MINI (Aug 2010 Edition)

8/9/2019 MINI (Aug 2010 Edition)

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AUGUST 2010 VOLUME I ISSUE 3www.iami.org.in

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2AUG 2010 VOLUME I ISSUE 3

From the Editors Desk

Dear Readers o MINI

I am sure all o you have enjoyed reading

the rst two issues o MINI. Te newslet-ter was started to complement the IJMI - ascholarly publication, so that we could bring to you inputs about the Medical In ormat-ics industry in general and also some newsabout events in India and abroad. Te MINIteam has enjoyed putting together the news-letter and each person has been working with dedication to make this a great publi-

cation. I took on the job o being an Execu-tive Editor with some trepidation about thecombination o time constraints and dead-lines. Te team, and very specially Dr AmitChatterjee, SM gave me all the support tohandle these, but it is with regret that I amasking to be let go or a while. Tis - due toa major change phase that my Foundation isgoing through currently. I have promised theteam two things. One - that as soon as thingssettle a bit, I will do all I can to get involvedonce again. And in the interim, I will at leasto er any comments or small bits o help thatI can. Dr Saurabh Bhatia will take over theresponsibility o being the Executive Editor

rom the next issue. Id like to thank the whole team and wish them the best.

Vasumathi Sriganesh

AUGUST 2010 VOLUME I ISSUE [email protected]

EXECUTIVE EDITOR /Ms. Vasumathi SriganeshPRODUCTION EDITOR / Mr. Mandar GoriCOPY EDITOR / Dr. Saurabh BhatiaTECHNICAL EDITORS/Dr. Kavishwar Wagholikar,Dr. Naresh YallapragadaNEWS EDITOR / Dr. R. PrajeeshDESIGN & TECHNICAL /Dr. Amit Chatterjee, SM

Cover: Susheela Venkataraman, CISCO, Dr Sanjee Sood, IAF, Surg Adm V K Singh, Chairperson, Ranjan Dwi edi,IPS, and Haripriya Eswaran, Accenture at the e-health session.Cover Inset: Almadina Centre ad isory board members Dr. Abobaker EL-Hosh, Dr. Mufah A. Dakhil, Dr. Mohammed Arteimi, and Dr. Mabroka Mheriq with Mr. Ajit Kumar.

Contents

From the Editors Desk 2

EVENTS 3

Government Trans ormation Forum-2010 3

Libya Goes or e-Management 5

TECH BYTES 6Promoting Wellness in India Schools 6

Who Drives Automation in Healthcare? 8

NEWS CLIPS 10

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EVENTS TECH BYTES NEWS CLIPS


EVENTS

Government TransformationForum-2010

N Delhi- 30 Jun to 01 Jul 2010

T he Government rans ormationForum is aimed at building thecapacity o e-Government Practi-tioners on e-Governance strategies so thatthey can incorporate the latest technologies while planning the delivery o public servicesto the citizens. Te con erence, organizedby the Society or Promotion o e-Gover-nance, was the 2nd in the series o ocusednational consultations on key e-Governanceissues and the 11th in the series o Interna-tional e-Governance con erences, to enablesharing o learning practices among globale-Government experts, academicians, prac-titioners, multilateral agency representa-tives and the industry representatives. Te plat orm has hosted many stakeholder con-sultation meetings in the past that have pro- vided valuable e-Governance policy inputsto the Government o India. Te Minis-try o Communications and In ormation

echnology, NIC, CDAC, II Delhi, the World Bank, UNDP, IDRC, Danish ech-

nological Institute and the European Insti-tute o Public Administration are some o the organizations that have partnered withthe SPeG or various knowledge activities.

Te agenda or the G F 2010 was or-mulated in consultation with key domainexperts and stakeholders rom across theglobe, with Accenture and CISCO asknowledge partners. In addition, there were content inputs and key expert speak-ers rom the Danish echnological Insti-tute, Denmark, UNESCO, World Bankand Department o Management Studies,II Delhi.

During the two day con erence at theHotel Imperial, New Delhi on 30th Jun

and 1st Jul 2010, the ollowing sessions wereheld:

Public Sa ety and Security o ICin rastructure - Collaborative e-Govern-ment ramework or police, intelligence, prisons and ports

Panel Discussion - Global Best Prac-tices and way orward or in ormationsharing strategies among government agen-cies

IC and New Media echnologies New Financial Inclusion Paradigm orGrassroots

Strategies or e-health Delivering

Inclusive Health services to the Rural Citi-zens through IC and Mobile technologies.

