4 cases depicting the ‘real’ healthcare world

By: Prerna Sharma & Ruchika Goel

Healthcare is not a privilege; it’s a right that every citizen should possess. But, there are many who are deprived of this right.

Varun Sood, CIO, Fortis Healthcare, says “There are three basic challenges that need to be addressed in healthcare: Accessibility, affordability, and quality.” Most of the people in India do not have accessibility to even the basic care. Inaccessibility of healthcare information to citizens and patients is one of the major challenges—patients typically have no visibility into availability of beds, blood, drugs, and equipments.

Further, affordability is always a challenge as the prices are very high, whereas quality is also always at stake because of quantity—the number of doctors and the beds available is very less compared to the patients. There is only one doctor per 1,700 citizens in India while the World Health Organization (WHO) stipulates a minimum ratio of 1:1,000. Further, the Union Health Ministry figures claim that there are about 6-6.5 lakh doctors available currently in the country and India would need about 4 lakh more by 2020.

Adding to it, Sunil Kapoor, CEO, Eternal hospital believes that long manual documentation, hand written prescriptions are still holding back Indian healthcare sector as compared to other countries. According to him, Indian regulations and the kind of volume the medical fraternity has to deal with are the two major factors contributing to it.

For instance, “If I go to a pharmacy to ask for a medicine, the computer will tell the chemist that the medicine is there in the shop but which shelf or row they still can’t tell. Today also the pharmacist has to remember that,” added Sunil. Pressure on both private and government hospitals is increasing immensely. Each doctor sees about 100 patients in four hours. That means, two minutes for each patient. In two minutes can he write the prescription on a computer? The volume is too high and the doctors are less. There is a lot of gap and that’s increasing and creating pressure on the system.

Technology Opens Up New Avenues for Healthcare From wearable devices to telemedicine, technology has changed the delivery of healthcare services. At one hand, telemedicine helps in reaching out to many people, while at the same time it also makes an affordable proposition as the doctors can utilize that time in something else and convenience factor for a patient goes up.

On the other hand, companies like Lybrate, Practo, etc, are connecting doctors and patients through health app and letting them communicate. It empowers patients to get the right advice at the right time and allows doctors to touch more lives.

Technology has taken these things amazingly ahead from where we were in the last decade. Today, we are talking about robotic surgery, or robot-assisted surgery, laparoscopic surgery, also called Minimally Invasive Surgery (MIS), bandaid surgery, or keyhole surgery.

So the world has changed in the last 10-15 years but the adoption of technology in healthcare has gone a little slow in the process side but it has taken leaps and bounds in the diagnostics side. Machines are fully computerized and can also generate amazing 3D images.

There are many real cases that are early adopter of technology and have revolutionized the way healthcare is delivered in India. After studying a number of cases, we have identified four real examples that stand out from the rest and are at the forefront in using technologies.

Medanta

Medanta is the first major hospital in the country to launch paid online video consultation service over the web. Having its telemedicine footprint in 53 countries, Medanta has

done over 10,000 video-based consultations out of which 20% are for international patients seeking experts’ opinion.

The hospital is also a telemedicine-enabled primary healthcare provider to 59 rural centers in the common services center network, a Government of India initiative. Additionally, Medanta is a design and implementation partner to the Central Asia e-Network, a Ministry of External Affairs initiative to facilitate medical tourism through telemedicine. Medanta joined the Vattikutti Foundation USA, to launch India’s first multispecialty multi-modality Institute for robotic surgery in November 2010 covering cardiac, urology, gynecology, and other super specialty surgeries.

It equips the surgeon with 3D HD visualization of the anatomy with enhanced dexterity, precision, and control with superior ergonomics and real-time interface from the robotic arm operating to the surgeon at the console to perform seamless surgeries.

It facilitates complex surgeries with minimum invasion reducing pain, trauma and the chances of infection which results in shorter hospital stay, benefiting the patient and enabling his/her early return to a normal life. Medanta has performed more than 1,800 robotic surgeries, the highest in Asia till date.

