Indian Healthcare going thru a paradigm shift

Indian Healthcare is going thru a paradigm shift right now. It is moving from fragmanted to consolidated. Its moving from Transaction based Healthcare model to a Healthcare contract.

Large consolidated hospital chains are emerging in the private sector. Clinic networks, Lab networks and Pharmacy chains are also emerging on the scene. Govt is also catching up with the modernisation of its hospitals and PPP. Health Insurance is begining to follow patients even after they leave the clinic and some systems are emerging to manage their health and disease in the society as well. However all this is happening on the brick&mortar side of the healthcare. What about technology, people and process?

TECHNOLOGY:
Is technology catching up at the same pace as brick&mortar? Are these networks/chains having the required technology infrastructure in terms of software, hardware and IT networks? Is the budget being allocated for the technology infrastructure? For a good IT setup, Indian hospitals have to get into a habbit of allocating 10% of their budget to IT.

There is a need to develop a Healthcare-IT platform specifically for India. A platform that will include HIS+EMR+ERP and will be hosted, so that every clinician, administrator or manager can use it over the web. Software as a service [SaaS] model can become a reality now in India because internet bandwidth is becoming available everywhere through fixed lines, mobiles and DTH. The SaaS moel is economically viable because it converts the Capex into Opex. Also there is no entry or exit barrier.

Current HIS/EMR are force fit to the unique requirements of the Indian Healthcare. Either they are imported and dont include the special needs of Indian business. Or they are home grown and dont recognize the global aspirations of Indian hospitals/clinics.

Public Health informatics is still a far cry!

PEOPLE:
Is there trained manpower available to run this show? we need people trained and experienced in Healthcare + IT + Management skills. Atleast 30% of the people should have all the 3 skills in the same brain and the rest can start from one descipline and acquire the other 2 in time.

I think the real change will happen when our Medical colleges restructure their courses to include management and IT as an integral part of the education curriculum. Some Healthcare Management institutes have taken the first step towards including some part of IT in the curriculum, but there is a long way to go before the model matures.

We need to have short term, medium term and longterm approach to the people issue. Do we have anyone thinking in this direction!

PROCESS:
Awareness about NABH, JCAHO and ISO standards is emerging in large hospitals. More because they want to look attractive to the MNC Health insurance, so that medical tourism can be routed this way. However the culture of Quality is yet to percolate down into the psyche of the Indian Healthcare. This will take time to happen and will require a significant push from central bodies like QCI.

The need of the hour is to define key performance indicators [KPI] for clinical, admin and management aspects of healthcare. Some standard mechanism has to emerge for KPI measurements, analysis, publication and debate. Some healthcare body has to take the lead for KPI in Indian healthcare. Unfortunately very few even understand the concept of Healthcare KPI.

During my recent lecture I asked the Healthcare management students if they are measuring their processes, and most of them could just draw a blank!

Disease Management Thru Mobile Platforms

• Disease management is emerging as the next big thing in Healthcare-IT. It is catching up in both US healthcare as well as Govt run healthcare systems in commonwealth countries like Canada, UK, Singapore, Australia etc. India should not be far behind.





• The prime reason for interest in disease management is due to rapid increase in chronic diseases owing to adoption of unhealthy lifestyles.





• Improvements in laboratory technology have enabled better monitoring of physiological and pathological markers.





• The disease can be monitored from predisposition stage itself.





• IT products for Disease management are few and far between. But leveraging the mobile technology can catapult the Disease management into the forefront of everyday life.
  Mobile platforms are ubiquitous in nature and are very personal to the patient and the doctor. Any Disease management program run by using mobile platform should be an instant hit.





• However the open question that remains is that who will pay for the program initially i.e. Disease Registry and Disease Management Program. Although the data generated by the program is expected to pay for the program over time, but initially there is no data and no value can be derived from it until much later.





• Governments, Mobile platform companies, Health Insurance companies and Pharma companies accrue the maximum benefits. They should be in a position to pay for the program initially and reap the rich benefits from the data collected over time.





• Governments are paying for the program in some commonwealth countries, whereas some Insurance companies are already investing in CDM in USA. It will be interesting to see who takes the lead in a country like India where the gold [data] lies at the bottom of the social pyramid!