Dr S Sood, Adm V K Singh and Krishna Giri, Accenture, Rajen Varada, UNESCO and Prof MP Gupta, IIT, Delhi



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Te inaugural address was delivered byDr. Shashi Taroor, MP and ormer min-ister o state or External A airs, GoI who was also the Chie Guest or the event. Hediscussed the current challenges acing theIndian State and how technology can bring about trans ormations in nance, gover-nance sector and delivery o quality health-care or inclusive growth and making Indiaa true superpower.

Some o the key speakers were JeremyMillard Head eGovernment, Danish

echnological Institute, Gp Capt (Dr)Sanjeev Sood-IAF , Pro . Vinaysheel

Gautam II Delhi, Ger Dely Globalleader or Public Sa ety and Moderniza-tion (Accenture Ireland), Mark Crego Chie Solution architect o US Homeland,Shashank Ojha o Te World Bank, VikasKanungo o SPeG and Krishna Giri,MD,Asia Paci c, Accenture.

Te eHealth session was held on 1st July with the theme o policy ramework ore-health applications and the role o Mobileand New Media echnologies or Inclu-sive health services. Te session broughttogether experts rom eHealth and develop-ment sector or discussion and showcasing

o current trends and innovative applica-tions in the domain o health services espe-cially or rural areas. Te session was chairedby Surg Rear Admiral (retd) Dr V K Singh,

ormer Director o IIHMR, Delhi and anexpert in quality assurance and lean manage-ment in healthcare services. Delivering hiskeynote address, he outlined the challengesand issues currently acing Indian healthcaresector and strategies to overcome these chal-lenges.

Gp Capt (Dr) Sanjeev Sood, Hospi-tal and Health Systems Administrator,spoke on Leveraging Mobile echnology

In HealthCare Issues and Challenges. Hestated that mHealth or wireless health is anintegral part o IC application in health-care was essential in reaching out the lastmile to deliver services at grass root levels.He discussed the immense opportunitieso mHealth applications in tackling ine -ciencies by improving communication eg.,missed appointments, compliance, due dates

or vaccination and enhancing accessibil-ity in healthcare. He quoted several voiceand text based 3G enabled applications and projects (Health MA E, Save the girl child)o mHealth running success ully across theglobe. Dr Sood concluded with a quote rom

Nobel Laureate Mohd. Yunus o GrameenBank - Te quickest way to get rid o povertyright now is to have one mobile phone,

Ms Susheela Venkataraman, InternetBusiness Solutions, Cisco Solutions, spokeon Better health in rural communities.She discussed various challenges in deliver-ing healthcare to rural India with emphasison a collaborative and integrated approachthrough appropriate technology and con-nectivity. Mr Ranjan Dwivedi, IPS, spokeon elemedicine and its potential in elimi-nating the barriers o accessibility, inequityand una ordability. Ms Haripriya Eswaran

o Accenture spoke on Te power o tech-nology or health services. Highlighting thede ciencies in Indian healthcare in rastruc-ture, services and skilled manpower, sheemphasized the need to leverage technol-ogy to overcome these challenges. She statedthat the journey to digitize health data has just begun

In the end there was an interactivesession where the audience enquired aboutquality o individual health data.

~Gp. Capt. (Dr) Sanjee Sood Email: [email protected]



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Libya Goes for e-Management

A lmadina Multimedia Centre is anindependent pioneering institu-tion with high-end acilities andresources. It was launched with a vision o disseminate the culture o in ormationtechnology, investigate the implementationmechanisms o Electronic managementin the world, and to utilize it e ectively inimplementation o Electronic managementin the Jamahiriyan (masses) society. As a part o the centres strategic plan, they orga-nized the First International Con erence

on E-Management rom 1st to 4th o June2010 at ripoli, Libya. Delegates rom 40+countries participated in the con erence.

Libya did not have any comprehensivestrategy in E-Management at national level.Some e orts had been made in the past but were not well coordinated and there oreunproductive. Tey needed a national levelcomprehensive strategy. Te con erencemade a salutary impact and the GeneralPeoples Committee (GPC) o Libya com-menced a study to establish an institutionresponsible or E-Management. Further,the Almadina Centre announced its inten-

tion to establish InternationalOrganisation or E-Management which will bring internationalcommunity to one common plat-

orm and emphasize the right o developing countries to reap the

ruits o in ormation and com-munication revolution. Tey alsoannounced Gadda Award onElectronic Management to thebest per orming member countryin the area o E-management.

Te con erence committeemembers cum advisory board members Dr.

