tag:blogger.com,1999:blog-47604299288477240082024-03-05T07:44:09.738-08:00Health Insights | innovations in healthcare service deliveryAdministratorhttp://www.blogger.com/profile/08080079860978274090noreply@blogger.comBlogger22125tag:blogger.com,1999:blog-4760429928847724008.post-36119137837700448372014-07-31T04:09:00.002-07:002014-07-31T04:11:13.368-07:00IT Solutions for Hospitals – Stakeholder-wise Perspective<h2>
IT Solutions for Hospitals in Perspective</h2>
It is an extremely common situation when a hospital, not matter what the size, calls in an IT vendor for their Information and Communication Technology needs and starts discussing about OS and development platforms, technology, hardware specification and such other trivia instead of focussing on what matters to the hospital. Let’s face it – it is not the core competence of the hospitals to be manage procuring, implementing and maintaining IT solutions. <br />
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While IT managers in hospitals may often appear to be extremely talented IT specialists, hardworking and brilliant professionals, these persons often have a limited exposure to the entire breadth of what an IT solution will need to do in an healthcare setting. This has often led to even large hospitals managing their IT systems with people who with limited vision for effectively using and enhancing their technological capabilities. The situation is smaller hospitals is even worse. The infrastructure is often managed by a person who is only knowledgeable about the IT products and not as much about what the IT products are expected to deliver in terms of changing the way the business processes of the hospital work.<br />
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What is it that the hospital needs when they say that they are looking for an IT solution? Ask any set of senior managers in a hospital this question and what one gets is an answer that looks like the response of the proverbial six blind men describing an elephant. Is an IT solution on which the hospital has invested anything near 2 to 5 percent of the total cost of the hospital project such an elephant? To answer that question truthfully and completely we need to evaluate the really need of various stakeholders in a hospital.<br />
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The Principal Stakeholder – Management</h2>
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The management is looking at principally the following:</div>
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<li>Strategic contribution of the IT solution for the initiatives for improvement of the hospital conceptualised by the management as a whole and in its various functions.</li>
<li>Ensuring an integrated solution that achieves synergy across functions rather than each function being an island of efficiency and having data in its own silos.</li>
<li>Business value of the IT solution that enables information regarding functional and financial measures required to improve the business efficiency.</li>
<li>Ensuring compliance with standards and ensuring adherence to rules, rates, policies, privacy and confidentiality expected of the hospital.</li>
<li>Enabling the compliance of the system with the corporate governance plan.</li>
<li>Tracking budgeted v/s actual expenses and income.</li>
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If the IT solution comes close to achieving these objectives of the system it would have made a big dent in the way the hospital would function.</div>
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The second most important stakeholder – the Customer</h2>
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The entity called the customer is difficult to define in the case of the hospital. For the IT vendor or an IT department of the hospital, the customer is each of the departments which are touched by the system, while for each of these departments it is their eventual customer – the patient, the materials vendor, the financial institutions, and the management – who needs to see the difference. The customer whichever way one defines the term from an immediate or a long term perspective has a very limited set of needs not all of which are easy to understand and fulfil namely:</div>
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<ol>
<li>Customer satisfaction based on the feedback received from the customers in the form of a positive feedback or a lack of negative feedback.</li>
<li>Extent of involvement of IT vendor or department in providing new strategic applications for the business processes enhancement.</li>
<li>Performance of the system in terms of its ability to provide quality measured by user feedback, timeliness measured in terms of reduced waiting period and reduced turn-around time, and reduced cost of and on the activities.</li>
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It is important that the impact of the systems on customers is kept as the primary operational focus of the systems.</div>
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Operational Excellence of the IT team or vendor</h2>
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Operational excellence centres on what is seen by multiple stakeholders as benefitting them in an indirect manner. Among the areas where IT contributes significantly are:</div>
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<ol>
<li>Process excellence measured through the capability of the organisation to meet regulatory and quality norms.</li>
<li>Simplification of the processes, resulting from single point of data entry and access to the data from across the hospital.</li>
<li>Process excellence measured in terms of ability to quickly identify areas of non-compliance, and areas deserving attention towards preventive and curative actions.</li>
<li>Assuring security and privacy of the data and ensuring safety of the information with rapid action against security breaches. It needs to be overemphasized that the largest source of security breaches is often the team responsible for managing the systems.</li>
<li>Providing a set of dashboards for decision support to various stakeholders in the organisation.</li>
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Operational excellence is often not only felt when one enters the organisation but also is something that translates into a direct benefit to the stakeholder.</div>
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Finally the Future Orientation</h2>
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There is hardly any field in the world that has seen a change that has been so rapid, as is visible in the field of Information and Communication Technology. The technology providers therefore need to have a vision, mission, capability and ability to deliver solutions consistent with the needs of the future, not only to ensure continued excellence but also to ensure that this critical aspect of business competitiveness receives its rightful place in the scheme of business processes.</div>
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<li>Among the various critical parameters for the IT systems to gauge future orientation are:</li>
<ol>
<li>Service capability improvement through delivery of internal process to plan for </li>
<li>On-going Process improvement</li>
<li>Readiness towards Organisation growth and development</li>
<li>Support for Professional development in providing efficient service</li>
<li>Technology leadership of the institution to ensure capability to provide state of the art services.</li>
</ol>
<li>Enterprise architecture evolution though development of the concept of the enterprise and systems to ensure adherence to the enterprise architecture plan, encompassing the network of hospitals and their associates</li>
<li>Active research and implementation of the benefits of advances in technology to meet the challenges of emerging techniques and technologies.</li>
</ol>
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It is therefore appropriate that every organisation considering IT solutions for their operational and strategic excellence needs to look beyond the set of numbers that will enable justification in conventional terms for the expenditure on IT which is now a critical component in the continued competitiveness of the organisation.</div>
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The justification of numbers for investing in IT</h2>
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For those who use the financial numbers as the gospel truth here are some numbers that will help you to decide how Healthcare IT solutions stack up. Most of the returns from an IT solution will be in the nature of improvements in business processes, removal of deficiencies that can potentially cost the organisation a substantial amount, reduction in revenue leakages due to erroneous calculations and rates, and the ability to carry out the business processes in shorter duration of time, at a lower cost, with reduced manpower and space requirements. It is important therefore to ensure that when one invests in an IT solution it should not be with the objective of replicating the manual process on computers, but with the objective to rework the processes that become redundant after the IT systems are in place.</div>
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Most organisations are confused regarding the cost of an IT system. Typically the investment in IT systems should be considered as written off in about 3 to 5 years time. It is unlikely that one would not need to refresh a system after 5 years of use. It would also be difficult to ensure proper maintenance of a system that is over 5 years old given the rate of changes and obsolescence in IT hardware and software. Considering the interest on the investment and the likely cost of maintenance over this period of time it may be a good idea to take 35% of the initial cost of the IT infrastructure as the annualised cost of the system. In case you are also deploying manpower for smooth operations the annualised cost would be at least 50% of the initial cost on the IT infrastructure including hardware, networks and software.</div>
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Most organisations have reported a 20 to 30% improvement in efficiency as a result of putting in place IT systems. In a labour intensive organisation like healthcare the improvements are at the upper end of the scale. It is typical that the investment in IT is unlikely to be more than 3% of the turnover of the hospital. Even a 10% improvement in efficiency will mean a return in excess of 2.5 times the initial investment or nearly 5 times the annualised cost – a return of over 500% on the investment!!</div>
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Recommendations for IT procurement for hospitals</h2>
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If you are a small or medium sized hospital, consider the feasibility of joining hands with similarly placed hospitals in your area and approach the IT vendors for a solution that meets your requirements. Outsource your entire IT infrastructure so that you end up paying for the benefits of the IT solution rather than take the pain of maintaining the IT infrastructure. Don’t try to buy everything at one go. Costs of IT products fall over a period of time, and it is advisable to go in for enhancements from time to time rather than pay for everything upfront and not utilise it for a year or more.</div>
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Use the benefit of a joint negotiation for the group of hospitals. Explore the possibility of using common services like inter hospital referrals, joint connections to one or more pharmacies and diagnostic centres through the system and other similar concepts to help you utilise the full benefits of an interconnected system. It is worth keeping the technology aspects out of the negotiations and instead focus on outcomes. There can be a mind boggling quantity of terminologies that experts in the field will throw, most of which you may not be able to appreciate at all.</div>
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If you are a large hospital or a hospital chain, the single most important aspect is to consider the credentials of the IT vendors in terms of their capability to provide and support a solution on an on-going basis for a size of hospitals or a network as large as your own, besides of course the features and functionality that you need in your hospital or hospital chain. The previous comments about incremental addition to the infrastructure equally well hold for even large hospitals and hospital chains. It is not worth attempting to swallow an entire elephant at one go!!</div>
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Administratorhttp://www.blogger.com/profile/08080079860978274090noreply@blogger.com20tag:blogger.com,1999:blog-4760429928847724008.post-38383730337141396712014-04-18T22:52:00.004-07:002014-04-19T00:17:08.005-07:00Bringing Change to our Lives<div style="border: solid 1px #CCCCCC; float: right; margin-left: 20px; padding: 5px; width: 170px;">
<img src="http://www.21ci.com/images/vasukumar.png" style="border: 0px solid rgb(204, 204, 204); padding: 10px; text-align: centre;" />
<span style="color: #0b5394; font-size: x-small;"><b>Vasukumar Nair</b>, <i>Director, 21st Century Informatics
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<i><b>Vasukumar Nair</b>, Director, 21st Century Informatics, in conversation with Japneet Sabharwal, ENN, about the growing role of technology in HMIS</i><br />
<b><span style="color: #cc0000;"><br /></span></b>
<b><span style="color: #cc0000;">How do you perceive the market for HIS & HMIS in India? </span></b><br />
The Indian healthcare industry is growing rapidly with an annual growth rate of 18 to 20%. Our research shows there is a big market for ICT applications. If one side the driver is due to growing population and a need for healthcare, the other end is less penetration and standardization of ICT systems. We also see, there is huge opportunity for training and implementation of ICT systems on how physicians, nurses, pharmacists and other care personnel of hospitals are trained in ICT. There is also a need for a centralized Electronic Health Record (EHR). Lack of EHR prevents the development of speed, accuracy and transparency throughout the healthcare system. We see the market is dynamic and promising. Now, we find that both government and private are in the race to provide better facilities, though there are administrative delays. We have experience; the transformation in certain pockets of the country such as tier-I cities and technology are bringing change to our lives in a big way. There is a huge opportunity in the semi-urban and rural areas that can undergo the same transformation through ICT and this will lead to deep impacts in these areas in the field of medicine.<br />
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<b><span style="color: #cc0000;">What are the unique HIS/HMIS solutions you have designed for Indian healthcare? </span></b><br />
21stCentury Informatics is a Dutchpromoted company with a global delivery centre in India. Our contribution to the healthcare industry has been consistent over the years. Our Dutch experience has helped us offer a global perspective to the Indian healthcare industry with respect to healthcare ICT applications. The BENLUX region in Europe is a frontrunner in applying advanced healthcare ICT applications. Our endeavor is to apply the knowledge and successful process applications from our company’s European experience to the emerging market. Our focus is on innovation and on adapting our product to the Indian healthcare industry.Presently we service more than 500 sites; our contribution to the healthcare industry has been consistent over the years. Our flagship product Apex enterprise HIS is a healthcare platform that comprises various plugin components. The end users can configure their required systems as per their requirements without coding and no hassles.<br />
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<b><span style="color: #cc0000;">On the technology front, what are the new developments that have come up in this field? </span></b><br />
We find a mix of new technologies that is being used or are in development. In Indian scenario, the revenue cycle management is still in the initial stages. Once health insurance comes into our landscape, there will be major changes in the IT systems towards global health insurance standards. Now in some areas, our customers are investing in automation of clinical processes. We find that there is a good acceptance of the implementation of EMR with Clinical Decision Support Systems in some countries. With respect to technology penetration, market response is good for cloud computing, healthcare analytics and BOYD. In the Indian scenario, we offer technology solutions and support with the usage of gadgets and devices and performance dashboard through mobile computing for the top management. Our team is constantly innovating to provide new features and functionality to our users. We have come out with a new platform that enables rapid expansion of functionality during IT product implementation. It is supported by advancement in cloud computing technology and emergence of the SaaS model. A few of our customers have tested this platform and we are currently in the process of taking it to the market.<br />
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With respect to technology penetration, market response is good for cloud computing, healthcare analytics and BOYD </div>
<b><span style="color: #cc0000;">What are the advantages the solution offers to the hospital caregivers? </span></b><br />
Our flagship product Apex enterprise HIS is an integrated enterprise-wide application with respect to hospital management, electronic medical records and clinical intelligence with analytics. Most of the HIMS applications have a rigid business logic flow and it is very difficult to change application behavior. With this platform our end users can change the process based on business dynamics.