To capitalize technological advancement in mobile space, Medanta is developing an app for care providers to place orders from their smartphones or tablets. These orders will appear in the work list at the point of execution for faster/better patient care while having convenience of one-click-order at the point of service. Additionally, Medanta is in process of launching a patient and physician facing app that allow them to view various reports of lab, radiology and consultations. This app would be the mobile EMR for the patient.

- Rajiv Sikka, Head of Information Technology, Medanta

 Asian Hospital

In order to give a better experience to its patients, Asian Hospital has an IVR solution to enhance patient care and provide them with timely information that is vital for their health. Multiple IVR solutions as per the requirement is set on the basis of different sugar levels of different patients. Every patient has a unique ID number. As the patient calls at the virtual number and inputs his/her sugar levels the IVR provides right information of the dosage for the particular patient, which is calculated at the backend on the basis of his/her

data. And in cases, where sugar value seemed to be critical, the patient is suggested to take advice from their doctor.

This ensures easy and timely check on the patient’s sugar level, hence saving from the last minute happenings. The solution also offers a missed call service and whenever a missed call is placed, an IVR script is initiated with a set of extension numbers in multiple languages. A total of 24 virtual numbers for missed call services are placed in the Asian Hospital. This gives callers the option to choose the right language and connect to the right department. The solution also provides round the clock service and a ‘Thank You’ SMS is sent to every customer after the call gets disconnected.

—Shuvankar Pramanick, GM,  Asian Hospital

Kokilaben Dhirubhai Ambani Hospital

We are privileged to be on the higher acceptability and rollout in terms of IT in the hospital. We have an EMR working in the hospital with high level of usage and have integrated RIS & LIS. This HIS from iSoft is integrated with all pathology analyzers and RIS is interfaced with Agfa PACS and advanced visualization from Siemens and Myrian besides the EMR for clinicians.

Information to the doctors is available in the proverbial sense at click of a button. We are exploring Beacon technology to make patient navigation easier in the hospital. And we would like to keep going on this gravy train to make clinicians spend more time with patients and focusing on outcomes and making patients smile. IT is part of the hospital strategy and the backbone of the hospital. We are now looking at analytics, as well.

We have had telemedicine center in the hospital for years. We have setup a few of remote centers for Telemedicine and do referrals post treatment at the hospital. However, we are seeing a small trend in terms of consult from remote centers before patients come for treatment to the hospital.

The process adds to the confidence building for the patient towards the doctor in the hospital and thereby reducing anxiety levels of the patient relatives. We are in the process of setting up more remote centers.

The other trend which is slowly happening is patient referrals from outside India. The telemedicine has provided them with a level of comfort that they are going to good institute and will have great outcomes. This is a slow growth area, as the patients like to meet the doctors face to face and get a better feel of the treatment plan and expected outcomes. However, the numbers are low currently but is expected to grow.

—Rajesh Batra, VP-IT, Kokilaben Dhirubhai Ambani Hospital

 Metropolis Healthcare

Today as far as the pathology business of Metropolis Healthcare is concerned, they have

over 600 analyzers and all samples are tested using quality audited machines. The machines are first selected based on international best practices in domain and are then used for sample testing.

They are one of the few laboratories that have received the CAP and NABL accreditation and all their business processes are complied with quality assurance to ensure the accurate reports are delivered to the end patient. They do more than 4,500 tests in almost all the domains and to support such a deep rooted process, it is a must to have a quality framework in place. The hospital has got nearly 6,000 SOPs related to these tests and have policy for all the tests.

The hospital follows six sigma policies in which every sample is bar-coded properly for identity management and identity linking. All the machines are interfaced so that the data from the machine is picked up automatically with the middle software and then integrated with the main LIMS software. So, in this case there is no human intervention and all the business processes are weaven around accuracy.

—Ajit Dixit, Senior Vice President, Metropolis Healthcare