Abobaker EL-Hosh, Dr. Mufah A. Dakhil,Dr. Mohammed Arteimi, and Dr. Mabroka

Mheriq expressed gratitude or the partici- pation and cooperation o Indian delegates.Pro . (Dr) Mohammed Arteimi praisedIAMI or providing support. He also appre-

ciated recently launched IndianGovernment supported Pan-A rican elemedicine Project,a vision o our ormer presi-dent Dr. A P J Abdul Kalam, toconnect India with all 53 coun-tries o the A rican Union with a

satellite and bre optic networkor sharing Indias expertise ineducation and health care.

~ Ajit Kumar Email: [email protected]

We wish continuous progress o India in the techni-cal eld, and we expect them to enrich their technical and scienti c abilities to compete on a global leadershipwith China. We also think that the people o India can play an important role in the development o techno-logical relations (South South), as this relationshipis the proper candidate to bridge the technical gap inthe world, and we eel that this cooperation betweenthe Indian people and people o the Jamahiriya has a pro ound historical basis and fee fom all suspicion,domination and exploitation. -Mohammed ArteimiChie , Almadina Multimedia Centre, Libya

Ajit Kumar with Mr. Mohamed Reda Tolba (Chief cum Mentor,Advisory Board, Almadina Multimedia Centre



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TECH BYTES

Promoting Wellnessin India Schools

Introduction

For most school stu-dents, health checkups areisolated events with littlecontinuity rom one checkupto the next. Tis non-inte-grated tracking approachdoes little to build the overallhealth management capac-ity o the school and bringslimited bene t to society.

Use o EHRs in SchoolsEHRs can be used to the

advantage o students andschools.

Emergency Management at

the School Level: It is pos-sible or schools to gatherrelevant in ormation rom parents and students in stan-dardized ormats, conduct a



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baseline student health checkup, and enterthe entire data in a central data reposi-tory. Tey would then be able to identi ystudents at risk or emergencies and theiremergency care plans. Te school EHR cantransmit an emergency SMS to the mobile phone o the amily physician and/or theschool physician whose name would also bestored as a rst contact in the EHR in con-sultation with the parents.

Chronic Disease Management at theSchool Level: Students can receive assis-tance in managing certain chronic diseases

such as diabetes, or risk actors including obesity, smoking, hypertension, epilepsy,asthma, and more. EHRs could also assistschools in implementing guidelines and protocols to reduce the social occurrence o such behavioral risk actors. Students couldbe guided to choose their own daily tness program through the Chronic DiseaseManagement system with assistance romcounselors and automatic schedule remind-ers.

Bene ts to Public Health Agencies atDistrict, State, and National Levels:

Tere are multiple potential advantages o automating and standardizing school healthrecords. Looking up the Disease Registry and

urther analysis o EHR data could help iden-ti y and understand the prevalence o certaindiseases/risk actors. EHRs can also helpenable systematic surveillance.

Better Care and Increased Student Sa ety: echnology can deliver less labor-intensive,

more accurate, and up-to date in ormation toschools that is use ul to provide appropriateand timely health services that promote well-ness among students. echnology can enable

greater control or students to participate inmanaging their chronic diseases and modi y-ing risk actors. o public health agencies, itcould provide systematic in ormation use ul

or planning and evaluation.

Summary Te bene ts o EHRs are ar-reaching.

Tey may be li e-savers in emergency man-agement, chronic disease management,awareness and health education, wellness pro-motion, and lastly, public health data analysis.

~ Dr. Pankaj Gupta & Dr. Alka Aggarwal Singh Email: [email protected]

UPCOMING EVENTS

Focus 2010:

Will be held on 7-8 August, 2010 at the AMC Au-ditorium, SCTIMST, Thiruvananthapuram 814149,INDIA. The use o Telemedicine and other applica-tions o In ormation Technology in healthcare areincluded in the theme or this meet.http://www.sctimst.ac.in/whatsnew/Focus%202010,Kerala%207th&8th%20Aug.pd

Evidence 2010

A con erence on Evidence Based Medicine, Evi-dence 2010 is planned or 1-2 November 2010 atBMA House, London. This con erence is an attemptto explore how developers o EBM resources, EBM

trainers and methodologists can meet the needs o the clinicians, managers and policy makers respon-sible or putting evidence into practice.http://www.evidence2010.com/

NCEGOVS 2010

National Con erence on E-Government & E-Society(NCEGOVS) is being jointly organised by ComputerSociety o India (Division-III & SIG on E-Governance)& Computer Society o India, Allahabad Chapter on

11-12 December, 2010. The key emphasis o NCE-GOVS-2010 will be to discuss & deliberate variouse-Governance initiatives to trans orm the Societyto an e-Society. e-Health & Telemedicine are thehealthcare topics included or discussion.http://www.csi-india.org/c/document_library/get_fle?uuid=8d325ba5-11b7-4204-a689-b e0e3 7c 91&groupId=10616



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Who Drives Automation inHealthcare?

