MINI (July Edition, 2010)

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JULY 2010 • VOLUME I • ISSUE 2

www.iami.org.in

Gp Capt (Dr) Sanjeev Sood

Indian delegate from IAMI

eManagement Conference

IAMI @ Libya

ENTER



2

2 JULY 2010 • VOLUME I • ISSUE 2

JULY 2010 • VOLUME I • ISSUE 2

[email protected]

EXECUTIVE EDITOR / Ms. Vasumathi Sriganesh

PRODUCTION EDITOR / Mr. Mandar Gori

COPY EDITOR / Dr Saurabh Bhatia

TECHNICAL EDITORS / Dr. Kavishwar Wagholikar,

Dr. Naresh Yallapragada

NEWS EDITOR / Dr. R. PrajeeshDESIGN & TECHNICAL / Dr. Amit Chatterjee, SM

www.iami.org.in

he use o inormationand communicationtechnology in general

and electronic managementin particular, has led to un-damental changes in the waythe services are delivered. hishas ensured administration inmore eicient and transparentmanner and in supporting thecomprehensive developmento the society at the grass rootlevel. Under the auspices o Col Muammer Al Gadhaiand within the values & prin-ciples o the First o Septemberrevolution and the emblemo ‘or the sake o an eectiveelectronic management or the Jamahiriya society, Al-Madina

multimedia center orga-nized ‘he irst InternationalConerence on Electronic Man-agement’ rom the 1st to 4th o June 2010. he conerence wasconsidered a major step in the Jamahiryia’s endeavor to ollow

the revolution in the I world.Libya is located in North-

ern Arica and its economy

depends upon revenues romthe oil sector, contributing toabout one-quarter o the GDP.Combined with a small popu-lation, this gives Libya one o the highest per capita GDPs inArica. he conerence repre-sented Libya’s initiatives in theinormation technologyrevolution, emphasizing its place on the map o the world o inorma-tion technology in thetwenty irst century.As o now, Libya hasminimal I inrastruc-ture in place, and wishes

to take giant strides inthis direction to achievehigh I penetration and provide I enabled governanceto its citizens. he event wasmanaged by Al Madina Multi-media Centre at hotel Radisson

Blue, also known as Al Maharyhotel. his hotel stands proudlyin a prime location on the

beautiul beach o the historiccity o ripoli. Arrangements were made or translation to/rom Arabic/English languageduring the sessions.

he aim was to disseminatethe culture o inormation andcommunication technology

and investigate implementa-tion mechanism or eectivemanagement or the Jamahiriya(masses). It was attended byabout 200 delegates rom

EVENSTe First International Conerence on Electronic Management at Libya

Contents

EVENTS 2

e-Management Conference at Libya 2

Tech Bytes 4

A need for Automation in Healthcare? 4

Paradigm shift in Indian Healthcare 6

News Clips 8

IAMI was represented by Dr.Sanjeev Sood who spoke on

‘IC as an enabler in delivery o

quality healthcare’ and Mr. Ajit

Kumar, who was one o the key

organizers or this international

conerence.

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Events Tech Bytes News Clips

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various parts o the globe includ-ing Arica, USA, Europe, Egypt,Middle-East and India. India was represented by a delegationo eight speakers rom e-Health,e-Commerce, e- governance and

public administration.he keynote address was

delivered by Dr. D C Misra,IAS (retd.), and an E-gover-nance consultant rom Delhi.He spoke on the ‘Role o Iin enhancing socioeconomicdevelopment’. He emphasized

the need or implementation o good e -governance to providecitizen centric, interactive gov-ernance with transparency andaccountability on part o theadministration. Steven Clit o E-Democracy.org, USA, spokeon ‘Social media in public lie’.Marcel Deturche emphasized

the need to ‘Ease the imple-mentation o e-democracy’.Pro Nigel Paine o UK spokeon ‘Eective e-learning andknowledge management in 21st

century’, and how visionarynations and organizations canleverage knowledge to remaincompetitive and successul. Dr.R Mohd. Al- Farsh presentedan overview o Pan Arican

e-network between Indian uni- versities and 53 Arican nations providing e-services with pri-ority on tele-medicines andtele-education. his was ol-lowed by speeches rom Syrian,Italian, Egyptian and urkishdelegation.