Typically, internal IT staff cannot change the application to map changes in business dynamics – they need to contact the software company or implementer to get the application reconfigured. We have changed that situation by empowering the ICT staff even to build new systems and process.<br />
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<b><span style="color: #cc0000;">With over decades of exposure and experience in healthcare, how do you visualize and evaluate the IT transformation? </span></b><br />
India’s healthcare system faces considerable challenges, such as dearth of right staff, low doctorpatient ratio, quality of care, rising costs in services and medicines, major divide between urban and rural facilities, etc. However, if you look closely at certain hospitals and hospital corporates, they have focused significantly on IT whether for management control or for bringing clinical excellence. The telecom revolution and IT have provided a huge opportunity to care providers to transform their service delivery models and there are many success stories in private and public system with respect to the use of right technologies such as HIS, mobile health, tele-medicine, EHR and also automation of government hospitals by transforming health care.<br />
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<b><span style="color: #cc0000;">IT illiteracy and lack of awareness often act as initial obstacles for health IT players. Did you face similar challenges? </span></b><br />
We don’t find IT iliteracy as the main challenge. However adoption of new systems and process is sometimes difffult for stakeholders. Although there is some standardization in the clinical care areas, with respect to other processes, this field still lacks guidelines and standardization and there is less control over variance.
Security is an integral aspect of Health IT Infrastructure. What’s your take on this?
With healthcare information being exchanged within the hospital and extending beyond hospitals to other labs and clinics, the confidentiality of patient data, hospital business records and other revenue data becomes topmost priority. Providers must think beyond the conventional antivirus and firewall combination for safety and security. Now, with the Bring Your Own Device (BOYD), security and compliance aspects have become the primary concern,internal and external breach, regulatory compliance, and inadequate deployment of right technology are the key factors that top management looks at while assessing solution providers like us. We have made sure that we comply with global standards in messaging and data exchange. Our solutions meet the regulatory requirements and can manage security threats. Our team is constantly focusing its effort to come out with innovative features that tighten privacy, security and safety.<br />
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<span style="color: #999999; font-size: x-small;"><i>Disclaimer: This article was published in eHealth Magazine's March 2014 Issue. The article can also be assed through the following link (http://ehealth.eletsonline.com/2014/03/bringing-change-to-our-lives/). All products and brand names mentioned are trademarks or registered trademarks of their respective owners. All Trademarks remain the property of their respective holders, and in no way indicates any relationship between 21st Century Informatics B.V or its associates and the holders of said trademarks. </i></span>Administratorhttp://www.blogger.com/profile/08080079860978274090noreply@blogger.com0tag:blogger.com,1999:blog-4760429928847724008.post-81717942091946895512013-11-28T08:40:00.003-08:002013-11-28T08:40:45.859-08:00Patient Advocacy - Giving Voice to Patients (4th Annual Conference)Aniruddha Nene, 21CI Board Member & Director Sales (Public Sector India) gave a presentation at the 4th Annual Conference: Patient Advocacy - Giving Voice to Patients<br />
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<br />Administratorhttp://www.blogger.com/profile/08080079860978274090noreply@blogger.com4tag:blogger.com,1999:blog-4760429928847724008.post-71145187705689244162013-07-11T23:16:00.000-07:002013-07-11T23:19:24.477-07:00ICT is driving the Med-tech Industry<div style="color: #333333; font-family: Georgia, 'Times New Roman', Times, serif; font-size: 18px; letter-spacing: -1px; line-height: 26px;">
‘Though investment for hardware takes a major share in the total investment
for ICT, the software segment is growing at an annual growth rate of 15
percent’ says
Rajmohan Nair, Head – Marketing and Partner Sales, 21st
Century Informatics</div>
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<strong>What ate the unique medical technology product/solution you provide to hospitals?</strong></div>
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We have been successfully transforming 21CI Apex Enterprise HIS into a new healthcare technology platform. This is true, if you go through market acceptance of our product that we received a good response from the market. The product is designed so as to help our customers to standardise their treatment processes, resulting in increased safety and quality for patients and increased productivity for the hospitals. With this we could bring-in uniqueness by providing innovative solutions that can integrate and coordinate a diverse set of factors including medical technologies, critical processes, inventories, revenue cycle management and MIS analytics. The solutions address the key challenges of ‘change management’ that constantly affecting the modern healthcare organisation. </div>
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<td style="background-color: #415a61;"><img alt="Rajmohan Nair" height="204" src="http://21ci.com/mailer/eHealthJuly2013/12.png" width="187" /></td>
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India's emerging economic trends, increase in medical enterpreneurs and demand for quality healthcare is fuelling growth in private and public sector investments in healthcare in urban India</div>
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<em>India’s emerging economic trends, increase in medical entrepreneurs and demand for quality healthcare is fuelling growth in private and public sector investments in healthcare in urban India </em></div>
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<strong>Can you tell us about any of your innovation in medical technology field?</strong></div>
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We found that CXOs of healthcare organisations are facing the twin challenges of delivering a high quality healthcare in one hand and maintaining significant operational process efficiencies and cost optimisation in other end. We are constantly innovating to provide new features and functionality in such a way that both these objectives are met. We are working on a new technology platform that enables rapid expansion of functionality during IT products that serves these challenges faced by CXOs. Our innovation team is currently working on launching our new platform ‘Componium’, which is aimed at empowering the entire value chain of Business Software Application IT lifecycle. With this platform, different stakeholders will be able to contribute to enrich the habitat and build newer functionalities for a specific or generic need of businesses. </div>
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<strong>Which are the hospitals have taken your solutions? </strong></div>
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This quarter of 2013, we have received a good response from Indian healthcare market. Our Flagship product Apex Enterprise HIS product has been selected by reputed brands from the Industry such as Hiranandani Group of Hospitals, Mumbai, QRG Healthcare group, NCR Region and HLL Life Care, India. </div>
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<strong>What is the size of medical technology product and solution in India?