Med insurers curb cashless acility; ake On Hospitals Overcharging Patients

Tese headlines o the newspapers on10th July10 brought certain happiness to me(click link above). I I am gauging the situa-tion correctly, this is an important happen-ing in Indian healthcare which willusher inmaturity, improvements and standardiza-tion in the healthcare industry. Tis will alsoensure automation o hospitals and better(read digital) health records. Let us examinethe industry practices and the implications o the news in this article in complete detail.

Insurance as a wel are measureHealth insurance is almost ubiquitous in

the wel are states o Nordic Europe, Dutchand German healthcare markets. Te result is

Patients cannot approach hospitalsdirectly but haveto go through primary care physicians

Hospitals have pre-agreed packages or various illnesses with insurers. Hospitals

cannot claim money beyond this pre-decided

range or any treatment.Doctors have to ll adaily orm o justi-cation to keep a patient admittedAll records are digital and strict audit trail

is maintained Almost all claims are cashless

Insurance: Te watchdogI Laws o the land are insu cient to

keep raudulent practices in check, commer-cial drivers will do the need ul. Te pro t andloss actors can drive healthcare providers toadopt better practices. In the case above, theinsurance conglomerate keeps some impor-

tant checks and balances.Tey discourage hospitals rom keeping patients longer than needed by limiting the payments. I hospitals tend to discharge patients too early to make more money rom pre-decided package, they su er the subse-quent year, because the insurance conglomer-ate will bring down the average length o stayand the associated cost o that illness.

Tey also discourage unnecessary/repeated investigationsby xing a ceiling tothe claim.

Tey encourage primary careby making the hospitals inaccessible directly (exceptemergencies). Primary physicians (GP) are

also paid by insurance and keep an equallystringent electronic medical record. Tisbrings down the overall costo treatment o an illness in the economy.

Insurance companies de ne astrin-gent record keeping method to allow claims.Tis kind o record keeping cannot be done without EMRs.

Hospitals are interested in EMRs becausethis ensures complete and compliant recordsmaking the insurance claim process muchsimpler and with very high hit-rate.

What happens only in India?

India has an abysmally low percentageo people using health insurance, especiallyin small towns and villages. Te gures vary

rom 5% to 17%. However, the up-markethospitals in metros receive up to 60% insured patients. Cashless settlement o claims withthese hospitals has come under the scannero insurance agencies now. Most agencies arealleging arti cial in ation o expensesby thehospitals and have stopped cashless claims.Tey will only provide reimbursements nowand that too, afer strict scrutiny. However,cashless settlements with smaller hospitalshave not been curtailed.

http://timesofindia.indiatimes.com/india/Medical-insurers-curb-cashless-facility-/articleshow/6148959.cmshttp://timesofindia.indiatimes.com/india/Medical-insurers-curb-cashless-facility-/articleshow/6148959.cmshttp://timesofindia.indiatimes.com/india/Medical-insurers-curb-cashless-facility-/articleshow/6148959.cmshttp://timesofindia.indiatimes.com/india/Medical-insurers-curb-cashless-facility-/articleshow/6148959.cms


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What happens next? Patients will have to cough out the hard

cash initially; then run pillar to post to getreimbursement. Lastly, only partial reim-bursement will become the order o the day.Te patients stand to sufer initially .

Patients will be driven towards smallerhospitals with cashless acility , directing therevenue away rom big, corporate providers.

In short term, the big hospitals willsurvive on their brand name and quality. Butslowly, the smaller hospitals with cashlessclaims will getbetter revenue and improvetheir services. Te game will then become

more even. Te national average or expense on agiven treatment will all and insurance companies will urther tighten their sts.

Te bigger hospitals will need to all inline eventually, reducing their claims to alevel where it is only marginally higher thansmaller ones. Even in that, theextra charges will have to belong to luxuriant stay (payableby individual)and not or clinical proce-dures or care.

Tis will bring parity in overall quality o care and the patient will eventually gain.

Immediate allout may be or the

patients who cannot produce hard cash ortreatment and may have to resort to smaller(perceived as in erior) providers but even-tually, over a decade or two, the quality willreach a level where a patient will happily walk in to the nearest available hospital without worrying about the quality o care.

How does this afect automation?

Automation o hospital processes andEMRs are yet to make it big in smaller hospitals and towns. Even in the so called big hospitals, these are sparsely utilized and cer-tainly not to its ull potential. Moreover, the patients are not so concerned about long termrecord maintenance. All this is set to changenow.