he Indian delegation com- prised o Dr Sanjeev Sood whospoke on ‘IC as an enabler indelivery o quality healthcare’.He apprised the audience withthe beneits o automation and

computerization in healthcareand how various applicationslike EMR, HIS, CPOE andCDSS can transorm deliv-ery o quality healthcare. Pro Ashok Sharma spoke on PublicAdministration while Rajku-mar Prasad, Piyush Gupta and

Vakul Sharma spoke aboute-Governance. Later, the Indiandelegation had a meeting withIndia’s Ambassador to Libya.

Pro Peter Kent, who hasauthored several books on

Dummies series on computers,spoke on ‘E-commerce successsecrets, stories o ailure’. here were other speakers rom thecorporate world like IBM, who spoke on ‘smarter planet’;Microsot on cloud computing and transormation in e-health

services; Newtech, Belgium;Oakridge National Laboratory,USA and elespazio, Italy.

For the Indian companies providing IC products, exper-tise and I enabled services,Libya oers immense oppor-tunities with no legacy systemsin place. Its oil rich, emerging

economy holds great promiseor the investors.

~Gp. Capt. (Dr) Sanjeev Sood is a Hospital and Health Systems Administrator serving in Jodhpur. Email: [email protected]

IAMI and other Indian delegates with the Indian Ambassador to Libya





4


ECH BYESIs there a need or Automation in Healthcare?

Whereas a negativeanswer to thisquestion would put

a question mark on the raisond’être o IMIA and IAMI,there is a signiicant percent-age o healthcare workers who would think or a minute beoreanswering it. he perceptiono the need or automationstrongly depends upon howthat department is interpreting ‘Automation’. For dierent rolesin hospital, automation bringsin dierent meaning, dierentbeneits and dierent liabili-ties. Let’s have an overview o the need o automation keeping in view the eort involved andbeneits realized.

Who needs automation?

Doctors: For most doctors,

automated medical records are‘good to have’. Decision supportsystems (CDSS) and compli-

ant nursing are also desirable(reduced ailures, reduced law-suits). hey are not particularly enthusias-tic about automation o inventories, Coding andMedical records (MR),bio-medical engineer-ing etc. while billing practices are airly watertighteven without ull automation.Lastly, most doctors resist theadditional work they have todo to keep up their end o theautomation deal e.g. typing caserecords, entering prescriptionsetc.

Paramedics & Nurses: heir liability quotient is

lower than that o doctors’ butresponsibility to keep medicalrecords updated is higher. Con-sequently, most see it as an

overhead or additional work.Unless well trained, computerentry increases the nurse’s timeaway rom patient thus reduc-ing the time he could have spent with the patient. Overall, this

group gains comparatively lessrom automation.

Stores, Front-oce and support services:

Inventories are mostlyobjective records which renderthemselves more amenableto computerization bringing better accountability, transparency and speeds up the

work. Moreover, the sotwareor AD, Billing and Storesare usually more user riendly,robust and mature. he eort-beneit ratio is well balancedhere.Quality department:

Automated medical recordsand other MIS (ManagementInormation systems) reporting tools are the bread and butteror the Quality department.Objective records with transpar-

ency help them keep stringentchecks on processes and aid cer-tiications like NABH & JCI.Signiicantly, this department’scontribution to creating com- puterized records is low but itreaps huge beneit in compari-son.

Hospital administration: Hospital Administration is

usually the consumer o recordscreated by various departments.hey gain signiicantly romthe objectivity, transparency,accurate record keeping and ithelps them in maximizing the

revenue through better insur-ance claims and higher patientsatisaction. hey are usuallythe driving orce behind auto-mation but contribute leasttowards creating records.






Government, WHO & regu-latory bodies:

he mandatory reporting to various government bodiesbecomes much easier and moreaccurate i hospitals are auto-

mated. his, in turn, helpsthe government in judging thehealth situations and disease patterns more accurately. hisgets relected in health poli-cies rolled out nationally andinternationally. Eectively, theautomation has its cascading

eect in government, WHOand UN policies. Eventuallythese policies aim or better patient care and better revenuesor hospitals & insurance agen-cies.

