of letters, numbers and symbols.
Protection against malicious software & software patch management. Most medical facilities fail to keep their systems updated and their operating and security software patched.
Facility access controls and physical security. Many times servers and data storage systems are not properly secured. They may be in a common area, in the kitchen or supply room, under the front desk or even in a hallway. Core IT systems should be located behind locked doors, with access only by those with a legitimate need.
Network security: One need multiple layers of security. If one fails, others still stand.
Network security is accomplished through hardware and software many network security threats today are spread over the Internet. The most common include viruses, worms, and Trojan horses; Spyware and adware; Hacker attacks; Denial of service attacks; Data interception and theft; Identity theft; Anti-virus and anti-spyware; Firewall, to block unauthorized access to your network; Intrusion prevention systems (IPS), to identify fast-spreading threats, such as zero day or zero-hour attacks; Virtual Private Networks (VPNs), to provide se- cure remote access
How has the IT helped to channelize the flow of information between the hospital, doctors and patients?
It goes without saying that more and more people are using the Internet to research their medical issue. Thismeans not only looking for symptoms but exploring treatments and medicines on the web. While it is never a good idea to skip out on the doctor completely, the internet has made patients more empowered to make decisions about what to do next. Healthcare facilities are using social media to establish contact with patients, launch public awareness campaign & perform community outreach.
IT adds to better treatment and less suffering by providing new ma- chines, medicines & non- invasive treatments that save lives & improve chances of recovery. It adds to improved patient care and work efficiency. Doctors and nurses use hand held computers to record a patients medical history and check that they are administered the correct treatment. Results of laboratory tests, record ofvital signs and medicine orders are all electronically put into a main database that can be refereed to later.
Doctors are easier to reach and are better at their jobs. Technology has also enabled doctors to use emails, tests, videos and conference facilities to consults colleagues from all over the world. The practice known as telemedicine is especially useful for doctors& patients in rural and under developed areas. Online database can accurately predict medical trends. This break- through will help medical experts respond to an outbreak quickly as well as take preventive measures.
“IT adds to better treatment and less suffering by providing new machines, medicines & non- invasive treatments that save lives & improve chances of recovery”
The value of cloud in Health care?
In Healthcare cloud takes many forms, but the private cloud is among the most common for line of business application. One needs to keep inmind the security of the data as confidentiality of patients related data is very important. Because of the stringent security and privacy needs, it is important for healthcare organizations to carefully select vendors that specialize in the Healthcare industry, and are compliant with the various regulations and guidelines relevant to this industry.
Cloud computing applications for the Healthcare industry are typically less expensive than the legacy applications that they replace, and offer organizations much more flexibility in where and when they can be used. Cloud computing also makes it less challenging to grow your health care organization, including setting up new offices, forming partnerships with other healthcare organizations, or setting up a brand new practice.
What are the unique initiatives you have adopted at Medanta – the Medicity?
A number of IT initiatives can be seen at Medanta. Hospital Information system which is integrated with Outpatient department, Inpatient department, Laboratory, Blood Bank, Radiology etc. Picture Archiving and communication system (PACS) where in a physician can see radiology images anywhere in the hospital and thereby increasing the efficiency.We use SMS Gateway to send SMS to patients while admission, discharges etc and to internal staff for different type of alerts like financial clearance etc.
There are digital Information Kiosks, telemedicine projects, E-pre- scription, Patient Portal, Mobile apps and Integrating Quality (JCI& NABH) standards.