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Healthcare IT: Opportunities
and Challenges
Shushmul Maheshwari
CEO
RNCOS – Business Consulting Services
ASSOCHAM: June 2014
 RNCOS is a leading business research and consultancy firm with more
than 12 years of market presence and expertise
 We offer Custom Research Solutions, Management Consultancy Services
and Syndicate Research to Fortune 500 companies and Government
agencies worldwide.
 Our client base falls in Healthcare, IT, Retail and BFSI Verticals
 Backed by a team of 35 research analysts with domain knowledge in
various verticals
 Shushmul Maheshwari CEO, brings more than 20 years of rich experience,
working with large corporate houses and well exposed to domestic and
international markets
About Us
Indian Healthcare : A Snapshot
2.9
2.6
0.7
US China India
Hospital Beds/1000 Population Ratio
(2013)
3.31
1.53
0.592
US China India
Doctors/1000 Population Ratio
(2013)
Source: EIU
There is only one doctor per 1,700 citizens in India
India would additionally need about 4 Lakh doctors by 2020
There is a severe shortage of hospital beds and medical
facilities
Approximately 1 Million Indians die every year due to
inadequate healthcare facilities
Nearly 700 Million people have no access to specialist care
The Indian government spends a trivial 4% of GDP on healthcare
Government spends a meager 33%
In comparison US and China, spend nearly 46% and 56%, respectively
2009 2010 2011 2012 2013 2014
US
China
India
CAGR of Healthcare Spending Per Capita (2009-2014)
Source: EIU
3.78%
17.07%
7.57%
Healthcare Spending Per Capita (US$)
9559
373
78.2
2013
US
China
India
Challenges slowing growth
Inaccessibility
Patient Monitoring
& TrackingClinical Errors
Lack of Data
Centralization
Maintaining huge
Medical Records
Healthcare ICT
The way to move forward
Healthcare Information Technology (HIT)
HIT - Holistic management of health information
across computerized systems and its secure exchange
between consumers, providers, government and
quality entities and insurers
Digitization of Patient health records
Reaching remote parts of country -Telemedicine
Advanced patient monitoring and tracking
Address scarcity of doctors and hospital beds issue
Knowledge management - vaccination, hygiene maintenance,
healthy lifestyle, etc., could be spread easily
Healthcare IT Components
Telemedicine M-Health
Health Information
Management System
(HIMS)
Health Information Management System (HIMS)
HIMS automates it all
Enables Patient/Vendor accounting (insurance
or other claims) and smoothens the whole
process
Saves a lot of space in physical terms
Patient’s data/test records are accessible at any
point of time, anywhere
Patient’s movements could be tracked with
data centralization
HIMS
Implementation of HIMS in India
In order to understand the penetration level of HIMS in
India, RNCOS research team interviewed IT
Head/Administrative Officers of various public and private
hospitals PAN India
Sample size for the research was approximately 200
public/private hospitals
Basic Level (for general patient
registration and billing process)
Moderate Level (up to LIS &
PACs level)
Advanced Level (up to e-
Prescription and CDSS level)
Source: RNCOS
Telemedicine
Telemedicine is the utilization of medical
information exchanged from one site to
another, via electronic communication tools for
improving a patient’s clinical health status
Unwillingness of doctors to work in the rural
areas
Large number of patients in rural India travel
to cities
Facilitating
Accessibility &
Affordability
Providing
treatment at
Par with
Metropolitans
Overcoming the
Scarcity of
Paramedics &
Hospital Beds
National Telemedicine
Projects
• Provides eye care specialty services to the patients of rural and remote areas through
tele-ophthalmology mobile vans covering Punjab, Uttar Pradesh and West Bengal
Tele-ophthalmology
Project
• 4 Regional Workshops for NRTN are planned in 4 different regions of the country to
educate the state functionaries and finalize the state project proposals
National Rural
Telemedicine
Network (NRTN)
• 27 Regional Cancer Centers will be linked with 100 peripheral centers for primary
prevention, early detection, treatment and rehabilitation of cancer patients
National OncoNET
Project
• Plans to establish a national grid on telemedicine for networking of medical collegesNational Medical
College Network
ISRO Telemedicine Projects
DIT Telemedicine Projects
ISRO & DIT Telemedicine Projects
Telemedicine: ISRO & DIT Projects
ISRO established a
Telemedicine Network
consisting of 382 Hospitals
DIT established more than
100 nodes all over India
Besides these, other ISRO &
DIT Projects are:
• Village Resource Center
(VRCs)
• Common Service Center
(100,000 nodes)
• E-PanchayatSource: RNCOS
M-Health
Smartphone shipments grew by 167% in 2013
M-health - Delivery of healthcare
services/information via mobile phones
Clinical data immediately viewable
throughout hospital on mobile and
desktop devices
Bridging the gap between the existing and required
healthcare services
Services such as telephone-based appointment scheduling
and prescription refilling
Improving the healthcare access for the vast underserved rural areas and enhances patient care for
urban consumers
Consultations using mobile or 3G based video
conferencing providing quality care - just a click away
Provides options of performing basic tests like glucose monitoring, BP/heart beat monitoring, urine
analysis etc. at home
M-Health - Changing Healthcare Paradigm
• Launched in 2009
• Over 10.5 Crore pregnant women and children have
been registered in MCTS
• System sends reminders to the Auxiliary Nursing
Midwives (ANMs) or Accredited Social Health Activist
(ASHAs) on the various treatments
• Once a mother receives her immunization, ANMs
send information to the system via SMS
• Ensures timely delivery and tracking of mother and
child health.