Te Patient: Lastly, let’s talk about the

cynosure o healthcare: the patient. Currently, the awarenesso the beneits o medical recordkeeping is low in India while thecost o treatment, even without

automation, is overwhelming.o add huge automation coststo the patient’s treatment maylook a little unair at present.In the long term, society standsto gain. However, individually,

a relatively small percentageo patients, care about how & where their treatment recordsare maintained.

Conclusion

Currently, the eort-beneitratio in healthcare automation issomewhat skewed. he people who need to make maximumeorts stand to gain relativelyless (paramedics, nurses anddoctors, in that order) while people who drive automationand gain maximum (HospitalAdmin, Quality, Government

& regulatory bodies) have to put in much less eort on dayto day basis. his skewed ratiohas caused many ailures inimplementations. However,the patient, who is the endconsumer and also aords the

This article is part of a series** on automation of

healthcare. The broad topics that will be covered:

• Need of automation: Is it there?

• What’s Automation?

• EHR and HIS

• What to Automate in a hospital?• Priority of automation

• How to choose what suits your hospital

• ROI

• Behavioral Aspects of Automation

• Expectations v/s reality

• Commercial facts

• Roadblocks

• Is our automation successful? KPIs

• What do patients want?

• Role in research• Success stories

• Review of some products

If subscribers want additional topics, please email the

author at [email protected]

**Tis series is a pre-publication excerpt fom a book being

written by the Author and cannot be reproduced in any orm with-out express permission fom the author and proper reerence.

whole process rom his pocket,irreutably stands to gain inlong term.

~ Dr Saurabh Bhatia, MBBS(AFMC), MS(Psy), FCR Email: [email protected]






ECH BYESParadigm shif in Indian Healthcare

Introduction

Indian Healthcare is going through a paradigm shit.From a ragmented sector,

it is moving towards being con-solidated and organized. It ismoving rom a ‘ransactionbased Healthcare’ model to a‘Healthcare contract’. Large, private hospitals in India areturning into a network o

healthcare organizations. hisnetwork includes ‘reatmentor Sickness’ and the ‘WellnessIndustry’. Clinic networks,Lab networks and Pharmacychains are also emerging on thescene. he Government is alsocatching up by modernizing itshospitals and by introducing

Public Private Partnerships.Health Insurance is begin-ning to ollow patients evenater they leave the clinic andsome systems are emerging to

manage their health anddisease in the societyas well. At the heart o

all these networks ismostly either a Pharma-ceutical company or anInsurance company.

hese healthcarenetworks seem to be pushing the ‘singleencounter-based medi-

cine’ to a more ‘holistic patient-based medicine’by providing all the services in the network andretaining the patient within the networkacross the country.hereore HealthcareNetwork is a very healthy trend

or India. However the emerg-ing healthcare networks cannotachieve their ‘ Enterprise LevelDigital Healthcare’ dream without an integrated Health-care-I policy. oday very ew

India based Healthcare-Isystems provide the required

support or running such amassive Healthcare Network.

echnology Is technology catching up

at the same pace as brick and

mortar? Do these networks/chains have the requisite tech-

nology inrastructure in termso sotware, hardware and Inetworks? Is the budget being allocated or the technologyinrastructure? For a good Isetup, Indian hospitals have to






get into a habit o allocating larger budgets or I, because Iis providing direct business ben-eits rather than just support.here is a need to develop aHealthcare-I platorm specii-

cally or India; a platorm that will include HIS+EMR+ERPand will be hosted, so thatevery clinician, administra-tor or manager can use it overthe web. Sotware as a service(SaaS) model can become areality in India because internetbandwidth is becoming avail-able everywhere through ixedlines, mobiles, DH and 3G.he SaaS model is economi-cally viable because it convertsthe Capex into Opex. here isno entry or exit barrier either.Public Health inormatics isstill a ar cry.