In what percentage the segment is growing?</strong></div>
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ICT also plays an important role in this growth. India’s emerging economic trends, urbanisation, growing middleclass, increase in medical entrepreneurs and demand for quality healthcare is fuelling growth in private sector and public sector investments in healthcare in urban India. ICT opportunities in tier two and tier three cities is growing fast. Mid-market opportunities & green field projects are having reasonably allocating good investments in ICT. The report about healthcare industry says that it is growing 20 percent per annum. Though investment for hardware takes a major share in the total investment for ICT, the software segment is growing at an annual growth rate of 15 percent. In a few years, healthcare technology segment, both product and services will grow faster due to technology triggered introductions of big data, BOYD, cloud services and other innovations in mobile solutions. <br />
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Disclaimer: This article was published in eHealth Magazine's July 2013 issue. The article can also be assed through the <a href="http://issuu.com/ehealth_magazine/docs/ehealth_july_2013/19?e=0/3973786" style="color: #333333; text-decoration: none;">following link.</a> All products and brand names mentioned are trademarks or registered trademarks of their respective owners. All Trademarks remain the property of their respective holders, and in no way indicates any relationship between 21st Century Informatics B.V or its associates and the holders of said trademarks.</div>
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eHEALTH is a premier print and online monthly publication focusing on the latest and most cutting-edge in healthcare ICTs and medical technologies. - For more information please visit: <a ehealth.eletsonline.com="" href="http://www.blogger.com/blogger.g?blogID=4760429928847724008" http:="" style="color: #333333; text-decoration: none;">http://ehealth.eletsonline.com</a></div>
Administratorhttp://www.blogger.com/profile/08080079860978274090noreply@blogger.com3tag:blogger.com,1999:blog-4760429928847724008.post-14913730429483565592013-06-23T21:47:00.000-07:002013-06-23T21:48:34.829-07:0021st Century Informatics:Healthcare not Global, but Local and Sensitive<div dir="ltr" style="text-align: left;" trbidi="on">
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<i>By CR Team</i><br />
<i>Monday, June 17, 2013</i><br />
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<strong><a href="http://www.21ci.com/aboutus/board_of_directors.html#4">Vasukumar Nair</a></strong>, <em>Director – Marketing & Sales, 21st Century Informatics</em></div>
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The Indian healthcare sector is increasingly adopting interoperability and standardisation of healthcare technology, yet slow decision-making and low-budget allocation from the providers pose as the key challenges. The industry is still struggling with the lack of awareness on advantages of IT automation. Not consider IT as an enabler to improve organisational performance reflects in their IT budget allocation. In this challenging environment, 21st Century Informatics (21CI), a global healthcare informatics solutions company, is addressing these issues by providing transformative solutions that improve the availability, accessibility and affordability of healthcare services.<br />
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21CI offers innovative healthcare informatics solutions used by healthcare service providers such as hospitals, diagnostic centers and speciality clinics among others. Their innovative offerings of Healthcare Information System, Clinic Information System, Laboratory Information System, Advanced Imaging System, and Electronic Medical Records are process driven, professionally made with input from practicing clinicians and are open to make the system 'tailor-made' for different sub specialities. Today, the company serves more than 500 sites and their experience has helped them offer a global perspective to the Indian healthcare industry that is slowly opening the doors for automation. Through their constant effort, 21CI is able to convince their customers and implement internationally accepted SOPS & best practices in the areas that they automate.<br />
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"Since we serve the emerging markets, we find a mix of new technologies that are already being used or are in development. Domain oriented areas such as EMR with Clinical Decision Support Systems has satisfactorily penetrated in some countries," says Vasukumar Nair, Director-Marketing & Sales, 21st Century Informatics. 21CI is currently working on additional areas such as patient kiosks, doctor’s tablets and personalised performance dashboards for the top management for a couple of their new HIS projects.<br />
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Several Indian hospitals are gearing up to accept the reasonable value for good systems. But their experience with low quality and low-priced applications systems claiming to be HIS or HMS to earn some quick business tends to confuse them. However, 21CI thinks that the hospitals deserve better products and innovative solutions and strives to bring further innovations to their products and services to match the changing requirements of their customers. They are selective in the Indian market and make sure that the company gets into the right place, where the people value their knowledge, best practices, domain and methodologies.<br />
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Since markets are in the early stage of growth, 21CI is also actively involved in developing new products and improving the scope of their current products to empower the entire value chain of Healthcare Business Software Application IT lifecycle. 21CI looks forward to become a global leader in providing best-in-class-innovative products and solutions to their customers, developed and implemented by a team of inspired Centurions.<br />
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<span style="font-family: Arial, Helvetica, sans-serif; font-size: 11px; line-height: 16px;">Disclaimer: This article was published in CIO Review Magazine's June 2013 issue. The article can also be assed through the </span><a href="http://www.cioreview.com/magazine/21st-Century-InformaticsHealthcare-not-Global-but-Local-and-Se...-WZUH951982310.html" style="font-family: Arial, Helvetica, sans-serif; font-size: 11px; line-height: 16px;">following link. </a><span style="font-family: Arial, Helvetica, sans-serif; font-size: 11px; line-height: 16px;">All products and brand names mentioned are trademarks or registered trademarks of their respective owners. All Trademarks remain the property of their respective holders, and in no way indicates any relationship between 21st Century Informatics B.V or its associates and the holders of said trademarks. CIO Review is owned by CIO Review, Bangalore.</span></div>
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21st Century Informatics - Corporate Communicationshttp://www.blogger.com/profile/11362210679429560504noreply@blogger.com1tag:blogger.com,1999:blog-4760429928847724008.post-15461934145181235452013-01-09T20:40:00.000-08:002013-01-09T20:52:36.618-08:00Embracing healthcare software applications<div style="width:150px; padding:15px; margin-left:25px; margin-bottom:25px; float:right; border:solid 1px #999999;"><img src="http://www.21ci.com/images/vasukumar.png" alt="Vasukumar Nair" width="150" height="225" />
<div style="font-family:Georgia, 'Times New Roman', Times, serif; font-size:11px; line-height:18px; margin-top:5px;"> <strong><a href="http://www.21ci.com/aboutus/board_of_directors.html#4">Vasukumar Nair</a></strong>, <em>Director – Marketing & Sales, 21st Century Informatics</em></div>
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<b><span style="color: #cc0000;">What were some of the key challenges that the Health IT sector faced in 2012?</span></b><br />
21st Century Informatics has achieved a few good orders in 2012. For these customers, we are providing solutions ranging from end-to-end hospital information systems to a multi-centred chain of enterprise level solutions. We have leveraged our domain expertise acquired through the last 18 years and continue to provide a scalable, affordable and reliable Hospital Information System. However, the key challenges continue to be slow decision-making and low-budget allocation from the providers’ side. I think there is still lack of awareness on advantages of IT automation and they don’t consider IT as an enabler to improve organisational performance. Finally this will reflect in low IT budgets allocated and sometimes lack of support during the time implementation and that has to be certainly changed.<br />
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<b><span style="color: #cc0000;">What changes you have noticed in healthcare in the year 2012 in areas like Health IT, Medical Equipment, Regulations etc? </span></b><br />
One of the few areas that we call ‘happening’ in India is healthcare. We found a lot of stakeholders such as service providers, regulatory bodies, software providers becoming very active and we believe they are the driving forces for that positive happening. In 2012 we participated in a few healthcare events and we found that the industry is talking about interoperability and standardisation. Advanced healthcare applications definitely require reliable and secured interoperable standards. Another factor is that standardisation of a healthcare process needs to be in place, which can also promote better regulation.<br />
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<b><span style="color: #cc0000;">What are the prospects of growth for the health IT market in 2013? </span></b><br />
Whether it is green fields or expansion of hospitals, or chain of general clinics, speciality clinics – all components of the Indian healthcare, irrespective of their size, are rapidly embracing healthcare software applications and we are seeing a healthy demand for our solutions. Definitely, there are some new healthcare projects coming up and also many in the expansion mode. There will be a need of healthcare IT applications for these new ventures.<br />
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We are constantly innovating to provide new features and functionality to our users. We are working on a new technology platform that enables rapid expansion of functionality during IT products implementation. </div>
<b><span style="color: #cc0000;">Please tell us about some new and innovative solutions/technologies that you are planning to introduce in 2013? </span></b><br />
We are constantly innovating to provide new features and functionality to our users. We are working on a new technology platform that enables rapid expansion of functionality during IT products implementation. It is supported by advancement in cloud computing technology and emergence of the SaaS model. We are hoping that by mid of 2013, we would be able to launch this for our customers.<br />
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<b><span style="color: #cc0000;">What are the top technologies in healthcare that will play crucial role in the year 2013 and beyond? </span></b><br />
There are many technology trends in the market. Whether it is Cloud, Analytics, Big data, the technology is here to stay, but I do not believe that the mid market healthcare organisations have yet taken full advantage of it. I am sure; they can capitalise these emerging technologies and attain competitive advantage.<br />
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<br /></div>Administratorhttp://www.blogger.com/profile/08080079860978274090noreply@blogger.com0tag:blogger.com,1999:blog-4760429928847724008.post-57356265721817503212013-01-09T20:36:00.001-08:002013-01-09T20:54:54.147-08:00Evolving software for transformation<i>The current set of healthcare products is designed to improve the healthcare process by providing customised interventions, reducing the cost incurred, and ensuring an integrated and shared patient-centred care</i><br />
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By <b><a href="http://in.linkedin.com/in/technologyandmarketing" target="_blank">Rajmohan Nair</a></b>, Head – Marketing and Partner Sales, 21st Century Informatics
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There is a tremendous leap in the market primarily due to the implementation of various healthcarecentric laws and acts by institutions and regulatory bodies, advances in technology, and increased awareness among patients and their demand for quality care at low cost. Healthcare providers, hence, have a wide variety of packages to choose from for facilitating healthcare reforms, competing in the market, providing high quality service with low cost of operations, planning for expansion and maintaining efficient control of operations. During the last two decades, a variety of software products have been developed and implemented for healthcare providers. Initially, when electronic records were introduced into the market, their functionality and application value were restricted to the same location (i.e., hospital) they were operational in. Over the years, this restriction has diminished, and the application has evolved into a unified patient-centred EHR system facilitating a seamless inter- and intra-hospital data transfer.<br />
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Although the plethora of healthcare ICT products available in the market provides the basis for a collaborative shared patient care, the effectiveness of these products depends on the accuracy with which they fulfil the dynamically evolving needs of the healthcare industry. These approaches generally encompass all the key processes such as diagnostic and therapeutic procedures, revenue cycle management, administrative function improvisation, policy management and business and clinical analytics.<br />
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Healthcare providers and other stakeholders in the industry must look forward to adopting highly evolvable healthcare applications software that will have the inherent DNA to adapt to ‘constant change’. </div>
<b>The challenge</b><br />
One of the main challenges that affect the need to fulfil the ever-changing requirement scenario is that users are often not satisfied with the products offered and their applications. Survey reports indicate that the dissatisfaction is primarily due to the products’ limiteduser interface and customisation to overcome changing needs. The healthcare ICT industry is becoming aware that the traditional business software approach towards building healthcare software products, which involves a rapid expansion of functionality during implementation and post-implementation stages, is not suitable for the healthcare segment. It has been observed and approved by industry leaders that, especially in the healthcare applications scenario, the key feature of any product is its ‘change’ capability. When organisations are faced with the ‘constant change’ phenomenon due to changes in the business ecosystem, such as organisational, political, economical, statutory, technological and legal, the need for a constantly improvised change request in application software is equally demanding. If these modification requests are addressed by the principal software provider, the biggest disadvantages are huge cost and time, both of which go against the primary requirements of an ideal healthcare product – quick goto- market and low cost. The users of healthcare software packages are demanding a new evolutionary approach in the handling of the product life cycle of healthcare systems. An aging product will not fit the current requirements of the healthcare segment. An evolvable application is hence a prerequisite to satisfy the changing needs of the healthcare industry.<br />