Mother and Child Tracking System (MCTS)
Integrated Disease Surveillance
Program (IDSP)
• Launched in 2004
• To detect and respond to disease outbreaks
• At present, over 90% districts report such weekly data
through e-mail/portal
• On an average, 30-40 outbreaks are reported every week by
all the States
• Over 1500 outbreaks in 2012, over 1900 outbreaks were
reported in 2013
• Launched in 2012
• More than 3.5 Lakh patients already registered
• It keeps track of TB patients across the country
and ensure timely delivery of medication
• An SMS is sent to patient with registration ID and
details of DOTS Operator
• SMS reminder is sent for taking regular medicine
• Daily SMS is sent to all monitoring authorities
Nikshay for TB
National Health Portal
• The NHP was launched in late 2013
• Aims to serve as a repository of medical
history of 1 Billion Indians
• Works as a single point access for
authenticated health information for
citizens, students, healthcare
professionals and researchers
• Promotes reliable, high quality health
information among the population to
decrease the risk of hospitalization or
disease burden
Despite India being an IT-enabled services’
giant, the use of HIT is limited
0.875
1.08
1.27 1.43
1.65
1.92
2013E 2014e 2015f 2016f 2017f 2018f
Healthcare IT Spending in India
(Billion US$), 2013-2018
Source: Gartner, RNCOS
Note: E = Gartner Estimation, e/f = RNCOS Estimation
HIT Adoption Challenges in India
Scarcity of trained
manpower
Insufficient
fund allocation
Multilingualism
Interoperability at
state/national level
Scalability
Low awareness
Lack of Proper
Infrastructure
Measures Required
Availability in regional languages
Provide Quality Training
Increased funding for infrastructural developments
Creation of Data Repositories
Linking of EMRs with PAN or Unique ID
Creating HIT policies for effective implementation
Better Knowledge Management
New Technologies to improve efficiency
Nanotechnology is the manipulation of matter on an
atomic, molecular and supramolecular scale
Nanotechnology
Application at DNA analysis/diagnostics level
Faster and accurate diagnosis with minimal sample size
Accurate targeting of the drug using nanoparticles
3D PRINTING
3D printing or additive manufacturing (AM) is a
process of making a three-dimensional solid object
of virtually any shape from a digital model
3-D printing saves time over casting handmade inner ear mould
Scientists are able to print the artificial meat tissue suitable for eating
In future, printing functional human tissues will also be a revolution
surgeons can design knees specific to each patient
What Is Required for Successful Implementation of HIT
Awareness about importance of HIT through Seminars and Conferences
Policy framework required for HIT implementation
Realist deadline of upto 10 years for complete implementation
Post grace period institutions/doctors should be penalised
Doctors/Hospitals should be encouraged to use HIT
Policy need to be defined for interoperability
Healthcare information should be available in regional languages
IT industry must work closely with doctors to develop user friendly applications
Shushmul Maheshwari
Chief Executive Officer
RNCOS
E mail: shushmul@rncos.com
Phone: +91 120 4224700 /01 / 02/ 03
Mobile:+91 9891048088
Website: www.rncos.com
For more information

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Healthcare IT Opportunities and Challenges

  • 1. Healthcare IT: Opportunities and Challenges Shushmul Maheshwari CEO RNCOS – Business Consulting Services ASSOCHAM: June 2014
  • 2.  RNCOS is a leading business research and consultancy firm with more than 12 years of market presence and expertise  We offer Custom Research Solutions, Management Consultancy Services and Syndicate Research to Fortune 500 companies and Government agencies worldwide.  Our client base falls in Healthcare, IT, Retail and BFSI Verticals  Backed by a team of 35 research analysts with domain knowledge in various verticals  Shushmul Maheshwari CEO, brings more than 20 years of rich experience, working with large corporate houses and well exposed to domestic and international markets About Us
  • 3. Indian Healthcare : A Snapshot 2.9 2.6 0.7 US China India Hospital Beds/1000 Population Ratio (2013) 3.31 1.53 0.592 US China India Doctors/1000 Population Ratio (2013) Source: EIU There is only one doctor per 1,700 citizens in India India would additionally need about 4 Lakh doctors by 2020 There is a severe shortage of hospital beds and medical facilities Approximately 1 Million Indians die every year due to inadequate healthcare facilities Nearly 700 Million people have no access to specialist care
