HOSPITAL INFORMATICS
​
Important factors for adoption of an EMR
Dr. Rajesh Gupta, Healthcare IT Executive

The hospital, as we know of today, has become a great mammoth which requires hell lot of resources to tame and keep under control such that it is able to generate value for all its stakeholders. Information systems play a pivotal role in taming this great mammoth.

A need for having a good information system is not just limited to big hospitals; but small hospitals, nursing homes and clinics also require information systems to achieve excellence in patient care, clinical standards and business functioning.

From outcomes perspective, many studies have shown that Health IT has the potential to enable a dramatic transformation in the delivery of health care, making it safer, more effective, and more efficient (i). Taking lessons from developed nations and looking at the trends, in future healthcare IT is not going to play a side role but it is going to take a central stage in all healthcare business operations. With this background, it seems to be a crucial time to come up with National Health Information Technology policy, guidelines and standards to ensure uniformity in HIT adoption and use across the country.


The Unrealised Requirement of Healthcare IT
The use of information and communications technologies (ICT) has been considered to be fundamental to the concept of integrated care, considering the needs of patients, rather than institutions, and introducing a ‘whole system’ approach (ii). The adoption of carefully thought national health IT plan will result in a win-win situation for all the stakeholders.
If adopted in a meaningful way, IT systems have potential of relieving physicians from routine documentation and other clerical functions. It helps the hospital to cut down on the paper work; sparing more time for patient care, reducing errors and increasing accuracy in transmission and storage of data. IT systems enable establishment of consistent clinical standards across the
enterprise and practice. Easy and direct access to varied information regarding patient through remotely located terminals and even on mobiles helps in achieving highest level of continuous monitoring and clinical decision making.

The growth of the Health Insurance industry is closely tied to the way the hospitals and other providers manage health information and provide it for claim reimbursements. Higher the effectiveness of claim submission and claim processing, the better it will be for all the parties involved. The patient gets his insurance benefits without hassle, the hospital can keep the denial rate low and the insurer/third party can be assured of fairness without asymmetry in sharing of information.

Current Scenario
The Health IT adoption in India currently is based on business need rather than regulatory requirement. The use of HIT is concentrated in Tertiary and Secondary setups but Primary setups and clinics are yet to reap the benefits. The main reason behind this is that the awareness about potential benefits has not yet percolated to the medical professional community who are the business drivers in clinics and primary setups (iii).
Corporate tertiary hospitals have been pioneers in adopting world class Health IT systems, for which they have also received the rewards in terms of return on investments and being able to provide high quality of care.
Government hospitals are lagging far behind in meaningful adoption of HIT. A strong requirement has been felt though by the government setups in various states and each is taking action based upon its perceived need. Because of lack of guidelines and central leadership we are seeing fragmented efforts in various quarters. Below are a few examples of Health IT implementations in government setups (iii).
  • Wipro for Delhi Municipal Corporation: Hospital Information System for 6 hospitals under DMC
  • TCS in Tamil Nadu: Solution to maintain electronic medical records (EMR) for government setups
  • 21st Century Health Net in Goa: Hospital Management Information System (HMIS) called Health NET in Goa Medical College (GMC) Hospital.
  • HP in Maharashtra: Automation project of 19 Govt. hospital and 14 medical colleges
The trend which is apparent is that we are proceeding towards a system with isolated health networks which are becoming silos of precious public health information. This information can be easily utilized for the benefit of the populace and healthy functioning of the healthcare system. The state should act as binding factor in the current fragmented situation by coming up with guidelines and regulations. Health information existing in silos in hospitals should be used for state reporting purposes resulting in awareness of health status of the country and more responsive policy decisions.

The gap is so obvious that private firms have taken this up as business opportunity and come up with business models to fill the gaps. One of the commendable examples is “HealthHiway”, a joint venture between Apollo and IBM India. It is a cloud-based Health Information Network which hosts value add applications and enables seamless exchange of information between patient, doctors, hospitals and Insurance companies.

Expectations from the Government
Currently Healthcare IT does not figure on central government’s strategic map for Indian healthcare.
Following are few expectations from the government so that we can get a uniform direction for
systemic implementation and not an unplanned development.
  • Data and system standards to allow for a cohesive, nationally-led IT architecture such that healthcare information can flow seamlessly
  • Provide essential infrastructure and security
  • Coordination of resources
  • Sensitizing the health workforce
  • Funding or Tax rebates to enable the adoption across all quarters

Why it is crucial and right time now?
Looking at the current developments in the Health IT landscape, delay in coordinated efforts will
lead to further divergence which could be difficult to deal with later. Infrastructure wise we have all
the ingredients available for a perfect recipe.
  • Technological Expertise
  • Good internet infrastructure across the country
  • Skilled and trained manpower
  • Acceptance of IT as a tool for business transformation
  • Increasing willingness for adoption among professionals
All we need is a coordinated effort and a directional leadership which could steer us towards an integrated health system so that the population can reap the benefits.

*The views expressed here are those of the author alone and do not necessarily reflect the views of his organization.

(i)  Costs and benefits of health information technology- Shekelle PG, Morton SC, Keeler EB.
     Evid Rep Technol Assess (Full Rep). 2006 Apr;(132):1-71. Review.Pubmed
(ii) Sir Derek Wanless, “Securing Our Future Health: Taking a Long-Term View,” An Interim Report, HM Treasury,
​November 2001, http://www.hmtreasury.gov.uk/consultations_and_legislation/wanless/consult_wanless_interimrep.cfm
(iii) Current e-Governance Scenario in Healthcare sector of India
     Subash Chandra Mahapatra;Rama Krushna Das, Manas Ranjan Patra,Computer Society of India

Contact: drsandeep.net@gmail.com

Disclaimer: The views expressed in the article are of the author and does not reflect the views of hospitalinfrabiz.com

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