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<b>The way forward and call to action</b><br />
Moving away from a traditional models of software applications, healthcare providers and other stakeholders in the industry must look forward to adopting highly evolvable healthcare applications software that will have the inherent DNA to adapt to ‘constant change’. This approach will make the product suitable for a multi-organisational management, facilitate collaborative workspace, provide flexibility to the users of the system to adapt the system to changing business needs without large customisation costs and empower the users through its learning tools.<br />
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Administratorhttp://www.blogger.com/profile/08080079860978274090noreply@blogger.com0tag:blogger.com,1999:blog-4760429928847724008.post-71276368720710511742012-12-14T02:28:00.002-08:002012-12-14T02:29:41.177-08:00Partner Perfect<em>The choice of the HIS vendor is crucial to the success of a hospital's IT solutions. <a href="http://in.linkedin.com/in/technologyandmarketing" target="_blank">Rajmohan Nair</a> helps you make the right choice in just six steps</em><br />
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Recently, I met a hospital administrator of a large hospital group in UAE. In the course of our discussion, he shared with me that even 11 years after implementing ICT solutions in the hospital, they were still not able to derive major benefits, especially with regards to consolidating data from different units. They had already tried three HIS applications without success! I was left wondering whether the problem was with the product, its implementation or the people involved.<br />
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Having partnered with quite a good number of healthcare institutions in emerging markets as a vendor, I have noticed that healthcare organisations, after spending months on selection and finally choosing a partner for HIS, often feel that they have been locked with a wrong associate.<br />
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Selecting a solution that is perfect for your requirement is the most important factor in a successful ICT implementation. This selection can result in service excellence for the healthcare delivery organisation. It also helps build a long-term relationship with the ICT solution provider. In my experience, there are several challenges in choosing a right company and a right product. But given that there are many companies providing healthcare IT applications—from big names to small players—how does a hospital zero in on the best match?<br />
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Step 1: Identify Your Objective</h4>
The first step a buyer should take is to finalise the objectives of the project and then, document them. This requires organisations to spend quality time and a lot of thought on probing into the expectations all the stakeholders, the processes and departments that need to be involved, and visualisation of what the end product must look like. <br />
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I have seen some organisations that have prepared detailed ICT roadmaps with proper milestones with respect to the philosophy and vision of the hospital. Some of them had even displayed these roadmaps as a summary or a balanced scored format in their departments and meeting rooms. This clarity on objectives is the first step to finding the perfect fit.<br />
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Step 2: Form a Good Team</h4>
Before going further, it helps to choose the set of right people to lead and drive this project. Generally, someone from the top management, for example, the CEO or the chief medical officer or a senior champion from the IT department or from the clinical team, leads the project as per the goal set by the management. <br />
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All stakeholders should bear in mind that this implementation is linked to the core business strategy, and not just to IT. We should also consider a senior person from the management with a good knowledge of the culture and history of the organisation to be part of the group. This person should be such that s/he is able to connect with end users. Also, a decision on who will drive this at the operational level must be taken, probably bythe hospital information manager.<br />
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Determining this third person in the team is one of the key challenges because often, organisations lack good human resources for hospital information management. Other than a few large corporate hospitals, the majority of hospitals in India don't have a good team in the healthcare ICT area. This dearth of qualified staff is due to few individuals looking at healthcare ICT as a good career, due to an absence of good pay or a clear career path. Because of these drawbacks, hospitals often end up recruiting systems managers (with hardware or networking background) or individuals with experience working as database administrators, for this post.<br />
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These candidates are then expected to be the driving factor of a clinically-driven ICT system. This is a costly error, which leads to the entire exercise failing at the implementation stage. Hospitals, keen on bringing in ICT systems as the key driver for an end-to-end revenue cycle management and clinical excellence, need to have the right set of people and form the ‘success’ team.<br />
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Step 3: Ensure that the Proposal Request is Well-Defined</h4>
Providing requirement specifications as precisely as possible is the key to a successful ICT solution implementation. The specification must be granular in nature and must define the complete picture, from the overall vision of the organisation to minute requirements such as user interfaces. Templates are available online that can be used to develop the base structure, though we cannot use the content. Depending on the organisation’s business objectives and expectations, these templates can be modified to make the requirement specifications clear and precise.<br />
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The department objectives (both short-term and long-term results), process efficiency results and the end-user requirements should be in tandem. Even if you choose only a few areas of the healthcare process, the depth and effectiveness of automation in them must be relevant — effectiveness is not measured by number of modules required. Hence, it is not the quantity, but the quality that matters. Further, you need to ask questions that are logical and that connect with the organisation’s internal processes and workflow.<br />
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Step 4: Involve the Top Management</h4>
At times, the top management delegates the task of HIS procurement and implementation to middle management. However, members of the management need to spend quality time with the team right from the ICT planning stage, as ICT solution implementation is a major business driver. If there’s no involvement from the top, they will be out of touch with important decisions taken at the initial stage.<br />
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Step 5: Allocate a Proper Budget</h4>
Often, the budget planned at the beginning shrinks by the time the project reaches implementation stage. The management should avoid doing this as implementation can easily go haywire without enough resources to support it. An unrealistic budget and/ or insufficient allocation of resources prove detrimental to a project and may cause additional problems, both in the short-term as well as the long-term.<br />
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Wrong allocation of resources and budget is equally detrimental to the organisation. For example, the organisation may eventually spend more for the hardware and less for the software. Any investment made on ICT will be mediocre if the right approach is not taken while going in for a new system. For instance, if staff members assigned to HIS project procurement do not spend time during the procurement process and try to hasten the process by packing demos and vendor interaction within a short time frame, the results will be disappointing. Hence, along with dedicating the right budget, it is important to allocate the right monies and time in right measure for each stage of planning and implementation.<br />
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ICT is a valuable tool to capture financial performance, attain patient satisfaction, and achieve clinical excellence
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Step 6: Look At Quality Not Quantity</h4>
For the last two decades, there has been an appreciable advance in the usage of HIS/HIMS applications in India. From a buyer’s perspective, a decade back, when we were to ask the CEO of a large or a medium-sized hospital about ICT solutions for the organisation, the reply would have been, “We are fully computerised. However, we are not getting the right benefits from the system.”<br />
In reality, the definition of a fully computerized system would have been front office billing, patient tracking in the wards, pharmacy and back office financial management systems. Many of these elements may not have been integrated. The management would not have been able to differentiate or assess the level of ICT maturity. There was low awareness about how ICT could help the management achieve better control — it is a valuable tool to capture financial performance, attain patient satisfaction, achieve clinical excellence and thereby gain competitive advantage.<br />
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If they are asked the same question today, the reply probably is: “Yes, we are managing information system in the billing, inventory, diagnostic and laboratory departments, and more. Our HIS has been integrated with a leading financial application. Our doctors have started using EMR and our IT staff is able to provide MIS reports. We are in the process of upgrading and we have to put lot of effort from our end to make this happen.” <br />
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Today, hospitals have tasted the fruits of successful HIS implementation and known its failures as well. Hence, it is important to know that there is a larger implementation cycle. Some buyers are ready to accept that it is not the product or implementation that makes a successful ICT solution, but the joint effort of the hospital management that makes all the difference.<br />
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THREE THINGS TO REMEMBER </h2>
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1. Arrive at the true cost</h3>
Calculate the true total cost of ownership (TCO) of the different products you are considering. The technology you select and associated components will also play an important role in pricing. Consider the license cost of the software—is it on premise or is it on demand? The true TCO of any large HIS solution covers license, customisation, project management, training, additional software associated with infra for on-premise solution network bandwidth and IT staff.
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2. Look at complementary products</h3>
Consider each vendor’s other business application offerings. HIS is often sold alongside such as EMR, RIS/PACS, CDSS and analytics. Decide now if you plan to extend ICT maturity into different stages of EMR maturity to narrow your vendor options. For instance, if you choose a solution with a specialty EMR, then an EMR that can be scaled to CDSS be will be the obvious choice. Finally, check out the basic standards and statutory requirement, such as ICD code and HL7, localisation and inter-operability.
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3. Consider SaaS</h3>
It is to wise include a Software-as-a-Service (SaaS) solution in your assessments. The SaaS model is soon going to be the next adoption for any business software application, including healthcare ICT. SaaS offerings not only have a lower total cost of ownership, but they are also easier to deploy than on-premise solutions. They can also be implemented faster. Besides, SaaS-based data security standards are fast evolving for the benefit of hospitals.
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<br />Administratorhttp://www.blogger.com/profile/08080079860978274090noreply@blogger.com0tag:blogger.com,1999:blog-4760429928847724008.post-89786440484362703042012-12-12T00:41:00.001-08:002012-12-12T00:41:35.719-08:00Spreading Knowledge: 21CI Team Member, a Visiting Faculty at a Prestigious Business School <a href="http://21ci.com/images/tushar_welinkar_lrg.jpg" target="_blank"><img alt="Tushar Ratanghayra" border="0" src="http://21ci.com/images/tushar_welinkar_th.jpg" /></a> <br />
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Tushar Ratanghayra, Head Business Support at 21st Century Informatics completed a course on Healthcare IT for PGP HCM Program at Welingkar College. The visiting faculty and Students (the batch size of 27 of working professionals consisting of Doctors & Para Medical Members of Clinical fraternity) at Welingkar College on a photo shoot of this exciting batch!<br />
Administratorhttp://www.blogger.com/profile/08080079860978274090noreply@blogger.com5tag:blogger.com,1999:blog-4760429928847724008.post-57185654443630919612012-10-19T05:24:00.001-07:002012-10-19T05:24:02.624-07:00 Technological Challenges while Implementing EMR and its solutions<div dir="ltr" style="text-align: left;" trbidi="on">
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The adoption of EMR has always been a matter of concern for HIMSS. EMR adoption lags behind other industry sectors significantly in the US and other developed countries and it is at very primitive levels in emerging economies like India. In June 2009, a HIMSS Task Force published a report on EMR Usability. In this report, the task force listed many causes for the low adoption such as cost, resistance to change, fear or avoidance of technology, ingrained patterns of behaviour and reliability and usability of the software.<br />
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In this talk today, we will hear about an important factor in boosting the EMR adoption – the way the IT systems handle the EMR software life cycle. The speaker is Devesh Rajadhyax who heads the R & D efforts at 21st Century Informatics. Devesh is a post graduate in Engineering and is working in Healthcare IT Systems since 1997. He has played various roles earlier, including architecting solutions and heading product development. The company he co-founded, 21st Century Informatics, is focussed on transforming the way IT systems are used by Healthcare organizations through innovation. Devesh is going to talk about a new approach to EMR software.<br />
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In his talk, Devesh argues that the traditional business software approach of looking at IT systems, which involves a rapid expansion of functionality during Implementation is not suitable for EMR. Certain characteristics of EMR and its users demand a new Evolutionary Approach to the handling of the life cycle of EMR systems. This approach is well supported by the advancement in cloud computing technology and emergence of the SaaS model. A wide acceptance of Evolutionary Approach can mean higher rates of adoption of EMR by Healthcare organizations.
