E-Prescription for Healthcare

IT adoption in the healthcare segment in India is still at a nascent stage, except for the large, premier hospitals in urban areas. The smaller hospitals and health clinics, like those in rural areas and smaller towns, still have a long way to go. In fact, they're still struggling with procuring even basic medical amenities, so thinking about using IT is still a distant reality. A key reason for this is the lack of awareness about the impact IT can have on their functioning. According to a research by Springboard, IT adoption is almost nil in Tier 3 cities in India. Hospitals in those cities are focusing more on better clinical delivery than spending on IT to ease their hospital delivery services.

Challenges Before Indian Healthcare

Industry

We can easily divide these challenges into two--one set of challenges are faced by the premier healthcare institutes who've already 'been there and done that' as far as IT goes. The second set of challenges applies to the remaining healthcare institutes, which form a bulk of this segment. As can be imagined, the challenges are completely different. Let's take a look.

For large, premier healthcare institutes, the challenge is related to managing their existing IT infrastructure, which includes their desktop fleet, the ultramodern medical devices that they use, securing their sprawling infrastructure, storing huge amounts of data and complying with industry standards and government regulations. Many of these healthcare organizations extend beyond hospitals to neighborhood clinics and off-site services such as radiology interpretation, etc. In such a dispersed environment, ensuring the security of critical infrastructure -networks, servers, databases, and PCs becomes more difficult.

Also there are challenges that range from defining protocols and procedures and diagnosing patients with the same problem in the same way. Electronic medical records should be made mandatory which bring in lot of regulations by itself.

Besides, the market is highly fragmented with 40,000 — 100,000 labs in the country; there are approximately 2,000 pathology laboratories in Delhi/NCR offering basic to advanced testing facilities for patients. While medical processes are evolving there is lack of domain expertise in IT consulting space.

Maintaining records for regular customers and taking orders regularly on the basis of their request date and time is also a challenge. Deciding a discount structure for different medicines on the basis of margins available to the company, keeping records for sales and purchase for sales tax purposes are other confrontations. The retrieval of the patient details, in an emergency is still a nightmare for many hospitals. Monitoring the progress of patients online is another challenge.

While moving from manual to electronic recording of patient records save money, increase efficiency and reduce errors --but it is difficult and expensive for many.

Latest trends, solutions

Today we see a range of practices being used across hospitals especially big ones to expedite the patient treatment and recovery system. One of them is the fast-track generation and retrieval of electronic medical records at point of service. Data generation is done with fast data entry applications like document scanning or retrieval of data using RFID or barcode. Another major development is the adoption of Software as a service (SaaS) model. Hospitals have started opting for SaaS model for IT applications. Instead of investing in CapEx for procuring apps, hardware, etc, they are going for SaaS model for apps like HIS, etc. Here, hospitals pay per use of the hosted applications which are maintained by the service provider. This not only helps them in saving capital costs but also aids in easy maintenance of patient records. We don't know of any hospital going this way, but yes, there is lots of buzz around this.

Real picture, IT implementations across hospitals

Let's have a look at the real IT implementations across a range of hospitals and pharma majors in India.

Information Systems

Kuppuswamy Naidu Memorial Hospital in Coimbatore deployed a Information System. This is a kind of Clinical Support systems to retrieve patients' details in an emergency. They were faced with a lot of data duplication and everything was paper-based. The patient waiting time at every point was more and it was crucial for the patient. The discharge summary for the patient was delayed due to non compilation of the data on time. The progress of the patient could not be monitored online. The overall statistics of the patient data and the birth details were not available. After the deployment of the information system, doctors now can get insight about a patient's status, progress meter among the other problems mentioned above.

ERP Deployment

Dr Lal PathLabs deployed an ERP project called Health Connect to enable the organization to automate and integrate its different business applications. Pre-implementation, they had various lines of business apps that helped they in running business but there was limited integration between applications. This resulted in business challenges like accurate and real time reporting, impact on desired service levels for customer, managing business growth, etc. PathLabs needed a centrally deployed secure, scalable and easy to use business solution to manage business growth across multiple geographies --a solution which is adaptable and flexible to incorporate evolving processes in a rapidly expanding organization. They required a solution that can enhance patient convenience and maintains high transaction volume with clinical precision. The ERP deployed included integrating specialized solutions like lab information system, document management system & business analytics in combination with ERP. It provided a Point-of-Sale solution to manage patient registrations & billing for individuals and corporate clients along with day-to-day receivables management.

Green Initiatives

Healthcare industry is equally considering deploying green IT project. The pharmaceuticals major Wockhardt targeted a comprehensive set of areas where they wanted to actively make an attempt to improve energy efficiency and cut down on harmful emissions. Interestingly, the company claims to have achieved over 70% energy savings by deploying virtualization using logical partitioning.

Pharmacy Management System

This is one of the most common IT solutions deployed by hospitals to ensure supply chain. Chandan Healthcare of Lucknow deployed this to manage purchase and supply of product and secure profit margin. The biggest problem for them was purchase and supply of product. There was a huge expiry of medicines at the shops although the same can be used in other units where the same medicines are being purchased. With that, the selection of expired products was not timely so that the same can be returned back to the stockist for realization of money. Also searching for availability and placement of medicines at the shop was a challenge. Post- implementation, there was a decline in expiry of medicines at the shops. Now the expiry of medicines at the shops is reduced to less than 0.5%, which is much less than industry average of 5%. It became possible by rotating the medicines from one shop to another on the basis of requirement through central warehouse.

Business Process Management & Automation Solution

Biocon Limited implemented Artwork Management System to get rid of the error prone manual processes. Biocon' s manual processes for managing artwork or the packaging process for labels, leaflets, packages were extremely time-consuming and sometimes error prone as comments at each stage were provided manually and then data entry operators entered the data to create an electronic copy. The artworks errors can even sometimes lead to product re-calls from the market place. There was a lack of automated auditing & reporting and also paper based approach was error prone. Security and control were critical and difficult to manage and enforce in a manual process. Post-implementation, the application manages the entire artwork life-cycle from product initiation by the marketing team to approval from various teams such as formulation, production, quality, regulatory, etc. to the process of printing and archiving approved artworks.