by May 14, 2007 0 comments



A pipe running through a maze in the most complex of patterns. Millions of nanoparticles inside this pipe on patrol, and on the look out for any culprit that might be planning to sabotage the whole system. No, it is not a micro-castle preparing for an attack against enemies that I am talking about. That is how a human body looks like from within. It is a continuous war that the RBCs and the antibodies keep waging against all those sick cells and the disease-causing micro-organisms. But soon this reality is going to change. You will be injected with magical robotic nanoparticles called ‘quantum dots’, dandromers and nano robots that will roam around with the RBCs guarding your body, and go to the diseased cell to cure it or kill it if it is malignant. These will act as nano medicines that will curb any diseases when it begins to take root and you would never fall ill-never ever.

Not only this, men and women might not be needed anymore physically to make a child birth possible. You could grow sperm and egg cells from say bone marrow cells taken from homo sapiens, that could then be cultured to fuse it to generate a new human being. The eye you donated could impart eyesight to many, let alone one. And then you might not even need doctors to diagnose and treat you. All this and more could be left to the technological miracles to treat an ailing body. And infact, none of these could even be conceptualized had technology not been there to support it.

Well, if you still wonder how advanced this industry has become, you have umpteen examples to quote from within India itself. You have state-of-the-art surgeries and implantations taking place in India that are also being telecast live to other countries in the world. Our expertise in healthcare is so well known that we have people visiting the country for treatments and even studies. Not much would have been possible if technology wouldn’t have been supporting the industry as one of the most important pillars. Despite so much happening in the industry, very little is known about how deep rooted the miracles of technology are, that are equally responsible for the accolades that the healthcare industry as a whole brings in to the country. We delve deeper to understand how IT serves healthcare.

The span of the healthcare industry is pretty vast. So before taking a plunge into the vertical, let us see what all it comprises. There is the hospital fraternity, there are pharmaceutical companies that are mushrooming at a pace like never before. You have medical tourism that is growing as an industry all together. There is biotechnology and bioinformatics that run in and around healthcare. Further, you also have a major chunk of insurance revenues that come from the health insurance part of the industry. And then there are many ways in which technology makes headway into this industry. Each and every sub-vertical in this, there are talks of increasingly higher use of infotech solutions.

While most of the time you will find IT being talked about only when it comes to service delivery and inventory clearance and taking and keeping a stock of the stocks, there is much more that IT can do and is actually doing with those who can innovate and take that extra step.

While most of the IT spend is still attributed to the hardware that they buy, that include the infrastructure components. It is closely followed by what these companies spend on the software and then on the services. The drivers to deploying IT in healthcare organizations include the need to match up with the dynamically changes technology environment worldwide, increasing employee efficiency and improving productivity, improving customer services and therefore customer satisfaction, and most importantly better stocks management and inventory movement.

India as a market
The largest chunk of the budget expenditure for this sector still goes into equipment and machinery for healthcare, per say. Most of the industry people
consider that as a separate implementation of technology that information technology though world’s largest companies like Philips are big time producers of the healthcare equipment like the MRI machines, and other big apparatus. Since none of these equipment were possible without the IT making it possible to make inferences and do diagnostics, we take these also to be a part and parcel of the IT infrastructure.

The case with the Indian market is not very different from the rest of the world as the trends here suggest that India is emerging to be a healthcare hub for a large part of the world, in view of the expertise and equipment available here. Total investments of about Rs 9000 crore have been announced for establishing superspeciality hospitals. Another Rs 5,385 crores are expected to come in from international healthcare groups that are planning to invest in India.

Apart from this, people from across the world come to India to get themselves treated, and a lot of Indian pharmaceutical produce is exported to the rest of the world. Medical tourism is another area where the demand is more than the supply and the bigger organizations from across the world have already announced their planned investments to reap benefits from it. We match the global statistics as IT has become an inseparable part of the drug distribution infrastructure even within India. Medical research and the use of IT therein is bringing together medical imaging, information technology and laboratory diagnostics to offer full service diagnostics.




Elementary, Watson!
It is implied that the healthcare sector is going to spread out into the suburbs and even rural India, thus, creating a healthier India both in terms of economy and the biological health of the country. This is because today all these superspeciality hospitals and other healthcare facilities and companies are spread only in and around bigger cities and metros. With such huge influx of capital being planned and already announced, even the under-priviledged cities are soon to see these superspeciality healthcare projects being launched in the next few years.