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Administratorhttp://www.blogger.com/profile/08080079860978274090noreply@blogger.com1tag:blogger.com,1999:blog-4760429928847724008.post-65993410317164458502012-08-08T23:14:00.005-07:002012-08-08T23:15:19.387-07:00Mapping the Implementation<i>
My experience with implementation of effective clinical transformation comes from a medical institute specialising in diabetes. The institute is equipped with state of the art medical technology and it conducts advanced research and takes educational initiatives</i><br />
By <b>Rajmohan Nair</b>, Head – Sales (Partner), 21st Century Informatics<br />
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There were various challenges faced by an institute in implementing IT solutions, as they were a new medical centre. The team there was not very IT savvy and this was basically a specialty centre, where research was also being conducted. Hence integration challenges of specialty Electronic Medical Records (EMRs) and revenue cycle management was also considered.<br />
<br />
They were also aware of the difficulties they would be facing while evaluating options to implement an EMR especially in the start-up stage. The industry reports made them take a very cautious approach – the report indicated that many organisations discovered post-implementation problems in their EMR. The EMR does not integrate well with other existing or new IT systems, it is not tailor-made for the organisation’s unique business needs. It brings down clinical workflow and creates dissatisfaction.<br />
<br />
The centre decided to implement a tightly integrated EMR that provides the benefits of realising the required cost reduction and achieving the desired efficiency improvements in patient care. The applications they were aiming for not only had to capture data at the point of care, but also had to support the doctors in decision making.<br />
<br />
<h4>
Approach taken</h4>
With the primary objective of optimising the clinical operations, 21CI’s highly trained consultants proposed business process consulting study, in other words an ICT roadmap creation and solutions deployment. 21CI’s business process consulting and business process blue print document provided an in-depth understanding of clinical and business processes that helped the medical centre build an ICT roadmap. Next, we mapped the organisation’s unique ICT needs and based on the business process blueprint, and we configured our 21CI apex health information system.<br />
<br />
A range of solutions were deployed under 21CI Apex Health Information System and proper training was provided to the key users. Clinic Information System (CIS) with day-care facility and laboratory Information system and Electronic Medical Records (EMR) and Picture Archiving and Communication Systems (PACS) were deployed.<br />
<br />
<h4>
Results</h4>
One year after the date of implementation, 21CI and the medical centre jointly evaluated the benefits achieved. The study found that the centre had attained ICT-enabled revenue cycle management with diabetes management as the core pillar. This had the potential of improving care processes, delay diabetes complications, and provide adequate healthcare. A major benefit was that the time needed to service clinical processes was transformed from a semi-automated to process-driven automation. There was a reduction in transaction cost, and this resulted in a saving of almost 30 percent. The overall quality of patient service was improved, leading to increased patient satisfaction. There was an improved and effective billing capability. This eased clinical reviews and accelerated disease prevention interventions<br />
<div>
<br /></div>Administratorhttp://www.blogger.com/profile/08080079860978274090noreply@blogger.com4tag:blogger.com,1999:blog-4760429928847724008.post-59106504180196604222012-04-13T10:41:00.000-07:002012-04-15T10:46:17.431-07:00ICT Processes in Healthcare Organizations at Welingkar College<img src ="http://www.21ci.eu/img/welingkar-team-tushar.jpg" /><br />
<p>Tushar Ratanghayra, Head Business Support at 21st Century Informatics teaches a course on ICT Processes in Healthcare Organizations at Welingkar College. The visiting faculty and Students at Welingkar College on a photo shoot of this exciting class! </p>Administratorhttp://www.blogger.com/profile/08080079860978274090noreply@blogger.com4tag:blogger.com,1999:blog-4760429928847724008.post-36852051984932077252012-01-07T09:25:00.002-08:002012-04-22T22:47:46.980-07:00Being Wrong: the great source of knowledgeTEDx Youth@Academy 2011 Simanta Das<br />
<br />
<iframe allowfullscreen="" frameborder="0" height="476" src="http://www.youtube.com/embed/SKsmBelz4pU" width="476"></iframe>Administratorhttp://www.blogger.com/profile/08080079860978274090noreply@blogger.com0tag:blogger.com,1999:blog-4760429928847724008.post-70154222653426917652011-06-26T07:44:00.000-07:002011-06-26T07:44:27.470-07:00Importance of Costing Systems in HospitalsModern day hospitals provide a variety of services to patients under one roof. It is akin to a large service organization considering the number of personnel involved and the capital-intensive nature of the business be it the civil structures, operation theaters & equipment, diagnostic and therapeutic equipment, resuscitation equipment, gas lines, surgical instruments, consumables, etc. Moreover, it is a 24 x 7 operations with people playing a vital role in the well being of the patients in the hospital.<br />
<br />
Unlike hotels or the hospitality industry, there are several distinguishing factors in a hospital such as:<br />
<ul><li>It provides a fundamentally humanitarian service. Thus, hospitals cannot turn away needy patients just because they do not have money to pay or because it is a Medico-legal case. Hospitals have to factor in costs incurred during such a scenario in the financials.</li>
<li>Corporate hospitals have a profit motto. However, they also have a Corporate Social Responsibility in which they serve certain sections of the population, at no or little cost.</li>
<li>Other than corporate hospitals, we have either Government run or charitable trust run institutions. So, public funds which is involved needs to be efficiently deployed so that healthcare needs of a large mass of the population is met. This is true even if the objective of the institution is not to make profits.</li>
<li>Certain class of hospitals, which are predominantly trust run or enjoy municipal / Government benefits are supposed to reserve a proportion of beds for the economically weaker section and/or for patients below the poverty line. Hospitals have to create an Indigent Patient Fund to cater to these patients.</li>
<li>Services provided by hospitals are the same across classes of patients; however, hospitals tend to cross-subsidize general patients by charging higher to deluxe class patients.</li>
<li>Hospitals today service corporate as well as insurance / TPA patients. Because of the commitment to serve large number of beneficiaries, they tend to demand and get discounts on rack rates.</li>
<li>Pharmacy stores are also to be differentially charged to BPL patients compared to regular patients.</li>
<li>“Packages” also form a mainstay in the business especially in the cardiology, orthopedic, gynecology and obstetrics specialties as also routine daycare surgeries such as cataract, appendectomy, hydrocele, pilectomy, renal calculi or hernia.</li>
<li>Hospital Accreditation and quality standards ensure that hospitals follow documented policies and this helps hospitals in having predictability of outcomes.</li>
</ul>The above complexities necessitates that the hospital management put in place robust costing systems. However, traditional hospital managements have not given serious thought to the same. The corporate world has adopted and benefited from good costing systems, since the early 1930’s. The same holds true of modern day corporate hospitals, who believe in providing cost effective services to patients and ensuring patient loyalty to the healthcare provider.<br />
<div><div><br />
It is sad to see that in most hospitals, even today, the process of fixing the Schedule of Charges has no scientific basis. They simply survey nearby hospitals for their rates and fix their rates a tad above or below the other hospitals, depending on the Management Philosophy / Marketing Strategy.<br />
<br />
Traditionally, hospitals used Bed Occupancy as the yardstick of measurement of performance. With the advancements in medical technology, the average length of stay (ALOS) is reducing and hence, bed occupancy is not the main performance measure any longer. The increased utilization of costly resources, e.g. equipment in operating theatres, ICUs, Cath-Lab, Pathology Lab etc. & Doctors’ times are the key to success in hospitals.<br />
<br />
<br />
<span class="Apple-style-span" style="font-size: large;">Importance of a good costing and management accounting system</span><br />
The scenario in the past few years has changed dramatically within the healthcare industry. Established names in the industry are facing tremendous competition from the newcomers. Thus, each hospital has to be competitive both in terms of the quality of services as well as cost management.<br />
<br />
Until a few years ago, it was practically absurd to think of a Marketing function within a hospital. That situation is passé with almost every hospital worth its salt employing marketing professionals to attract new corporates. Hospitals also employ Loyalty Cards, Discount Health cards to attract and retain customers.<br />
<br />
The advent of health insurance companies has also queered the pitch. With the costs of treatment going up and the privatization of the insurance industry, the hospitals are forced to give quality service at highly competitive prices as the insurance companies will pay only for the services that are desired and will also monitor the services that are rendered closely. This leads to deductibles, co-payments and all claims by hospitals do not get settled hundred per cent. There is also a time element involved as costs are incurred upfront and outstanding amount is received only after a couple of months.<br />
<br />
It is therefore imperative for hospitals to have a system to control the costs, while at the same time providing high quality service to the patients.<br />
<br />
<br />
<span class="Apple-style-span" style="font-size: large;">The Costing Problem</span><br />
Patients undergoing treatment receive services of varied nature from different departments. The hospital has to recover the expenses of the direct departments as also of the support departments from the patients availing of these services.<br />
<br />
Nowadays, any composite hospital with latest facilities for advanced medical/surgical procedures in the various areas of treatment will have nearly 50 or more revenue centers and about 10 to 15 supporting service centers. Furthermore, most of the revenue centers, particularly, in-patient wards, will have classification depending on the level of services for different class of patients according to their monetary or other needs. Again, each department, other than Wards, undertakes several types of procedures/operations etc.<br />
<br />
All these make the list of procedures and classification of services quite large. It is for this reason that ascertaining true costs of various services and fixing of the Schedule of Charges becomes extremely complex. Costing needs to be done after careful analysis of past data, comparative data from other hospitals, study of utilization of capacities. Costing techniques shall be applied to provide acceptable costs and charges, enabling optimization of capacity utilization, which, in turn, result in better overall revenues and leave adequate funds for growth and development of newer and advanced facilities.<br />
<br />
<span class="Apple-style-span" style="font-size: large;">Setting up a Costing System</span><br />
Unlike in other industries, where pricing of products / services is generally uniform except in special cases such as exports, institutional sales etc., in hospitals most of the services rendered are charged at different rates based on class of patients. Besides, a category of patients are given free or semi-free treatment, where the charges are nil or kept very low.<br />
<br />
Thus, the final charges or pricing has no direct relevance to ‘costs’ individually. But, the overall revenue expected from the charges recovered from all patients has to cover the total costs incurred, to make the procedure or department self-supporting. This matching of expected revenue and costs can be done only on the basis of exhaustive analysis of past quantitative and financial data. Thus, detailed statistics play an extremely important role in Costing of services and fixing of schedule of charges.<br />
<br />
Based on such analysis, discussions with medical personnel of each department, regarding the practical problems and expected quantum of each procedure withclass-wise level of patients and detailed budgeting of revenue has to be made. This forms the broad structure for cost allocation to the various cost centers and fixation of individual charges. Keeping in mind the purpose and its importance to the hospital in recovering all expenses incurred, the procedure for cost allocation should be designed so as to obtain accurate and realistic results. We shall not go into the intricacies of these procedures in this article but limit ourselves to the basic steps for the purpose of ascertaining the final costs to obtain the desired results.<br />
<br />
Broadly, the steps needed are:<br />
<ol><li>Identify the various cost centers in the Institution and arrange them into:</li>
<ol><li>Revenue producing centers by charging to patients for the services and</li>
<li>Supporting non-revenue producing centers</li>
</ol><li>Allocate direct expenses to all centers by analysis of each element of cost</li>
