1. ea 0 (-3 HimssASIA-PACIFIC INDIA ChapterTransforming Hcalthcarc through IT

2. DisclaimerHIMSS Asia Pacific India Chapter has exercised professional care and diligence in collection and processing of the information in this report. However,the data used in the preparation of this report (and on which the report is based) was provided by third-party sources.This report is intended to be of general interest only and does not constitute professional advice. HIMSS Asia Pacific India Chapter makes no representations or warranties about the accuracy of the data in this report.HIMSS Asia Pacific India Chapter is not liable to any user of this report or to any other person or entity for any inaccuracy of information contained in this report or for any errors or omissions in its content,regardless of the cause of such inaccuracy,error or omission. Furthermore,to the extent permitted by law,HIMSS Asia Pacific India Chapter,its members,employees and agents accept no liability and disclaim all responsibility for the consequences of you or anyone else acting,or refraining from acting,in relying upon the information contained in this report or for any decision based on it,or for any consequential,special,incidental or punitive damages to any person or entity for any matter relating to this report even if advised of the possibility of such damagesI ASIA-PABIFIB INDIA C / Iupfer T. ~.um'. mmng iimiiiwm-c through IT@@66)(-9State of Healthcare IT in I | ndia201112 3. HimssASIA-PAGIFIII INDIA Chapter Trunsfmlning Hcalthcurc through ITState of Healthcare IT in | ndia201112_ Dr.SAM PITRODA. . WAdvisor to the Prime Minister of India@@6)(-9ForewordIndia's ability to achieve the healthcare related goals depend on her ability to narrow the demand-supply gap in healthcare services.Information Technology (IT) has the potential to improve the quality,safety,and efficiency of healthcare.Improvement in patient safety is the largest benefit that IT brings to the healthcare field.Leveraging IT in Indian healthcare is one of the most beneficial ways of integrating all the resources and utilizing the information in the best interest of the individual and country. Through this research study,an endeavor has been made to display the challenges and opportunities in healthcare IT and ways to transform healthcare with proper use of IT.In terms of healthcare information technology,development of national standards for interoperability and connectivity is crucial. For the need of an Enterprise Public Healthcare Information System,HIMSS Asia Pacific India proposes an information highway to connect the large number of healthcare entities.Healthcare improvement starts with getting a unified view of an individuals health history.This information is stored in various organizations and often,in disparate systems within those organizations.Comprehensiveviews of an individuals health information will enable personalized medicine (use of information to optimize that patients preventative or therapeutic care) and can be analyzed to improve population health.Staggered investments on ICT enabled health services are in practice;the need of comprehensive Public Healthcare Information System is the need of the hour. With proper guidelines and adequate investments in terms of finance,research and manpower,IT has,and in the near future,should further reform the Indian healthcare scenario,not just to find health solutions for medical tourists,but also for the common man residing in the remotest locations of our country.IT has played a great role till date,but it needs to explore other avenues in order to make the country stronger. I encourage you to think about this report and discuss with others to make IT central to the deployment of healthcare delivery systems. | congratulate HIMSS Asia Pacific India team under the leadership of Rajendra Pratap Gupta for coming out with the first such report. Warm Regards, Sam Pitroda 4. t7~; .