Role of ICT in Enhancing Quality and Assuring Accessibility of Healthcare Services, Gp Capt (Dr) Sanjeev Sood, Air force Hospital, Chandigarh

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7th eIndia – India’s largest ICT event

Role of ICT in Enhancing Quality and Assuring Accessibility of Healthcare Services

Gp Capt (Dr) Sanjeev Sood MD, PGDHHM, M.Phil (HHSM), FCGP, AFe ISAM

NABH Empanelled Assessor


Millennium Development Goals, especially target 18:

“In cooperation with the private sector, make available the

benefits of new technologies, especially information and

communications”.


Affordability

How conveniently can all availquality healthcare?

How can all get an assurance onquality of Healthcare being provided?

The Healthcare Triangle


JCAHO

• It defines quality of patient care as the degree to which patient care services increase the probability of desired patient outcomes and reduce the probability of undesired outcomes, given the current state of knowledge

• Definition is incomplete as it– Fails to address patient’s view point– Result oriented instead of being process oriented


All Institutions are Falling Behind All Institutions are Falling Behind the Pace of Technology Changesthe Pace of Technology ChangesAll Institutions are Falling Behind All Institutions are Falling Behind the Pace of Technology Changesthe Pace of Technology Changes

Time

Change

Technology

Social

BusinessMedicine

Unleashing the Killer App : Digital Strategies for Market Dominance- Larry Downes, Chunka Mui http://www.killer-apps.com/


ICT as an enabler¶ Technology has revolutionized worldwide the

delivery of healthcare¶ Delivering of quality healthcare & positive

clinical outcome¶ Cost containment, reductn in T A T of

workflows¶ Reduced workload, Medication errors & Space

reqt ;Faster access to patients MR¶ BI-Data Analytics for research and smart

decisions– Audit Trail and Compliance to Clinical Pathways


Role of Mobile Phones in Increasing Accessibility & Efficiency in Healthcare

Voice & Text Applications– Tackling inefficiency in service provision by improving

communication & interface eg., missed appointments, compliance,due dates for vaccinatn

– Contacting Blood Donors– Improved self management & monitoring of patients– Providing psychological support & helpline– Increasing the ability of some inaccessible groups

teenagers, mobile & working pop to access health service by reducing the barriers

3G Networking application– Transmitting data – image, ECG– Patient educatn through web based services– Amputation service performed


Advantage of Telemedicine• Eliminates barriers of time, distance & space• Can directly reach the patient – educational,

preventive & admin• 1/7th the cost of conventional OPD visit• Can avoid white coat hypertension• Can reduce ER visits-’Pre hosp Thrombolysis’

in MI & Stroke• Universal access, no inequity in healthcare

delivery• Allows home-based care, patient

empowerment• Effective screening – 12 lead ECG, USS, X-

ray, Bld Sugar, PFT, Oxymeter,


NRHM – Gets the IT Edge

• Health Statistics Information Portal – a web based MIS – facilitates speedy & efficient flow of information from periphery to centre

• Tools for advanced data analysis, reporting, monitoring, evaluation & programme management

• More efficient public health planning & forecasting for service provisioning, emergency preparedness ,resources mobilization

• Objective – data for Action


• Launched in Gujrat state to combat high MMR

• A comprehensive IT application for mother & child tracking system from pregnancy till complete LC for better public health services delivery .Covers the entire rural, urban slum pop.

• Application generates unique health ID for every mother & child ; ensures complete continuum of ANC delivery to reduce IMR/MMR.



Hospital Information

System


Computerized Physician Order Entry (CPOE)

A Computerized System that aims to reduce prescription & dosage errors, drug allergies & interaction alerts

Keeps physician updated on treatment guidelines Prevents superfluous inv & drugs that are not part of

standard formulary Prevents medication errors due to human factors – poor

handwriting, fatigue CPOE must support sophisticated decision such as drug

choice, dosage and patient monitoring strategies CPOE could be integrated with pharmacy, lab workflows

& inventory mgt


Diagnosis Decision Support System (DDS System)

• A Software that presents comprehensive list of possible conditions(Isabella)

• Prevents failure to consider reasonable alternative diag (Premature closure/Cognitive failure)

• Directs physician to helpful medical reference,interfaced with CPOE and HIS


Networking• Connected Approach• Align technology & operational needs to

support & streamline information flows• Critical Health Information available anytime

from anywhere• Interconnected applications like MIS, PACS &

EMR• Connecting entire chain of Hospitals, thereby

creating an integrated network of care among physicians, health systems & ancillary services

• Diverse entities can collaborate & communicate effectively working seamlessly


108-Hope Gets a Number

Toll free 108-Free ambulance service accessible fm all phones, 24 * 7

EMRI-PPP- Around 10 000 amb,25 ctrl centres,1 lac trained pers

Goal-Respond to 1million calls/day &save a mill lives/yr by 2010


• Early Warning & Response System-Remote Sat Imagery +GIS+Met data

• Outbreaks of infectious dis, vector borne diseases-Cholera , SARS can be quickly analyzed using GIS tools.

• .


CLOUD COMPUTING (SaaS)

Set of virtual servers working in tandem over the internet Shared hardware, servers & Software High Speed Network More powerful & Dynamic than Grid Computing Inexpensive, efficient ubiquitous & secure


Evolution of Computer HardwareHardware Genera-

tions

Feature 1st 2nd 3rd 4th (early)

4th (1988)

4th (2001)

Circuitry Vacuum tubes

Transistors Integrated Circuits

LSI and VLSI

ULSI GSI

Primarystorage

2 KB 64 KB 4 MB 16 MB 64 MB 128 MB

Cycle times 100 millisecs 10 microsecs 500 nanosecs 800 picosecs 2,000 picosecs 333 MHz

Average cost $2.5 million $250 thousand

$25 thousand $2.5 thousand $2.0 thousand $1.5 thousand


The Future Vision


CONCLUSION

ICT has made the delivery of healthcare more efficient, effective,accessible and safer across the care continuum for both, patients and providers

Holds immense promise of changing medical practice for the better


Go as far as you can see, and then see what lies beyond