PeopleIs there trained manpower

available to run this show? We need people trained and

experienced in Healthcare +I + Management skills. In atypical Healthcare-I team, atleast 30% o the people shouldhave all the three skills; the restcan start with one and acquire

the remaining skill(s) subse-quently. he real change willoccur when our medical col-leges include management andI as an integral part o thecurriculum. Some HealthcareManagement institutes havetaken the irst step towardsincluding some part o I inthe curriculum, but there is along way to go beore the modelmatures. We need to have short,medium & long term approachto the people issue. Do we haveanyone thinking in this direc-tion?

ProcessAwareness about NABH,

JCAHO and ISO standards isemerging in large hospitals toattract Health Insurance andinternational business. Howeverthe culture o ‘Quality’ is yet to

percolate down the psyche o the Indian Healthcare indus-try. his will take time and willrequire a signiicant push romcentral bodies like CI. heneed o the hour is to deine Key

Perormance Indicators [KPI]or clinical, administrative andmanagement aspects o health-care. Some uniorm mechanismhas to emerge or KPI measure-ments, analysis, publication anddebate. Some healthcare bodyhas to take the lead or KPI inIndian healthcare. Unortu-nately very ew even understandthe concept o Healthcare KPI. We live in a country that getscars beore the roads and air-crats beore the runways. Ithink Healthcare will not bedierent either.

~ Dr. Pankaj Gupta, Managing Direc-tor – India, International Healthcare, Dell Systems Email: [email protected]






NEWS CLIPS

Robot guided knee replace-ment surgeries

Surgeons at a Scottish hospital are test-ing out an operating technique using arobot to carry out knee replacement op-erations as a part o clinical trial at theNHS. Around 150 patients are enrolledin this ongoing research which is being conducted at Glasgow Royal Inrmar ycollaboration between surgeons, bio-engineers and a US based health carecompany.

Images o the patient’s knee pre-loadedonto a soware controls the robot’smovements and the sensors placed onthe patient’s knee conveys the inorma-tion on the exact position. A display ona screen guides the operating surgeon

with an accuracy o within a millime-tre. Te procedure is expected to cut re-covery times to a matter o days, saving costs and improve the outcome o kneereplacements.

Read more...

Smart Phone Application orHealth Advice

Aridoctor is a mobile phone applica-tion designed and launched in SouthArica by Blueworld, a social mediacompany based in Cape own.

Aridoctor works as pocket doctor andit oers a “snapdiagnosis” service, pa-tients can send pictures o their ailmentto a panel o doctors who then contacttheir patient with a diagnosis within 48hours. Te other eatures incorporatedinto the application include “nd a doc-tor” and “distress” as well as rst aid tipsand a symptom checker.

Te “nd a doctor” system uses GoogleMaps to geo-locate local health servicesincluding doctors, hospitals and emer-gency clinics. Te distress eature en-ables users to contact a amily memberor riend at the touch o a button. Tis

person will be notied o the phone’slocation when the distress button is

pressed.

Aridoctor developed or high-end mo-bile phones is supposedly the rst per-sonal mobile health clinic in the Ari-can continent but Blueworld is hoping to strip it down so that the app can workon less technologically savvy handsets.Read more...

Smart clothes ofer emotionalaid

Smart clothes developed by BarbaraLayne rom Concordia University inCanada and Janis Jeeries rom Gold-smiths College’s Digital Studios wereon display at the Congress o the Hu-manities and Social Sciences held inMontreal rom 28 May - 3 June.

Te prototype garments created as parto an artistic project called WearableAbsence monitor physiological statesincluding temperature, breathing, gal-

vanic skin response and heart rate. Teclothes are connected via a smartphone

to a web based database that analysesthe data to work out a person’s emotion-al state. Te captured biological data isused to trigger a response rom the da-tabase previously created by the wearer.

When the wearer is detected as being in a particular emotional state, the da-tabase will send media to the clothes tohelp try to change a person’s mood. Me-dia, including songs, words and images,

are then transmitted to the display andspeakers in the clothes to calm a weareror oer support. Smart clothes helping their wearers cope with the stresses o modern lie could soon be a reality.

Read more...