|RAJENDRA PRATAP GUPTAChairman,Board of Directors,HIMSS AsiaPacific India ChapterI ASIA-PAIIIFID INDIA C hupter Transfnnning Hcullhcmc through ITcaeeooChairmans MessageGreetings from HIMSS Asia Pacific India team! Healthcare holds the key to a vibrant economyand without IT,healthcare cannot be complete. The 12th Five Year Plan is talked of as the plan for health,and without leveraging IT in healthcare,healthcare for all,will remain a distant dream.At HIMSS,we are committed to coordinate with all the stake holders in healthcare to bring out the best for healthcare IT in India. It gives me immense pleasure to present the first report of HIMSS Asia Pacific India Chapter.This probably is also the first report of its kind on the state of healthcare IT in India.A lot of hard work has gone into this report under the leadership of A.Vijayarajan,Amit Mishra and the team at Hea| thMinds.I wish to put on record my deep appreciation and thanks to Prof.Santosh Kumar and his team from IIHMR and all the others who contributed to this report. Though the team has taken every effort to make sure that report fulfills the information gap in healthcare IT for practitioners,providers and policy makers,since this report is apioneering effort,it will certainly have some gaps and deficiencies associated with all first time reports.Please write to us with your views on this report so that we can improve upon the subsequent ones. HIMSS is a global platform for over half a century for those associated with healthcare IT and HIMSS India will continue to add value to all stake holders in healthcare IT in India through regular reports,training,certifications,and inputs on healthcare policy.We will reach out to you with our initiatives on reports,training and live events,to build a matchless platform for practitioners,providers,and policy makers in healthcare IT at HIMSS India. I await your feedback. With best wishes,Rajendra Pratap GuptaEmail:chairman@himssindia. org 5. IiimssASIA-PAIIIFID INDIA Chapter Transforming Hculthcurc through ITState of Healthcare IT in | ndia201112IVSTEVEN YEOVice President and Executive Director,HIMSS Asia Pacific,General Manager,HIMSS Analytics AsiaPrologueWelcome to the 2012 HIMSS India Chapter along with | |HMRs very first white paper published on the state of healthcare IT in India.This white paper is developed from surveying 49 healthcare facilities from both public and private sector providers.The survey looks into the challenges in the deployment of HIS and technologies,driversand trends for IT investment,trends for technology adoption and projected market size. For individuals or companies that are interested to have an insight into India's healthcare IT market,this white paper also provides a good start with an overview of the industry in India,health spending along with the complexity and challenges for healthcare providers.The paper ends with the recommendations proposed to advocate the increased use of IT in healthcare in India for the government,healthcare providers and solution providers. Best wishes,Steven Yeo(%@@(6)(-I9 6. 0 ASIA-PAIIIFIG INDIA Chapter Transforming Healthcare through ITcaeeoe Sponsor of theReponThe Telemedicine Society of India is honored and privileged to be the sponsors of the State of Healthcare IT in India 2011-12 report by HIMSS Asia Pacific India Chapter.For us,this report represents the prevalence of the healthcare IT scene in India.We feel that this report is filled with absolutely high quality insights that are a treasure trove of practical information for our healthcare IT community. The Board of Directors, Telemedicine Society of India. About Telemedicine Society of India (TSI)TSI is a not-for-profit society formed in 2001 by senior scientists of the Indian Space Research Organization (ISRO),senior doctors from various national level institutes,and senior officials from the Ministry of Health and Ministry of Information Technology,Government of India.For the past ten years,TSI has done commendable work in promoting the practice of Telemedicine and mHea| th,spreading awareness and updating the users,providers and patients on the benefits of using telehealth and mHea| th in healthcare delivery.State of Healthcare IT in V | ndia201112 7. // /V HIMSS Asia Pacific India ChapterRajendra Pratap Gupta ChairmanA Vijaya rajan PresidentDr.Chandil Gunasekara Vice PresidentGaurav Mundra SecretaryAmit Mishra TreasurerManick Rajendran Executive MemberVishal Gupta Executive Memberi/ IASIA-PACIFIC IIIDIA Chapter Transforming Healthcare through ITState of Healthcare IT in VI | ndia201112 8. HimssASIA-PABIFIB INDIA C / Iupfer T. ~.. mI1mnIng IIcLI| IlIcaI'c through IT(%Iel(6)(-JDAcknowledgmentsAt the very outset,we would like to offer our sincere thanks to all the respondents who devoted their time and effort to completing the study questionnaire.We are thankful to the advisory team for their constant support in the conceptualization of the study as well as support and guidance. This