Patients will demand comprehensiverecords rom bigger hospitals to make insur-ance claims.Partial claims due to incompletehospital records will make hospitals unpopu-lar, and to some extent, even prone to litiga-tion. Tis will drive the hospitals to either

automate at a bigger scale or utilize theiralready existing EMRs in a more substan-tial way.

Smaller hospitals who have not yetelt the need or ull automation and EMR

implementations will now change theirstance. Tey will like to maintain their statuso cashless hospital because it earns thembetter revenue. Tis willdrive them to main-tain at least EMRs i not ull automation.

ConclusionOverall, the insurance conglomerate

will be able to arm-twist the bigger hospi-

tals into providing good care at reasonable prices. At the same time they will nudge thesmaller providers to raise their quality o careand record keeping. Automation will be themost important tool to ensure & gauge thisquality and record keeping. Te patient wins, eventually.

~ Dr Saurabh Bhatia

Email: [email protected]

Editors Note: As we go to press, the efectso the action that the author predicted arealready beginning to emerge. See1. Times of India2. Digital FC

Te need of the hour may be to make thecommon man aware of what the industry is going through. Tis education will allow this phenom-enon to happen and reach its logical conclusion; and not get killed for short term political gains.

http://epaper.timesofindia.com/Default/Scripting/ArticleWin.asp?From=Archive&Source=Page&Skin=TOINEW&BaseHref=CAP/2010/07/16&PageLabel=1&EntityId=Ar00104&ViewMode=HTML&GZ=Thttp://www.mydigitalfc.com/news/more-hospitals-fall-line-insurers-475http://www.mydigitalfc.com/news/more-hospitals-fall-line-insurers-475http://epaper.timesofindia.com/Default/Scripting/ArticleWin.asp?From=Archive&Source=Page&Skin=TOINEW&BaseHref=CAP/2010/07/16&PageLabel=1&EntityId=Ar00104&ViewMode=HTML&GZ=T


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NEWS CLIPS

~Dr. R. Prajeesh

Te Australian e-health initiativeTe Healthcare Identi ers Service (HI

Service) has been established as a ounda-tion service or e-health initiative in Aus-tralia and it commenced its operations on01/07/2010. Te HI Service will issue andmaintain national healthcare identi ers (aunique number) or consumers, healthcare providers and healthcare organisations.

Te e-health initiative is intended toenable electronic access to ones own in or-mation, support healthcare providers intheir decision making by making in or-mation available at the point o care andmanage the personal health record in asecure, con dential and tightly controlledmanner.

Te net generation, seems to haveliked the web based inter ace and i all goes well with the implementation the e-healthrecord will indeed be a great tool or the young to manage their health.http://www.medicalnewstoday.com/articles/195722.php

Te rst telepathology sysytem or On-tario

University Health Network (UHN)established its rst telepathlogy system inOntario by connecting to physicians inthree Northern Ontario communities. Te project is supported by Canada HealthIn oway (In oway), the Ontario governmentand eHealth Ontario.

Te new way o diagnosing pathologycases over the Internet using virtual slidetelepathology allows physicians in rural andremote hospitals to access and consult withspecialized UHN pathologists by instantly

transmitting digital images o pathologysamples thus enabling ast and accurate diag-nosis or patients.

Some o the community hospitals haveno pathology services and are required totransport tissue and blood samples to labo-ratories in other cities which at times takebetween 24 and 48 hours. Tis telepathol-ogy system will bring the capacity to provideclinical support and diagnostic capacity tothe remote laboratory thus saving on time,costs and discom ort to the patient.http://www.eurekalert.org/pub_releases/2010-07/uhn-ue 072110.php

Neurostimulator implants or pain relie Doctors at Guys and St Tomas Hos-

pital in London are testing out a new typeo pain relie implant by installing a neuro-stimulator in an accident patient. Te wiresimplanted in the spinal cord deliver mildelectrical signals which help to mask thebodys pain signals with a tingling sensation.Te device uses motion-sensing technologyto adjust the level o pain relie being admin-istered.

Tough neurostimulators are indicatedonly in a minority o cases with unresolvedsevere back and leg pain, it has the potential

to signi cantly improve the quality o li e ormany patients.

http://news.bbc.co.uk/2/hi/health/10509063.stm

Robotic legs or the paraplegicA couple o British engineers in New

Zealand have invented a unique device which allows paraplegic people to walk again.

REX, the Robotic Exoskeleton, is designedto help those usually bound to wheelchairsto stand up and walk. REX allows users tosel -trans er rom chair to the exoskeleton,and then control their movements via a joy-stick and control pad. It runs on a recharge-



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