Healthcare-IT outsourcing is different

Offshore outsourcing in Healthcare-IT or eHealth is very different from any other industry vertical. However many IT companies tends to treat it as just any other vertical.

Reasons why Healthcare-IT outsourcing is different:
1. Healthcare and IT knowledge needs to exist in the same brain and needs to be processed together by the same processor. The idea of putting a Domain expert with IT team doesn’t work in Healthcare because Healthcare experts talk Greek and Latin jargon which IT folks don’t understand.
2. Way of thinking is very different between clinical and engineering disciplines. Clinicians think in terms of lists and rule-out one by one to reach a decision. Intuition developed with experience plays a vital role in decision making. Whereas engineering discipline thinks in terms of 2-by-2 tables and makes decisions based upon numbers from hard data. Intuition developed with experience has no place in engineering disciplines.
3. Doctor-Patient relationship is like that of Priest-Disciple relationship completely based upon trust. You remove the trust factor and no patient will ever want to go under the knife of a surgeon no matter what quality standards are applied.
4. Cost of the Healthcare is Bourne by the payer [Employer, Insurance or Govt], whereas the benefits go to the patient. The payers believe that increase in productivity will pay for the cost of healthcare in the long-term; however this has never been proved. In other words, Cost of Healthcare goes in one direction and the benefit goes in opposite direction. This is exact opposite of what happens in any transaction based industry.
5. Management principles like 80-20 rule don’t apply to healthcare. Hospitals earn 80% of their revenue from 20% of the investments. Rest 80% is spent for treating diseases that provide 20% of revenue. Any other industry will optimize on the non-performing investments and save lot of costs, but the hospitals can’t ignore these non-performing investments else morbidity and mortality will shoot up.
6. Healthcare-IT has developed over a period of time where the systems are developed in wide variety of technologies and they don’t talk to each other.
7. Old systems don’t have any documentation and common sense doesn’t work in understanding the logic because the keywords are Greek and Latin.
8. Most of the knowledge is stored in the heads of old employees working on the systems
9. Systems are mission critical and need to be up 99.99% of the time.
10. No one can ever document all the requirements 100% at the beginning because doctors know only small% of the human body and rest is guess work.
11. Processes in a hospital are dynamic and change at the drop of a hat. In emergency doctors need to take over everything outside the system and then the system have to catch-up post-facto
12. Doctors and nurses are ubiquitous in the hospital setting and can be giving orders anywhere in the hospital. The orders are executed almost simultaneously. Therefore little time to switch between order entry system and order fulfillment systems!
13. Learning and absorbing the Healthcare knowledge takes time. Therefore quickly training the IT resources in healthcare domain knowledge and deploying them on Healthcare projects is seldom useful. Also rotation of IT resources is not possible because you need to lock the Healthcare trained IT resources for next similar projects. Healthcare-IT resources continue to increase in value with every cycle.