report is the result ofthe collaborative efforts of HIMSS India,IIHMR and other partners.Our special thanks to some of the research staff and ex-students of IIHMR,Jaipur,namely,Akhil Agrawal,Bimlesh Sinha and Anjali Vaishnavowe for sincerely pursuing the respondents for timely completion of data collection.We also thank the Project and Research Officers of IIHMR,Jaipur namely S P Chattopadhyaya,Sudeep Sharma,Dr.Tukaram Khandade,Dr.Priti,and Shashi Ranjan,who have helped in preparing the draft report by tabulating the data and developing the literature review.We would like to mention in particular the contribution of the team of Hea| thMinds for all their support they provided in the areas of technical review of the content,editing and designing of this report. We were very fortunate to be able to access professionals from public and private health organizations,academic institutions,and industry,with extensive experience in the area of health services information systems.To them,we would like to declare our recognition and gratitude. Executive CommitteeHIMSS Asia Pacific India ChapterState of Healthcare IT in | ndia201112Vll 9. I I Q Ix/ Li.. >1/J ASIA-PACIFIC INEIIA ('/ mprcrimmiminiiig IILIIIlIlC. II1II1IFinance >Pharmacy >Diagnostic Services >| PD >Support Services including university management system- Providing user friendly standardized templates to ensure records are maintained uniformly across the consultants of the same specialty along with creation of detailed standard operating procedures for allt-; er--modules of HMIS to bring consistency and accuracy in the HMIS implementation and subsequent usage of HMIS system. - Detailed study of the equipment available in various diagnostic centers across the hospitals were collected and then a composite application was developed to integrate with the existing HMIS application- Computers in the ratio of 1-1 (one doctor one computer) to the consultants in OPD to ensure time wastage does not happen in busy OPD- All servers of application and database are configured in High Availability mode with network switches in auto failover modeIQt? 58. HimssASIA-PABIFIB INDIA C/ Iuprer T. -.rm. II. mnmg IICIIIIIICLIIC llimugh ITC-39@t6)(-3Conclusions &_ RecommendationsBased on the analyses conducted during this survey,the following recommendations are proposed to advocate the increased use of IT in healthcare in India. - Government to lead the way:the govern- ment of India should ensure adequate involve- ment,investment and completion of the IT implementation projects that have been proposed and cleared in the past.The govern- ment,in conjunction with advocacy agencies such as HIMSS should ensure a policy involving IT in healthcare delivery,both in public and private systems,similar to the lines of the ARRA and HITECH acts in the USA.It should also invest in establishing an agency in association with industry bodies to develop a standard,thereby promoting uniformity and interoperability across the healthcare system. o Advocacy agencies and industry bodies to create awareness:the dissemination of information should be facilitated through conferences,seminars,case studies and other similar vectors.Changing dynamics of health- care in areas of insurance,delivery models,and interre| ations of all auxiliary agencies will also change as a direct impact of hospital computer- ization.The certain prospect of increased government involvement in this domain in the future,awareness and popularization of the benefits of IT need to be effectively communi- cated.The responsibility of this task would most likely lie with advocacy agencies such as HIMSS. o New projects to be launched:both govern- ment and private players in the healthcare market,through a visionary thought leadership,should be the driving force to start new projects,encourage the development and application of newer technologies by funding research and supporting pilot projects.Our study observed that most of the computeriza- tion in hospitals is in the areas of billing and administration,and we feel that priority investments need to be made in the areas of clinical care delivery,secure data storage and management to enable providers to make clinical decisions,clinical education and training,and patient education technologies.The government should be able to create an environment that is conducive to innovation and piloting of novel technologies. o Macro guidance to define minimal require- ments:there