  • 4. The Indian government spends a trivial 4% of GDP on healthcare Government spends a meager 33% In comparison US and China, spend nearly 46% and 56%, respectively 2009 2010 2011 2012 2013 2014 US China India CAGR of Healthcare Spending Per Capita (2009-2014) Source: EIU 3.78% 17.07% 7.57% Healthcare Spending Per Capita (US$) 9559 373 78.2 2013 US China India
  • 6. Inaccessibility Patient Monitoring & TrackingClinical Errors Lack of Data Centralization Maintaining huge Medical Records
  • 7. Healthcare ICT The way to move forward
  • 8. Healthcare Information Technology (HIT) HIT - Holistic management of health information across computerized systems and its secure exchange between consumers, providers, government and quality entities and insurers Digitization of Patient health records Reaching remote parts of country -Telemedicine Advanced patient monitoring and tracking Address scarcity of doctors and hospital beds issue Knowledge management - vaccination, hygiene maintenance, healthy lifestyle, etc., could be spread easily
  • 9. Healthcare IT Components Telemedicine M-Health Health Information Management System (HIMS)
  • 10. Health Information Management System (HIMS) HIMS automates it all Enables Patient/Vendor accounting (insurance or other claims) and smoothens the whole process Saves a lot of space in physical terms Patient’s data/test records are accessible at any point of time, anywhere Patient’s movements could be tracked with data centralization HIMS
  • 11. Implementation of HIMS in India In order to understand the penetration level of HIMS in India, RNCOS research team interviewed IT Head/Administrative Officers of various public and private hospitals PAN India Sample size for the research was approximately 200 public/private hospitals Basic Level (for general patient registration and billing process) Moderate Level (up to LIS & PACs level) Advanced Level (up to e- Prescription and CDSS level) Source: RNCOS
  • 12. Telemedicine Telemedicine is the utilization of medical information exchanged from one site to another, via electronic communication tools for improving a patient’s clinical health status Unwillingness of doctors to work in the rural areas Large number of patients in rural India travel to cities Facilitating Accessibility & Affordability Providing treatment at Par with Metropolitans Overcoming the Scarcity of Paramedics & Hospital Beds
  • 13. National Telemedicine Projects • Provides eye care specialty services to the patients of rural and remote areas through tele-ophthalmology mobile vans covering Punjab, Uttar Pradesh and West Bengal Tele-ophthalmology Project • 4 Regional Workshops for NRTN are planned in 4 different regions of the country to educate the state functionaries and finalize the state project proposals National Rural Telemedicine Network (NRTN) • 27 Regional Cancer Centers will be linked with 100 peripheral centers for primary prevention, early detection, treatment and rehabilitation of cancer patients National OncoNET Project • Plans to establish a national grid on telemedicine for networking of medical collegesNational Medical College Network
  • 14. ISRO Telemedicine Projects DIT Telemedicine Projects ISRO & DIT Telemedicine Projects Telemedicine: ISRO & DIT Projects ISRO established a Telemedicine Network consisting of 382 Hospitals DIT established more than 100 nodes all over India Besides these, other ISRO & DIT Projects are: • Village Resource Center (VRCs) • Common Service Center (100,000 nodes) • E-PanchayatSource: RNCOS
  • 15. M-Health Smartphone shipments grew by 167% in 2013 M-health - Delivery of healthcare services/information via mobile phones Clinical data immediately viewable throughout hospital on mobile and desktop devices
  • 16. Bridging the gap between the existing and required healthcare services Services such as telephone-based appointment scheduling and prescription refilling Improving the healthcare access for the vast underserved rural areas and enhances patient care for urban consumers Consultations using mobile or 3G based video conferencing providing quality care - just a click away Provides options of performing basic tests like glucose monitoring, BP/heart beat monitoring, urine analysis etc. at home M-Health - Changing Healthcare Paradigm
  • 17.