ECG on Blackberry mobiles

Maestros Mediline Systems Limited inassociation with Vodaone announcedthe launch o its mobile ECG applica-tion or BlackBerry smartphones. Temobile apps is created by Research In

Motion (RIM) the makers o Black-Berry mobile.

Tis application on mobile ECG calledeUNO R 10 enables the doctors to re-motely monitor their patients. Tis tele-medicine device not only saves time o the doctors but also helps in early andquick dignosis o the cardiac ailments.

Tis application is being tested by Car-diologists at Nanavati Hospital, Mum-bai and is reported to have helped doc-tors make quick diagnosis and initiate

appropriate treatment in acute cases.

Read more...

HIMSS Virtual Conerence& Expo

A two day virtual conerence jointlysponsored by the Postgraduate Instituteor Medicine was conducted by Health-care Inormation and ManagementSystems Society (HIMSS) on 9th and10th June 2010. Te HIMSS Virtual

~Dr. R. Prajeesh


http://news.bbc.co.uk/2/hi/scotland/10218060.stm

http://news.bbc.co.uk/1/hi/technology/10407081.stm


http://www.medi-line.com/euno_maestorsR10.pdf

http://www.medi-line.com/euno_maestorsR10.pdf



http://news.bbc.co.uk/2/hi/scotland/10218060.stm





Conerence & Expo was an interactiveevent incorporating online learning,live chat realtime vendor presentationsand contests. Online availability andthe fexibility o on demand learning

were appreciated by the participants.

Virtual Conerence & Expo remainsopen until July 10.

Read more...

Upcoming Events

eHEALH India 2010Tis three-day international conerence is to be held in Hy-derabad during 4-6 August 2010.

Details

HORIZON 2010: National Conerence on “CreatingSynergy in Healthcare or Excellence”

I or cost reduction in Hospitals is one among the topicsat this 3 day National conerence hosted by Father MullerMedical College, Mangalore between 5th and 7th August2010.Details

National Conerence on Evidence Based Healthcare

Department o Hospital Administration, Sher-i-KashmirInstitute o Medical Sciences, Srinagar, Kashmir is conduct-ing a two day conerence on Evidence Based Healthcare rom18 to19th September, 2010.

Te topics include Quality improvement in Health Care,Evidence Based Medicine, Research Methodology, PatientSaety, Inormation Communication echnology, PublicPrivate Partnership.Details

www.iami.org.in

PRESIDENT / Dr. S. B. Bhattacharyya

SECRETARY / Dr. A. Thangaprabhu

TREASURER / Dr. U. S. Mahalonobish

VICE-PRESIDENT / Mr. Bhudeb Chakravarti

ADDITIONAL SECRETARY / Dr. R. PrajeeshEDITOR IN CHIEF, IJMI / Dr. Supten N. Sarbadhikari

INTERNATIONAL R EPRESENTATIVE / Dr. R. S. Tyagi

ADVISORY BOARD

Dr. S. B. Gogia

Prof. Khalid Moidu

Dr. Gopalapillai Sreedharan Nayar

EXECUTIVE BOARD

Mr. B. S. Bedi

Dr. Naresh Yallapragada

Mr. Sukhdev Singh

Dr. Sanjay BediMr. A. U. Jai Ganesh

Dr. Senthil K. Nachimuthu

Dr. Kavishwar Wagholikar

Dr. Rajeev Joshi

Dr. Amit Chatterjee, SM

Dr. Ashok K. Attri

Dr. D. Lavanian

Dr. Vivek Sahi

Mr. Devendra Patel

MINI (Medical Informatics Newsletter

from IAMI) is a monthly ezine brought to you by IAMI. IAMI is a non-gov-

ernment, professional organizationrecognised by the International Medi-cal Informatics Association (IMIA) as

the National Member for India.


http://www.himssvirtual.org/

http://www.eindia.net.in/2010/eHealth/index.asp

http://www.fathermuller.com/medicalcollege/news.asp?news_id=389

http://www.skims.ac.in/

http://www.skims.ac.in/

http://www.fathermuller.com/medicalcollege/news.asp?news_id=389

http://www.eindia.net.in/2010/eHealth/index.asp

http://www.himssvirtual.org/

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MINI (July Edition, 2010)