State of Healthcare IT in India – Care Providers’ Perspective

HIMSS ASIAPAC12 CONFERENCE17-19 SEPTEMBER 2012

MARINA BAY SANDS, SINGAPORE

STATE OF HEALTHCARE IT IN INDIA

AMIT MISHRA

EXECUTIVE MEMBER, HIMSS INDIA

10/13/2012 2©2011 Healthcare Information and Management Systems Society

India Healthcare Landscape

• Public Healthcare Infrastructure

• Public Health Programs

• Private Healthcare Infrastructure

• Demand Supply Gap

• Complexity and Challenges

• Growth Perspective

• Healthcare IT Spending in India

• The Way forward


Healthcare Infrastructure

Private Healthcare Public Health

Programs – GOI

Public HealthcareNot For Profit Org /

Other Healthcare Org



States of India Number of Hospitals

Mizoram,Nagaland,Pondicherry,Himachal,Manipur,Meghalya,Goa >10

Orissa,Chandigarh,Haryana,Bihar 11-50

Assam,Punjab,MP,Karnataka,UP 51-100

Rajasthan,Gujarat,Kerala 101-200

Andhra Pradesh , Tamilnadu,West Bengal, Delhi, Maharashtra < 200

Source: Research Paper of Ramesh Bhatt and Nishant Jain, IIMA

Spending on Health


Health expenditure ratios a

Member State

Total expenditure on health as % of gross domestic

product

General government expenditure on health

as % of total expenditure on health

Private expenditure on

health as % of total expenditure on

health

Out-of-pocket expenditure as %

of private expenditure on

health

2000 2008 2000 2008 2000 2008 2000 2008

USA 13.4 15.2 43.2 47.8 56.8 52.2 25.5 24.4

Germany 10.3 10.5 79.8 74.6 20.2 22.0 54.8 53.9

UK 7.0 8.7 79.3 82.6 20.7 17.4 64.6 63.7

Sri Lanka 3.7 4.1 48.3 43.7 51.7 56.3 83.3 86.7

India 4.6 4.2 27.5 32.4 72.5 67.6 92.2 74.4

Source: WHO


The density of doctors per 10,000 populations in India is 6 as compared to

the world average of 11.5, while the density of nursing staff in India is 13 per

10,000 as compared to the world average of 28.4.

India is a signatory to the Millennium Development Goals (MDGs).

World Health Organization report that India needs to add 80,000 hospital beds each year for the next five years to meet

the demands of the population.

The Urban and Rural Divide: Although about 70% of India’s population lives in

the rural areas, it accounts for only a meager 15% share of the cumulative

healthcare resources

Complexity and Challenges


Rational Use of Drugs

Inadequate accessibility to affordable quality services

Low Government funding & lack of efficient execution of schemes & initiatives

Shortfall in Health care infrastructure and Workforce

Dependency on Paper Records

Costs Continue to spiral

Growth Perspective


“Information systems at any McDonalds's are more advanced,

and more useful, than those in your doctor’s office.”Fast Company – April 2006

Healthcare IT Spending in India


Source :SHS

HIMSS India Study Highlights


The Healthcare IT …User Experience


Reasons of dissatisfaction

• HIS is not user friendly as all systems are not fully integrated

• Limited user interface and lack of customization

• Outdated technology, unsatisfied with vendors, limited support


Barrier for Health IT adoption

Lack of sufficient funds

Lack of human resources

Lack of strategic plan for computerization

Return on Investment of computerization cannot be quantified

Lack of clinical guidance

Unsuccessful implementation of computerization projects

Providers cannot meet requirement for products and services

Lack of legal and policy support

Lack of support from hospital administrators


Slow Adoption …Cost is an issue

System is not ready and doctors and staffs are not willing to use HIS

Lack of supporting infrastructure

Hospital expansion

Lack of IT literacy among Medical & Para-medical professionals

Lack of Govt. determination to introduce HIS in hospitals

Government policies

Phase- wise implementation of HMIS in Govt. District Hospitals

Training issues, lack of capacity building program for clinical staff

Resistance of staffs


Suggestions….

• “Should be user friendly and staffs should be provided need based training”

• “Hospital should go for Computerized HIS as early as possible”

• “Sensitization of Doctors and staff to use the technology by using various medical professional association such as IMA, FOGSI etc”


The Way Forward…


NEED OF HEALTHCARE IT STANDARDS

NATIONAL STANDARDS FOR INTEROPERABILITY

NEED OF A PUBLIC HEALTHCARE INFORMATION SYSTEM

TASK FORCE FOR HEALTHCARE INFO SYSTEM

IT TRAINING - HEALTHCARE PROFESSIONALS AT MED-schools

THE EARLIER THE BETTER

May be a UNIVERSAL ADAPTER


Standards and Interoperability• Standards provide a common language and set of expectations

that enable interoperability between systems and/or devices.

• “Interoperability” describes the extent to which systems and devices can exchange data, and interpret that shared data. For two systems to be interoperable, they must be able to exchange data and subsequently present that data such that it can be understood by a user.


Importance of Standards and Interoperability

• Standards bring technological, economic and societal benefits.

• Healthcare dependency on information

• Benefits in figures

• GBP 2.5 billion - annual contribution standards make to the UK economy

• 80% - percentage of world trade impacted by International Standards

• AUD 100 million - benefits to Australian economy from sampling standards in the mining industry

• 84% reduction in transportation time due to standardization of container transport : source ISO


India’s Imperatives for Standards• Effective Management of limited Usable Healthcare Resources

• Population > Data > Information

• Languages and Dialects

• Cost – having many different competing ways of doing the same thing can be costly. Examples of this are the large number of different mobile phone power sockets; or where every computer supplier developed a list of allergies from scratch.


• Safety – for example specifying the minimum safety requirements for a baby car seat; or the safest way to present an allergy alert on a computer screen.

• Health Insurance

• Medical Tourism

• Measurement of health status, performance monitoring, and the achievement of national performance targets.


NEED OF A PUBLIC HEALTHCARE INFORMATION SYSTEM


TASK FORCE FOR HEALTHCARE INFO SYSTEM


IT TRAINING - HEALTHCARE PROFESSIONALS


THE EARLIER THE BETTER

• Need of Healthcare IT Standards Specifically designed for developing Country like India where the HIT is still in nascent stage.

• Eliminate waste and duplication while ensuring that patient information is available at the point of care, eliminating unnecessary tests, enabling more informed decisions and improving the quality of care.


Better…

• Telecom Industry India – Telecom Centers of Excellence

– Development Organization of Standards for Telecom in India

– Telecom Sector Skill Council

• World’s Reputed Clinical Staff

• World’s Recognized IT resources


Aneesh Chopra: ‘There’s never been a better time to be an innovator’

THANK YOU


State of Healthcare IT in India – Care Providers’ Perspective

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