  • 18. • Launched in 2009 • Over 10.5 Crore pregnant women and children have been registered in MCTS • System sends reminders to the Auxiliary Nursing Midwives (ANMs) or Accredited Social Health Activist (ASHAs) on the various treatments • Once a mother receives her immunization, ANMs send information to the system via SMS • Ensures timely delivery and tracking of mother and child health. Mother and Child Tracking System (MCTS)
  • 19. Integrated Disease Surveillance Program (IDSP) • Launched in 2004 • To detect and respond to disease outbreaks • At present, over 90% districts report such weekly data through e-mail/portal • On an average, 30-40 outbreaks are reported every week by all the States • Over 1500 outbreaks in 2012, over 1900 outbreaks were reported in 2013
  • 20. • Launched in 2012 • More than 3.5 Lakh patients already registered • It keeps track of TB patients across the country and ensure timely delivery of medication • An SMS is sent to patient with registration ID and details of DOTS Operator • SMS reminder is sent for taking regular medicine • Daily SMS is sent to all monitoring authorities Nikshay for TB
  • 21. National Health Portal • The NHP was launched in late 2013 • Aims to serve as a repository of medical history of 1 Billion Indians • Works as a single point access for authenticated health information for citizens, students, healthcare professionals and researchers • Promotes reliable, high quality health information among the population to decrease the risk of hospitalization or disease burden
  • 22. Despite India being an IT-enabled services’ giant, the use of HIT is limited 0.875 1.08 1.27 1.43 1.65 1.92 2013E 2014e 2015f 2016f 2017f 2018f Healthcare IT Spending in India (Billion US$), 2013-2018 Source: Gartner, RNCOS Note: E = Gartner Estimation, e/f = RNCOS Estimation
  • 23. HIT Adoption Challenges in India Scarcity of trained manpower Insufficient fund allocation Multilingualism Interoperability at state/national level Scalability Low awareness Lack of Proper Infrastructure
  • 25. Availability in regional languages Provide Quality Training Increased funding for infrastructural developments Creation of Data Repositories Linking of EMRs with PAN or Unique ID Creating HIT policies for effective implementation Better Knowledge Management
  • 26. New Technologies to improve efficiency
  • 27. Nanotechnology is the manipulation of matter on an atomic, molecular and supramolecular scale Nanotechnology Application at DNA analysis/diagnostics level Faster and accurate diagnosis with minimal sample size Accurate targeting of the drug using nanoparticles
  • 28. 3D PRINTING 3D printing or additive manufacturing (AM) is a process of making a three-dimensional solid object of virtually any shape from a digital model 3-D printing saves time over casting handmade inner ear mould Scientists are able to print the artificial meat tissue suitable for eating In future, printing functional human tissues will also be a revolution surgeons can design knees specific to each patient
  • 29. What Is Required for Successful Implementation of HIT
  • 30. Awareness about importance of HIT through Seminars and Conferences Policy framework required for HIT implementation Realist deadline of upto 10 years for complete implementation Post grace period institutions/doctors should be penalised Doctors/Hospitals should be encouraged to use HIT Policy need to be defined for interoperability Healthcare information should be available in regional languages IT industry must work closely with doctors to develop user friendly applications
  • 31.
  • 32. Shushmul Maheshwari Chief Executive Officer RNCOS E mail: shushmul@rncos.com Phone: +91 120 4224700 /01 / 02/ 03 Mobile:+91 9891048088 Website: www.rncos.com For more information