Healthcare IT: Opportunities and Challenges

Shushmul MaheshwariCEO

RNCOS – Business Consulting Services

ASSOCHAM: June 2014

RNCOS is a leading business research and consultancy firm with more than 12 years of market presence and expertise

We offer Custom Research Solutions, Management Consultancy Services

and Syndicate Research to Fortune 500 companies and Government agencies worldwide.

Our client base falls in Healthcare, IT, Retail and BFSI Verticals

Backed by a team of 35 research analysts with domain knowledge in various verticals

Shushmul Maheshwari CEO, brings more than 20 years of rich experience, working with large corporate houses and well exposed to domestic and international markets

About Us

Indian Healthcare : A Snapshot

US China India

2.92.6

0.700000000000001

Hospital Beds/1000 Population Ratio (2013)

US China India

3.31

1.53

0.592

Doctors/1000 Population Ratio (2013)

Source: EIU

There is only one doctor per 1,700 citizens in India

India would additionally need about 4 Lakh doctors by 2020

There is a severe shortage of hospital beds and medical facilities

Approximately 1 Million Indians die every year due to inadequate healthcare facilities

Nearly 700 Million people have no access to specialist care

The Indian government spends a trivial 4% of GDP on healthcare

Government spends a meager 33%

In comparison US and China, spend nearly 46% and 56%, respectively

2009 2010 2011 2012 2013 2014

USChinaIndia

CAGR of Healthcare Spending Per Capita (2009-2014)

Source: EIU

3.78%

17.07%

7.57%

Healthcare Spending Per Capita (US$)

2013

9559

373

78.2

USChinaIndia

Challenges slowing growth

Inaccessibility

Patient Monitoring & TrackingClinical Errors

Lack of Data Centralization

Maintaining huge Medical Records

Healthcare ICTThe way to move forward

Healthcare Information Technology (HIT)

HIT - Holistic management of health information across

computerized systems and its secure exchange

between consumers, providers, government and

quality entities and insurers

Digitization of Patient health records

Reaching remote parts of country -Telemedicine

Advanced patient monitoring and tracking

Address scarcity of doctors and hospital beds issue

Knowledge management - vaccination, hygiene maintenance, healthy lifestyle, etc., could be spread easily

Healthcare IT Components

Telemedicine M-Health

Health Information Management System

(HIMS)

Health Information Management System (HIMS)

HIMS automates it all

Enables Patient/Vendor accounting (insurance or other claims) and smoothens the whole process

Saves a lot of space in physical terms

Patient’s data/test records are accessible at any point of time, anywhere

Patient’s movements could be tracked with data centralizationHIMS

Implementation of HIMS in India

In order to understand the penetration level of HIMS in India, RNCOS research team interviewed IT Head/Administrative Officers of various public and private hospitals PAN India

Sample size for the research was approximately 200 public/private hospitals

Basic Level (for general patient

registration and billing process)

Moderate Level (up to LIS & PACs

level)

Advanced Level (up to e-

Prescription and CDSS level)

Source: RNCOS

Telemedicine

Telemedicine is the utilization of medical

information exchanged from one site to

another, via electronic communication tools for

improving a patient’s clinical health status

Unwillingness of doctors to work in the rural areas

Large number of patients in rural India travel to cities

Facilitating Accessibility & Affordability

Providing treatment at Par with Metropolitans

Overcoming the Scarcity of Paramedics & Hospital Beds

National Telemedicine Projects

Tele-ophthalmology Project• Provides eye care specialty services to the patients of rural and

remote areas through tele-ophthalmology mobile vans covering Punjab, Uttar Pradesh and West Bengal

National Rural Telemedicine Network (NRTN)

• 4 Regional Workshops for NRTN are planned in 4 different regions of the country to educate the state functionaries and finalize the state project proposals

National OncoNET Project • 27 Regional Cancer Centers will be linked with 100 peripheral

centers for primary prevention, early detection, treatment and rehabilitation of cancer patients

• Plans to establish a national grid on telemedicine for networking of medical collegesNational Medical College Network