<li>Develop cost allocation criteria for allocating costs of supporting cost centers to other supporting cost centers and revenue producing centers, ultimately bringing all costs into revenue producing centers, do this on the basis of services rendered for other centers.</li>
<li>Now, each revenue center has the total direct costs of the center and indirect costs representing the allocated expenses of the supporting centers.</li>
<li>The total costs thus arrived at for each of the revenue providing centers is to be appropriately distributed among the various services rendered to the patients by that center. This involves not only finding the nature of the services but also learning the general application of the services to the patients. This should be done in conjunction with the medical personnel and modalities determined for each type of service.</li>
</ol>Once the costs are available for each profit & cost center, they can be used for the various purposes identified earlier. Typically, to arrive at the above costs, one needs to setup various monitors across the hospital, which will give the necessary data for computing the costs. Computerization could significantly simplify the process of data collection and analysis. A good Hospital Management System software should form the basis for the costing system.<br />
<br />
<span class="Apple-style-span" style="font-size: large;">Objectives of a costing system</span><br />
<br />
<b>Utilization of resources:</b><br />
A costing system should monitor the resource utilization across the hospital. These resources can be infrastructure, equipment, materials or personnel. Each department has a key driver and the system should track these drivers on a continuous basis. This will ensure that each department is efficient.<br />
<br />
<b>Department-wise profitability analysis</b><br />
A good costing system should enable generation of this very valuable information on an on-going basis. Managements can take corrective steps using this data. It enables fixation of responsibilities and monitoring them. Coupled with a budgeting system, hospital management will have full control over the working of the hospital.<br />
<br />
<b>Fixation of doctors’ honorarium</b><br />
This is a very touchy subject for most hospital management. The honorarium systems can be very complex, with some hospitals adopting honorarium calculations, for each individual consultant. With a costing system, they can negotiate a fair rate for the doctors for each service rendered. The doctors also will be assured of a reasonable and scientific basis for their remuneration.<br />
<br />
<b>Fixing Schedule of Charges</b><br />
This document also called the Rate card can make or break a hospital. The costing system should provide inputs to fix the charges for the various services rendered for each class of patient.<br />
For purchases of new equipment or infrastructure, the costing system should enable the managements to arrive at the feasibility of the project, based on hard data. More importantly, the system should keep track of the status of the projects after they are commissioned. Generally, at the time of feasibility stage, certain estimates & assumptions are made. But almost never are they monitored after commissioning.<br />
<br />
<b>Monitoring of factors affecting pricing</b><br />
The costing system will keep a tab on all factors affecting pricing. For example, material costs directly affect prices. Any major variation in material costs should be highlighted and price changes effected immediately after ascertaining the impact of the variation on margins.<br />
<br />
<span class="Apple-style-span" style="font-size: large;">Summary</span><br />
Whatever be the philosophy of the Management, they need to ensure efficient utilization of costly resources and they should take informed decisions on pricing. A scientific Costing system is a very important tool for Managements to fulfill these needs and hence, is imperative for the successful running of a Hospital.<br />
<br />
<div style="background-color: #f0f0f0; border: dotted 1px #CCCCCC; color: #333333; color: #666666; font-size: 11px; line-height: 16px; padding: 10px;"><strong>About the Author: </strong><br />
<br />
Mr Ravi Mani is the CEO of 21st Century Health Management Solutions and has over two decades of experience in designing robust solutions in the Healthcare vertical. Mr Ravi Mani has a Bachelor’s degree in Engineering and is a qualified Cost Accountant.</div></div></div>Administratorhttp://www.blogger.com/profile/08080079860978274090noreply@blogger.com0India20.593684 78.9628800000000416.071455499999999 64.319952500000042 35.1159125 93.60580750000004tag:blogger.com,1999:blog-4760429928847724008.post-60879591278911841742011-06-23T13:57:00.000-07:002011-06-23T13:57:57.169-07:00The EHR Story in NHSAn analysis of NHS doctors of Indian origin using EHR<br />
The practice of medicine is inextricably entwined with the management of information—Shortliffe<br />
<b>Dr Mithun Barik</b><br />
<b><br />
</b><br />
<br />
Practicing medicine can be unforgiving, dangerous and unrewarding. Life is often a nightmare if it comes to treating patients in a completely new and advanced set-up like National Health Service (NHS), UK. Especially doctors from developing countries can find it quite hard to adjust to a setting governed by strict protocols designed to maintain its high standards. The fact that bothers them most is that the amount of detailed documentation to be done for each patient and that too in a 'computer-based medical record system' which is totally unique to them. So, do computer-based patient records help these young doctors to cope with the challenges or does it make their life more dreadful?<br />
<br />
To find out the effects of Electronic Heath Records (EHR) on the practicing life of Indian doctors in the UK, several informal interviews were conducted with NHS doctors of Indian origin. The synopsis is that EHR is indeed a boon and it actually has helped to dramatically improve the outcomes of their treatment process.<br />
Experiences Galore As Dr Nitin, SHO, General Medicine recalls, "When I first saw nurses carrying laptops in ward rounds, I thought that it was a complete waste of time and money. But soon I realised that these were more than just gadgets, they are actually the backbone of the whole patient medication system."<br />
<br />
According to Nitin, the laptops are used to maintain patient medication charts and the nurses fill up a checklist for every patient after giving them medicine. "This way, I can see the exact amount of medicine a patient has received during his inpatient days and accordingly calculate the doses required after his discharge." Nitin also feels that computer-based patient records significantly decrease human errors through alerts and contraindications of drugs. It is also a great learning experience for her, as the system contains detailed information about drugs: indication, dosages, pharmacokinetics, pharmacodynamics etc.<br />
<br />
Dr Nrupaditya, SHO, Geriatric Medicine, feels that EHR boost team working. "An integrated computer-based patient record improves the communication between different axes of clinical care team. The supervising and referral consultants, radiologists, pharmacists and nurses can interact within the system which enhances team work as well as saves valuable time." For example, the prescriptions by the SHOs are regularly validated by pharmacists and views about the appropriate medicine are often exchanged between them in the form of notes.<br />
<br />
<br />
the name of medicines from the drop down menus. Also, it makes doctors forget the doses of medicines as it comes automatically in the system." According to him,<br />
doctors become too dependent on the system over a period of time and in turn become less efficient. Despite this, he is in the favour of the system as ultimately it leads to totally computerised patient records, which is of immense importance to medical researchers.<br />
<br />
On the other hand, PACS as a part of computerisation of patient records has revolutionised the concept of medical imaging, feels Dr Nimbalkar who is attached to the Department of Radiology in a leading NHS hospital. "PACS helps me to focus on the specific image showing disease pathology and thus helps to reach diagnosis faster. It also gives me the opportunity to report quickly by providing disease specific templates which describes the common diagnoses." The possibility to select and enhance specific slides containing disease pathology has helped the surgeons to focus better on the exact site of the disease. "The system includes complete pre-surgical protocols for common operations which saves lot of time as they are very lengthy to write," comments Dr Vaidya, SHO,General Surgery.<br />
<br />
<b><span class="Apple-style-span" style="font-size: large;">Better Auditing Systems</span></b><br />
EHR is also of paramount importance in medical audits. According to Dr Bhattacharya,Endocrinologist and Clinical Research Fellow, computer-based patient records fasten up the data collection and analysis process of medical audits. "Whenever I need any information about any patient, I search the database by providing specific criteria and the data just appears in a flash. This saves time, especially in retrospective clinical studies." The results of drug trials can be closely monitored and accordingly the findings lead to foundation of new research activities. Overall, the doctors believe that EHR has helped them to serve their patients better and feel that this kind of system should be introduced to Indian hospitals as well. As expressed by Dr Arora, who is currently doing a clinical attachment in a NHS hospital: "It is really exciting to see that such a system exists and I am looking forward to use it." Oxford Handbook of Clinical Medicine states that the most elemental thing of clinical house job is 'survival' amongst adverse working conditions. It appears that electronic medical records have provided few more 'lives' to the combating medicos.<br />
<br />
<i><span class="Apple-style-span" style="color: #444444; font-size: x-small;">The writer is an EMR Consultant 21st Century Health Management Solutions UK</span></i><br />
<i><span class="Apple-style-span" style="color: #999999;"><br />
</span></i>Administratorhttp://www.blogger.com/profile/08080079860978274090noreply@blogger.com0tag:blogger.com,1999:blog-4760429928847724008.post-26572890071438138642011-06-22T00:46:00.000-07:002011-06-22T00:46:16.662-07:00How to run your healthcare business better?<span class="Apple-style-span" style="color: #666666; font-size: large;">It does not matter whether you are a "for profit" organisation, a "not-for-profit organisation", a "charitable institution", or a "welfare organisation", your end goal remains the same. To be an affordable, accountable and efficient service delivery platform</span><br />
<br />
Irrespective of being a small clinic, a laboratory, a diagnostic centre, a hospital or a pharmacy or for that matter anyone who needs to work with patients, your primary aim is to provide a service. The service is to resolve the problem for which your patient came to you. It is equally important that you make profits, not because it happens to be the reason for your existence in business, but because that's the only way your business can run. Address it as a service, a profession, a vocation or by any other name that pleases you. The bottom line is that your role is to provide an efficient service to the patient, at an affordable price that too in a manner, such that it ensures you can continue to provide the service better, as a profitable venture, keeping in mind your employees and associates enjoy what they do.<br />
<br />
It does not matter whether you are a "for profit" organisation, a "not-for-profit organisation", a "charitable institution", or a "welfare organisation", your end goal remains the same. To be an affordable, accountable and efficient service delivery platform.<br />
<br />
In this and the upcoming features slated to be published in the due course of time, we invite you on a journey towards improving the way your business can run. It is a journey without any ending, for improvement has no limits, except your own thought process.<br />
<br />
Anyone who has been running a healthcare facility knows that the money comes in from the surgeries, diagnostics, pharmacy, bed charges and nursing charges. These are the services, for which the patient pays the most. The money comes from patients, insurance, corporate organisations who cover their employees and their dependents, and other financers like private and public trusts, government and good samaritans who donate generously.<br />
<br />
Introspecting on your healthcare organisation inwards, you need to provide the services efficiently, maximise delivery at the lowest cost. Looking outwards, you need to be a good public relations organisation managing relationships with insurance, corporate organisations, government, trusts and the members of the society.<br />
<br />
The single largest cost of running a healthcare organisation undoubtedly is the cost of manpower. This fact holds largely true for organisations that provide a service. At times, the cost of finance, the cost of materials and the cost of maintenance of the organisation may also compete with cost of manpower, often depending on the nature of the organisation, its age and location, its mode of financing, its policies and its efficiency.<br />
<br />
That is where the money is spent though not intended. Where the money goes as ''waste'' may well be unpaid bills, loss of efficiency of the staff, pilferage, breakage and misuse of materials, losses due to delayed payments to vendors and delayed receipts from customers, Concessions and cancellation of wrongly billed services and materials for which the patient was never billed.<br />
<br />
If you could quantify the money that you may be losing on account of the aforementioned parameters, it is indeed an indication to take a fresh look at your work style and approach. Here is a small check list of how much money you are losing which is not based on arithmetic calculations, but on the impact it has on your business:<br />