is strong need for macro guidance in defining the minimal requirements of features that need to be adopted while implementing IT in a hospital.We feel that this is a critical advisory role that needs to be played by advocacy and industry bodies,since our study found that close to 70% of our respon-dent hospitals had a plan to computer- ize their organizations.The generalization of the survey findings reflects the fact that there would be an increased number of hospitals considering the adoption of IT,and reliable guidance and advice in the initial stages across the industry would lead to utilization of deployed technologies in a uniform manner with a common language,thereby creating anState of Healthcare IT in | ndia20111248 59. O ASIA-PACIFIC INDIA Clmptcr IIii. iisixii-ihiiig iieiiiiiiem Illmllgli IIState of Healthcare IT in | ndia201112Recommendationsinteroperable ecosystem.Guidance can be extended to adopters of IT in the form advisories similar to "EMR Adoption Model know as EMRAM released by HIMSS Analytics.The model is developed through focused research that helps hospitals grade their prevailing EMR capabilities as a baseline and provideslaU6t6)t-I9advice and guidance on the stage wise implementation of Electronic Medical Records in order to strategize their path to build a paperless,digital hospital with the right infrastructure in place tosupport it. 49EMR Adoption Mode|5"" TrendsUnderstanding the level of electronic medical record (EMR) capabilities in hospitals is a challenge in the healthcare IT market today.HIMSS Analytics has created an EMR Adoption Model that identifies the levels of electronic medical record (EMR) capabilities ranging from limited ancillary department systems through a paperless EMR environment.HIMSS Analytics has developed a methodology and algorithms to automatically score hospitals in our database relative to their IT-enabled clinical transformation status,to provide peer comparisons for hospital organizations as they strategize their path to a complete EMR and participation in an electronic health record (EHR).The stages of the model are as follows: analytics asiaEMRAdoptionModeI Stage Cumulative Capabilities St 7 Complete EMR;(co tlansactioris to share data,Data age Wi1lE: IVOllSIllg,Data ((ill(IllIItIWlll1 en,airibulatorv,orP .ll necuiiiencaciei trurtured templates),full coss (variance 1 compliance),Closed loop meditation aaminisnatiuhiliiisiiigiciiiiicai UOCUIYIEIIIBIIOII l_U. l sheem CD55 lab ulsitle i= ..i(iioii, .g. icor.Controlled lvlerllta Vocabulary.cos,may have [7DCUlI'iElll: Ill7E1glrIg',HIE capableStage 0 All Three Aritillarles llcit Installedin am HIMSS AnalyticslE'lrUr thetiihgw, http: //www. himssanalyticsasia. org/ emradoptionmode| .asp 60. HimssASIA-PABIFIB INDIA C/ zuprer TI'. 'in~llrn1ing llciiltltczilc through I rt-tttit-9References10.11.12.13.Healthcare.Indian Brand Equity Forum;2011 [updated 2011; cited];Available from:http: //www. ibef. org/ download/ Hea| thcare50112.pdf. NRHM.Rural Health Care System in India;2010 Contract No. : Document Number| . WHO,India.Foreign Investment in Hospitals in India;2011 Contract No. : Document Number| . WHO.World Health Statistics 2011; 2011 Contract No. : Document Number| .Technopak.Accessible Healthcare Joining the dots now.techopak;2010 [updated 2010; cited 2012];Available from:http: //www. technopak. com/ resources/ healthcare/ TLF%20whitepaper. pdf. WHO.World Health Statistics 2010; 2011 Contract No. : Document Number| .Census,of,India.India Profile.2011 [updated 2011; cited 2012];Available from:http: //censusindia. gov. in/2011census/ censusinfodashboard/ stock/ profiles/ en/ IND_lndia. pdf. Census,of,India.Provisional Population Totals Paper 1 of 2011 India - Chapter 8 - Population Projections;2011 Contract No. : Document Number| .KPMG.Emerging Trends in Healthcare - Ajourney from bench to bedside:ASSOCHAM;2011 Contract No. : Document Number| .Narayanswamy S,Zainulbhai A.India's consumer evolution.Business Standard (India).2007.Pricewaterhouse,Coopers.Healthcare Unwired Health Insurance and Healthcare Access:India Health Progress;2011 Contract No. : Document Number| .Mckinsey,&,Company.India Pharma 2020 Propelling access and acceptance,realising true potential Contract No. : Document Number| .WHO.The impact of chronic disease in India;2004 Contract No. : Document Number| .State of Healthcare IT in | ndia20111250 61. Q-39@@(A)(-BASIA-PACIFIC INDIA Chapter Transforming Healthcare through IT