ISRO Telemedicine Projects

DIT Telemedicine Projects

ISRO & DIT Telemedicine Projects

Telemedicine: ISRO & DIT Projects

ISRO established a Telemedicine Network consisting of 382 Hospitals

DIT established more than 100 nodes all over India

Besides these, other ISRO & DIT Projects are:• Village Resource Center (VRCs)• Common Service Center (100,000 nodes)• E-PanchayatSource: RNCOS

M-Health

Smartphone shipments grew by 167% in 2013

M-health - Delivery of healthcare services/information via mobile phones

Clinical data immediately viewable throughout hospital on mobile and

desktop devices

Bridging the gap between the existing and required healthcare services

Services such as telephone-based appointment scheduling and prescription refilling

Improving the healthcare access for the vast underserved rural areas and enhances patient care for urban consumers

Consultations using mobile or 3G based video conferencing providing quality care - just a click away

Provides options of performing basic tests like glucose monitoring, BP/heart beat monitoring, urine analysis etc. at home

M-Health - Changing Healthcare Paradigm

• Launched in 2009

• Over 10.5 Crore pregnant women and children have been registered in MCTS

• System sends reminders to the Auxiliary Nursing Midwives (ANMs) or Accredited Social Health Activist (ASHAs) on the various treatments

• Once a mother receives her immunization, ANMs send information to the system via SMS

• Ensures timely delivery and tracking of mother and child health.

Mother and Child Tracking System (MCTS)

Integrated Disease Surveillance Program (IDSP)

• Launched in 2004

• To detect and respond to disease outbreaks

• At present, over 90% districts report such weekly data through e-mail/portal

• On an average, 30-40 outbreaks are reported every week by all the States

• Over 1500 outbreaks in 2012, over 1900 outbreaks were reported in 2013

• Launched in 2012

• More than 3.5 Lakh patients already registered

• It keeps track of TB patients across the country and ensure timely delivery of medication

• An SMS is sent to patient with registration ID and details of DOTS Operator

• SMS reminder is sent for taking regular medicine

• Daily SMS is sent to all monitoring authorities

Nikshay for TB

National Health Portal

• The NHP was launched in late 2013

• Aims to serve as a repository of medical history of 1 Billion Indians

• Works as a single point access for authenticated health information for citizens, students, healthcare professionals and researchers

• Promotes reliable, high quality health information among the population to decrease the risk of hospitalization or disease burden

Despite India being an IT-enabled services’

giant, the use of HIT is limited

2013E 2014e 2015f 2016f 2017f 2018f

0.875000000000002

1.081.27 1.43

1.651.92

Healthcare IT Spending in India (Bil-lion US$), 2013-2018

Source: Gartner, RNCOSNote: E = Gartner Estimation, e/f = RNCOS Estimation

HIT Adoption Challenges in India

Scarcity of trained manpower

Insufficient fund allocation

Multilingualism

Interoperability at state/national level

Scalability

Low awareness

Lack of Proper Infrastructure

Measures Required

Availability in regional languages

Provide Quality Training

Increased funding for infrastructural developments

Creation of Data Repositories

Linking of EMRs with PAN or Unique ID

Creating HIT policies for effective implementation

Better Knowledge Management

New Technologies to improve efficiency

Nanotechnology is the manipulation of matter on an atomic, molecular and supramolecular scale

Nanotechnology

Application at DNA analysis/diagnostics level

Faster and accurate diagnosis with minimal sample size

Accurate targeting of the drug using nanoparticles

3D PRINTING3D printing or additive manufacturing (AM) is a process of making a three-dimensional solid object of virtually any shape from a digital model

3-D printing saves time over casting handmade inner ear mould

Scientists are able to print the artificial meat tissue suitable for eating

In future, printing functional human tissues will also be a revolution

surgeons can design knees specific to each patient

What Is Required for Successful Implementation of HIT

Awareness about importance of HIT through Seminars and Conferences

Policy framework required for HIT implementation

Realist deadline of upto 10 years for complete implementation

Post grace period institutions/doctors should be penalised

Doctors/Hospitals should be encouraged to use HIT

Policy need to be defined for interoperability

Healthcare information should be available in regional languages

IT industry must work closely with doctors to develop user friendly applications

THANK YOU

Shushmul MaheshwariChief Executive Officer

RNCOSE mail: shushmul@rncos.com

Phone: +91 120 4224700 /01 / 02/ 03

Mobile:+91 9891048088

Website: www.rncos.com

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