How much money have you lost due to concessions, cancellations and write offs? All amounts to a dead loss.<br />
How much money have you lost on account of delayed payments? For every Rs 1000 delayed by one week you lose Rs 3.50.<br />
How much stock went unaccounted? How much did you lose because the physical stock was lower than the stocks as per your books of account?<br />
Are you overstocked on inventories? Every Rs 100000 of additional inventory costs you Rs 15000 per annum.<br />
Every time you delayed payment to your vendors by one week your effective cost of materials will be more by at least three per cent.<br />
Are you losing money due to misuse of materials? Look at items that should not be consumed in such a high quantity. Often this figure may be of the order of two to 10 per cent depending on how good your systems may be.<br />
How much money are you losing because your costly equipment is lying under-utilised? These figures are anywhere from bet ween five to 25 per cent or more.<br />
Are you conducting diagnostic tests where the reagents are under-utilised? Are you getting only 10 tests done from a kit that can be used for 50 tests? That loss can well be 10 per cent of the total cost of kits or more.<br />
It does not take a qualified college degree in financial management to know that if your total costs are 10 million you may be losing anywhere between three million rupees of the total costs due to such a waste. If you are losing under one million, we would like to learn from you, how you are managing your business.<br />
<br />
Can we teach you how to run your business better? Yes, No or Maybe.<br />
Yes, because that's what we are going to talk about in the rest of the series of these articles. We will guide you through these articles to help you run your business better.<br />
<br />
No, because you know how to run your business. No one can do it for you.<br />
<br />
Maybe because if you would like to run it better, help is always available.<br />
<br />
The question is how? The forthcoming features will include articles that will give you an outline on how to set business objectives, understand your current state, and plan for the future. We will also help you to create a business process improvement project plan, select the right tool for change, facilitate you to put that plan into practice and finally prepare a road map to success.Administratorhttp://www.blogger.com/profile/08080079860978274090noreply@blogger.com2tag:blogger.com,1999:blog-4760429928847724008.post-61378885887058063412010-10-15T09:20:00.000-07:002012-04-07T09:24:42.791-07:00TEDxAcademy - Simanta Das<iframe allowfullscreen="" frameborder="0" height="323" src="http://www.youtube.com/embed/Y72QTeBIkQM" width="476"></iframe>Administratorhttp://www.blogger.com/profile/08080079860978274090noreply@blogger.com2tag:blogger.com,1999:blog-4760429928847724008.post-16405333720794522682010-08-04T01:18:00.000-07:002011-07-03T01:24:49.521-07:00Aniruddha Nene at eIndia 2010Aniruddha Nene, Principal Consultant and Director at 21st Century Health Management Solutions Private Limited speaking at eIndia-2010.<br />
<hr /><iframe allowfullscreen="" frameborder="0" height="435" src="http://www.youtube.com/embed/ZuJroA7eBJg" width="580"></iframe><br />
<hr /><iframe allowfullscreen="" frameborder="0" height="465" src="http://www.youtube.com/embed/pAdR7xovSVw" width="580"></iframe><br />
<hr /><iframe allowfullscreen="" frameborder="0" height="435" src="http://www.youtube.com/embed/FXlEgrpZkqQ" width="580"></iframe><br />
<hr /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiuHsBJRZumB1QAisexZqmAlJjmXylLnbCKrB0HLdAATavWtBkZjpvADjEOBbfCdXWYb5OOJ5VGxPXsdSG5mmw67Ex2DkrU_nf2rZmzXjn40GbIkExBHOnmonyvua_wbfCK1BfTVE5FzXp6/s1600/eIndia2010.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="162" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiuHsBJRZumB1QAisexZqmAlJjmXylLnbCKrB0HLdAATavWtBkZjpvADjEOBbfCdXWYb5OOJ5VGxPXsdSG5mmw67Ex2DkrU_nf2rZmzXjn40GbIkExBHOnmonyvua_wbfCK1BfTVE5FzXp6/s320/eIndia2010.jpg" width="320" /></a></div>Administratorhttp://www.blogger.com/profile/08080079860978274090noreply@blogger.com1tag:blogger.com,1999:blog-4760429928847724008.post-66877172272123631442010-03-31T06:01:00.001-07:002012-03-31T06:08:25.826-07:00Featured Contributors<table width="450" border="0" cellspacing="0" cellpadding="2" style="text-align:center;"> <tr style="text-align:center;">
<td><img src="http://21CI.eu/healthcareinsights/blog_imgs/sim_das.jpg" width="103" height="68" /> </td>
<td><img src="http://21CI.eu/healthcareinsights/blog_imgs/rsm.jpg" width="103" height="68" /></td>
<td><img src="http://21CI.eu/healthcareinsights/blog_imgs/dev.jpg" width="103" height="68" /></td>
</tr>
<tr>
<td><em><a href="#">Simanta Das </a></em></td>
<td><a href="#"><em>Ravishankar Mani </em></a></td>
<td><a href="#">Devesh Rajadhyax </a></td>
</tr>
</table><p> </p><table width="450" border="0" cellpadding="2" cellspacing="0" style="text-align:center;"> <tr style="text-align:center;">
<td><img src="http://21CI.eu/healthcareinsights/blog_imgs/asn.jpg" width="103" height="68" /> </td>
<td><img src="http://21CI.eu/healthcareinsights/blog_imgs/vkn.jpg" width="103" height="68" /></td>
<td><img src="http://21CI.eu/healthcareinsights/blog_imgs/blnk.jpg" width="103" height="68" /></td>
</tr>
<tr>
<td><a href="#"><em>Aniruddha Nene </em></a></td>
<td><a href="#"><em>Vasukumar Nair </em></a></td>
<td> </td>
</tr>
</table><p> </p>Administratorhttp://www.blogger.com/profile/08080079860978274090noreply@blogger.comtag:blogger.com,1999:blog-4760429928847724008.post-703804948035063842010-01-15T06:38:00.000-08:002011-07-02T06:43:57.127-07:00Healthcare IT Projects – Issues and Opportunities<span class="Apple-style-span" style="color: #666666; font-size: large;">"Be it the hospitals, pathology laboratories, diagnostic imaging centres or for that matter even pharmacy outlets, today all are strategizing to be different from others and dream of being market leaders. And in order to be able to realize this explicit objective they have started looking at healthcare IT solutions as a critical differentiator."</span><br />
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<span class="Apple-style-span" style="font-size: large;">Introduction</span><br />
The vibrant and dynamic healthcare market of contemporary times continues to thrive in an environment of severe cut-throat competition and enormous uncertainties. On the one hand is the opportunity to cash in on the tremendous growth opportunities, while on the other hand there is intense pressure to survive against young, lean and innovative players. Acknowledging this reality, majority of the market players have undergone a dramatic transformation in their attitudes. Be it the hospitals, pathology laboratories, diagnostic imaging centres and for that matter even pharmacy outlets, today all are strategizing to be different from others and dream of being market leaders. And in order to be able to realize this explicit objective they have started looking at healthcare IT solutions as a critical differentiator. This paradigm shift has significantly paved a way for increased percolation and utilization of healthcare IT products and solutions in healthcare delivery. There is a clear and unanimous understanding among all the stakeholders about the benefits of information technology in improving the operational efficiency, quality of patient care and image branding. Thus, in the recent times healthcare IT is undergoing serious boost in its acceptance. However while acceptance signals a triumph; the flip side is that the very decision of deploying IT solutions by healthcare delivery providers exposes a raw wound and thus reveals issues and challenges associated.<br />
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If we categorically target the hospital sector, as a general observation, most of the hospitals venture in the adoption of IT solutions keeping in minds the above mentioned benefits. Once decided the process encompasses a whole gamut of activities which ranges from vendor selection to software implementation.<br />
<div style="background-color: #f7f7f7; border: dotted 1px #d8d8d8; float: right; font-family: Georgia, 'Times New Roman', Times, serif; font-size: 16px; font-style: italic; line-height: 24px; margin: 10px; padding: 10px; width: 200px;">"Healthcare IT projects involve a galaxy of management techniques and skills. These projects offer a tremendous learning opportunity to all stakeholders involved.".” </div><span class="Apple-style-span" style="font-size: large;"><br />
</span><br />
<span class="Apple-style-span" style="font-size: large;">Issues</span><br />
<b>Vendor selection is not the end</b><br />
For most of the hospitals, a myth prevails that selection of a big IT company is synonymous to a robust system and a successful implementation. Hence, a significant amount of time and energy is devoted in selecting an IT vendor. In fact, majority of the hospitals managements believe that once the budget is allocated and vendor selection is done, their role and responsibility for the remainder of the project becomes passive and is limited only to providing data, infrastructure and some resource. However, in my opinion it is this mindset which is responsible for most of the failures in software implementations in healthcare. Indeed vendor selection constitutes a critical step but hospitals should look at the project beyond it and with a broader spectrum.<br />
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<span class="Apple-style-span" style="font-size: large;">Select solution partners, not vendors</span><br />
The second biggest issue is that hospitals in general select vendors as against solution partners. There could be a non exhaustive list of vendors in the healthcare IT market but what hospitals should look for is a solution partners and not a vendor. Generally it is found that vendors come with a technical perspective and thus a very confined knowledge of healthcare domain. This limits them from addressing many such issues<br />
which are crucial from the hospital management's perspective On the contrary a solution provider with its rich and varied knowledge of the domain appears more promising and provides both the IT solution as well as the required expertise of the field. <br />
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<span class="Apple-style-span" style="font-size: large;">Focus on project management approach </span><br />
Another issue is the practice of neglecting the important role of project management. Project management approach holds the key to sustained success for any software implementation. Hospitals should prioritize this concept, both while constituting the inhouse plan and also while evaluating the solution partner's charter. Similarly, adequate attention should be paid while forming and evaluating the project team of both the sides. Emphasize on people management approach Yet another issue, which needs to be tackled is people management.<br />
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It is a universally accepted fact that success of a software project is highly people dependent. Therefore, in case of healthcare projects, like all other parameters, equal and strong emphasis should be laid on people management as well. It becomes highly imperative for project heads of both sides to keep the team morale significantly high throughout the project. Project delays and apathy at management levels could lead to people disillusionment, which in turn may lead to attrition and thus affect the project outcomes.<br />
<br />
<span class="Apple-style-span" style="font-size: large;">Opportunities</span><br />
As discussed above, healthcare IT projects involve a galaxy of management techniques and skills. These projects also offer a tremendous learning opportunity to all stakeholders involved. <br />
<br />
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<span class="Apple-style-span" style="font-size: large;">Opportunities to the healthcare providers </span><br />
Healthcare providers of any group are the biggest beneficiaries of the IT solutions. They not only get the direct advantages of automation, which the systems offer, but gain much more from other opportunities during the process of IT solutions deployment. Some of such interlaced opportunities include:<br />
<ul><li>Business Process Engineering (BPR): Majority of implementations today involves some kind of re-engineering in the existing processes and work flows. By undergoing such changes and improvements, healthcare systems adopt the standard best practices and thus improve their operational efficiency.</li>
<li>Accreditations: With quality the dictum in today's times, implementation of IT solutions provide an opportunity to healthcare providers in getting their information systems and operations aligned with the standard requirements set for accreditation.</li>
<li>Similarly there exist many such hidden opportunities, which can be explored and exploited in the best interest of the organisations.</li>
</ul><br />
<br />
<span class="Apple-style-span" style="font-size: large;">Opportunities to solution partners</span><br />
Healthcare IT projects often become a demanding proposition on the solution partners. The difficulties and challenges that accompany any new project can be taken as opportunities of continuous improvement. Invariably projects of any size can be taken as a canvas to improve and grow on: • New improved processes<br />
<br />
<ul><li>Innovative use of technology</li>
<li>Expectation management skills</li>
<li>Change management skills</li>
<li>Time and resource management skills</li>
<li>Risk management skills</li>
</ul><br />
<span class="Apple-style-span" style="font-size: large;">Conclusion</span><br />
At 21st century health management solutions, we address the problems of 21st century healthcare with a unique blend of innovation and expertise of domain and technology. With solutions catering to a vast market segment and implementations done using professional and knowledge based project management skills, we catalyse the healthcare delivery systems. With a strong core team of subject matter experts, it is a very exciting place to work with highly passionate fellow experts as healthcare IT solution partners to some of the leading healthcare providers in India and abroad.Administratorhttp://www.blogger.com/profile/08080079860978274090noreply@blogger.com1tag:blogger.com,1999:blog-4760429928847724008.post-79688705358344044892009-12-01T12:12:00.001-08:002012-04-07T12:24:05.859-07:00Future of Healthcare<div style="color: #999999; font-family: Arial, Helvetica, sans-serif; font-size: 20px; font-style: italic; letter-spacing: -1px; line-height: 22px;">The future of the sector is bright, as professional healthcare institutes are mushrooming across the country</div><br />
With over 23 years of rich experience, he has been instrumental in providing IT solutions to various industries and verticals. He has in-depth knowledge about the industry and the emerging trends that would take the healthcare IT segment forward.<br />
<b><br />
Role of IT in healthcare and Indian scenario...</b><br />
IT plays a significant role today, as it is a business enabler. More so, the effective use of IT and communications technology has enabled the access of healthcare to hitherto remote areas. There is more predictability and reliability with the use of IT systems & processes in an otherwise person dependent scenario.<br />
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In India, the use of IT in healthcare is fragmented. Some institutes use disparate systems, while others have enterprise-wide systems in place at the top end. On the applications side, the focus of a large majority of institutes is on the administrative functions like billing, materials, etc. However, now there is a small but growing demand and deployment of applications for clinical purposes.<br />
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<b> Emerging trends...</b><br />
Some of the emerging trends include the increasing use of innovative devices like RFID, smart cards, e-pens, handheld devices like PDAs, tablet PCs, modern-day diagnostic laboratory equipment. These devices offer digital interfacing and facilitate shorter turnaround times.<br />
The use of telemedicine including Teleradiology and Telepathology also assist patients in getting better clinical care without having to travel.<br />
<br />
<b>Cost-effectiveness in healthcare IT...</b><br />
Healthcare IT investments pay for itself, either directly in a financial manner or by promoting preventive healthcare. This indirectly increases the productivity of human resources. Generally, healthcare institutes tend to overstock materials at various stock locations, thus<br />
increasing carrying costs. However, with proper systems, the optimum stock levels can be maintained without the attendant risks of stock-outs. In case of enterprise wide chains, economies of scale can be achieved by common procurement across various entities within the chain. As far as hardware systems are concerned, clients could be deployed across the hospital connected through terminal servers, thus bringing about savings in both one-time as repetitive maintenance costs and also providing reliability.<br />
<br />
<b>Combating challenges...<br />
</b>Healthcare IT implementation in India is comparatively at a nascent stage. Most hospitals are not networked and the IT systems in place are usually not interoperable. Due to<br />
this, the hospital cannot provide holistic solutions. It is advisable to get all laboratory information management systems, imaging systems, electronic medical records, telemedicine and patient portals from a single provider, thus ensuring interoperability & avoiding duplication of<br />
efforts.<br />
<br />
<b>Future possibilities...</b><br />
The future of the sector is bright, as professional healthcare institutes are mushrooming across the country. Also, the world has now become a global village. Now a scan done in the US can be reported in India within the same day, which otherwise would have taken a couple of<br />
days. Such things are possible because of IT & communication technologies. Also, proper<br />
implementations of healthcare IT systems facilitate institutes get accreditation from both national as well as international agencies.<br />
<br />
<b>Future possibilities...</b><br />
The future of the sector is bright, as professional healthcare institutes are mushrooming across the country. Also, the world has now become a global village. Now a scan done in the US can be reported in India within the same day, which otherwise would have taken a couple of<br />
days. Such things are possible because of IT & communication technologies. Also, proper<br />
implementations of healthcare IT systems facilitate institutes get accreditation from both national as well as international agencies.<br />
<br />
<div style="font-family:Arial, Helvetica, sans-serif; font-size:11px; padding:8px; border:solid 1px #e4e1de; background-color:#f5f4f3; color:#6b6454; "><strong>About the Author <br />
Dinesh Shenoy, </strong> Senior Advisory Consultant, 21st Century Health Management Solutions<br />
With over 23 years of rich experience, he has been instrumental in providing IT solutions to various industries and verticals. He has in-depth knowledge about the industry and the emerging trends that would take the healthcare IT segment forward<br />
</div>Administratorhttp://www.blogger.com/profile/08080079860978274090noreply@blogger.com8tag:blogger.com,1999:blog-4760429928847724008.post-5201356936289647012009-09-15T12:00:00.000-07:002011-07-02T06:28:43.015-07:00Transforming Healthcare through Technology'<span class="Apple-style-span" style="color: #666666; font-size: large;">"The most important beneficiary for any technology enabled process change should be the patient who visits the hospital. The second beneficiary should be the hard-pressed doctors, who have to deal with demand, which is far more than the supply."</span><br />
<br />
If I can view my bank balance and order my bank statement sitting 5000 kilometers away from my bank online, then why do I need to personally visit the hospital a few kilometers away for the second time just to collect my blood reports. I can book a railway ticket sitting in the air conditioned comfort of my office or home but I have to trudge to the nearest hospital to get an appointment to see a doctor.<br />
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In fact, it is extremely important to make things easier for a person, who requires healthcare services, by offering such solutions, as he is already hassled because of his illness. These are some of the few things that have led me to believe that if technology has changed people's lives in other areas, then it has the potential to bring about a paradigm shift in the delivery of healthcare in India, as well.<br />
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The most important beneficiary for any technology enabled process change should be the patient who visits the hospital. The second beneficiary should be the hard pressed doctors, who have to deal with demand, which is far more than the supply.Let us take for example a person, who while on a vacation, gets a severe bout of asthma. At the hospital he is subjected to a battery of diagnostic tests and a long history taking session because he cannot reproduce his medical records in a distant location. If he had his own previous medical records in electronic form, it would have saved him considerable money and inconvenience of undergoing the tests and consultations by the clinicians.<br />
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Currently technology permits a patient to have his important medical records in a small card, of the size of a credit card, which can be carried by him wherever he goes. Companies like Google and Microsoft provide free space on the internet for a person to store his health records safely and confidentially which be can produced by him anytime and anywhere with basic internet connectivity. These advances in technology will bring about a revolutionary change in the patient health records in the times to come.<br />
<br />
Twelve years ago when I was a fresh medical graduate I had noticed that all patients had to visit the hospital or a diagnostic centre for a second time just to collect their laboratory reports. I always found this to be very inconvenient. I thought why not have systems wherein the patient can be given an ID while collecting his sample and the freedom to view or print his report at home or at office. All that is required for this is a basic internet connection.<br />
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All at 21st Century Health, the company where I am currently the Lead Consultant, passionately believe in transforming healthcare through People, Processes and Technology. Which is why I have joined the team and we have been successfully implementing web-based laboratory reporting for hospitals and chains of diagnostic centres.<br />
<div style="background-color: #f7f7f7; border: dotted 1px #d8d8d8; float: left; font-family: Georgia, 'Times New Roman', Times, serif; font-size: 16px; font-style: italic; line-height: 24px; margin: 10px; padding: 10px; width: 200px;">“Healthcare delivery institutes, which use technology to amplify their medical skills will be able to scale their operations to higher level and provide services to larger number of patients at lower costs.” </div><br />
At some hospitals, I have also noticed the patients undergoing repeated radiological investigations because they have misplaced their original films and reports or are not carrying them on that particular occasion. Having the same on a PACS (Picture Archival and Communication System) solves their problem to a small extent, because traditional PACS only stores and reproduces certain types of images, which are DICOM in nature. At 21st Century we have gone a step further and are not only able to store non – DICOM images like 2D echo cardiograms, C-arm images, and endoscopic procedures for example but also waveforms like ECGs with the DICOM images so the patient is not exposed to unnecessary repeated investigations including harmful radiations for want of his old investigation records. All these are then stored in patient CD with valuable patient education material made on an innovative device called 21st Century IBox.<br />
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Let us see how technology would benefit the hospital in the long run. Firstly having the medical records in an electronic form would reduce their dependence on paper and make it possible for the hospital authorities to give the same to their patients whenever asked for. Now that the Apex Court and the MCI (Medical Council of India) have also issued directives pertaining to patient medical records, it becomes all the more important that hospitals address this issue effectively.The requirements of space to maintain conventional records are huge. These can be lost due to natural causes like floods, fire etc, or due to other causes like theft, pilferage, usage of poor quality of paper or ink. On the other hand if the patient records are in electronic format the space requirements for storing them is reduced considerably and it is no more prone to any sort of losses as backups can be stored in remote disaster plan sites.<br />
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Secondly, having web-based laboratory and radiology reporting and maintaining images of patient diagnostics can result in reducing the direct and indirect costs incurred to the patients, which ultimately results in patient delight. The patients will be happy to recommend the hospital to others and thereby increase the hospital's image and patient base leading to higher profitability. Correct and accurate MIS can help the hospitals to plan more effective patient management and marketing strategies for the future.<br />
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I remember those days when as a medical student I used to turn the pages of my books to either confirm a diagnosis I had made for a patient or to look over for different treatment protocols that I could select for a given patient. If I had the technology that would have had helped me to either confirm a diagnosis for a patient or inform me regarding different treatment protocols for a given disease, I could have saved the precious time of the patient to decide his course of treatment. Fortunately, now this is possible in the form of evidence based medicine and clinical decision support systems. This will come as a boon to young medical students.<br />
<br />
A CDSS can now help a medical student to arrive at the most probable disease condition of a patient by entering the various symptoms. After this he is also guided with different treatment protocols, which are available to treat the disease. I wish to stress here that this evidence based approach to medicine needs to go through regular updates to keep abreast with the latest medical protocols. This approach has taken the west by a storm and it will not take long before it establishes its credibility in India. All these systems use modern IT.<br />
<br />
We need to accept the fact that those healthcare delivery institutes which use technology to amplify their medical skills will be able to scale their operations to a higher level and provide services to larger number of patients at lower costs. On the other hand, those who stick to age old practices, however well they have served them in the past, will be overtaken by those who adopt consumer oriented ICT enabled processes. While technology is not a panacea for poor medical skills, it is an invaluable innovation which can help good doctors and clinicians to reach out to remote places and serve more patients with less efforts. Hospitals need to seriously look at harnessing the effective use of technology to transform themselves into state-of-the-art 21st Century Healthcare InstitutionsAdministratorhttp://www.blogger.com/profile/08080079860978274090noreply@blogger.com0