As a result, there is immense potential for IT industry to act as an enabler and provide all necessary ecosystem comprising infrastructure, solutions as well as services in these budding new healthcare setups. There are huge amounts of IT requirements that will be generated out of this, which will require both technologies as well as skilled manpower to meet the demands. The focus, then, will not only be on providing good quality solutions, but also keeping the healthcare sector up-to-date with all cutting edge trends and technologies so that we are neck to neck with economies like Singapore and US that boast of best-of-breed healthcare facilities.

Key enablers
There are many a technologies that are serving as great enablers for all the needs of the healthcare industry. These comprise inventory apps, CRM, ERP, accounting and finance, communication technologies like video/audio conferencing, mail messaging, HR mgmt, HIS (Hospital Information Systems), network and information security, wireless, and more. Most of these are very commonly used tools that derive their adoption from the organization’s business objectives.

Sensors: Wireless technology is slowly settling for exhaustive use in the healthcare industry. The latest entrants in this area are the RFID tags and wirelss sensors that are being used across hospitals and pharma companies for different purposes. The hospitals can use RFID tags and wireless sensors for better patient care, security, inventory management, tracking medical devices, maintaining medical records, patient histories and more. On the other hand, the sensors can be attached to the drugs in the pharmaceutical sector for sales management, or for gauging the drugs being used in the clinical trials. Many other innovative usages that these tags and actuators can be put to could be tracking the path of a drug or a food item through the supply chain, or generating a small alarm when it is time to take a particular drug that has such a sensor embedded onto the packaging. The time, date and type of medicine taken in the medical records of patients could be updated on their own when the patients open a certain packaged and sensor-laced tablet that sends out signals to an equipment. While the usages are fascinating enough to deploy them at the earliest, the only deterrent today, for a country like ours, in adopting this technology is the cost that these technologies come at. Once that is brought down, much more can be done with these tiny utlitites.

Outsourcing: Another very important enabler for increasing IT adoption in the healthcare sector is not a technology but a means–Outsourcing. Many of the services and deployments along with their maintenance in these rather big healthcare setups are outsourced. The helthcare units have smaller in-house teams to manage only a selected few implementations, that are either developed by them, or are more closely linked to their mainline of business. One such example would be an ERP system for a pharma company.

Challenges
Training and retaining: An implementation is never complete without trained personnel to use it. While retaining and training staff to use the new technologies is a challenge in many other industry verticals, the healthcare vertical is not far behind. Almost all the CIOs and industry experts we talked to, face the same issues too. They need to keep themselves and the staff up-to-date and motivated at the same time.

Standards and compliance: while a lot of technologies and their applications are in place and many new ones like the wireless healthcare are being implemented, it becomes very important that all these are commonly accepted to all and follow common standards so that they can be shared amongst the partners and the governing and regulatory bodies. All the technologies need be interoperable and integrated well with the IT infrastructure so that all the applications at all the levels can talk to each other freely, thus, making the information available anytime anywhere.

Vendor issues: The healthcare sector also suffers from another common problems all other CIOs face-that of zeroing on the best technologies to deploy and the vendor to provide deployment and post deployment support. Most of the time, the vendors seem to be proactive only till the time they freeze a deal. After that, their response degenerate and you end up with poor service post installation.

 

R S Tyagi,
Dy Director and Head,
Computer facility, AIIMS

The All India Institute of Medical Sciences is known more as a hospital than as an institution that indulges in a lot more of education and research. In fact, not many from the healthcare industry, be it doctors or pharma cos, know the truth behind an institution as AIIMS. It is to believe that a lot of sweat must have gone behind getting an infrastructure in place to be able to support the kind of facilities on offer there. We explored the state of IT affairs at the institute with the man in charge of all such operations.

Tell us about the IT infrastructure at AIIMS.
“Like any other business sector, AIIMS also erected its IT infrastructure in steps. It was long back in 1967-68 that AIIMS began using computers for the first time in research. Later in ’79 -’80 we made use of these only pieces of modern information technology then for inventory management in research and other projects. Medical records were then automated in 81-82 followed by the actual IT implementation for medical stores management and supply of medicines.

IIT Delhi did a feasibility study of carrying forward IT deployment in the institute in the year 1985-86 to give a go ahead. As a consequence, a separate IT department was set up in the leadership of Professor T P Singh. With his efforts, TCS did hospital records management in 1989.”

So how far have you come since then. How does IT look at the apex healthcare institution today?
“We have automated various functions like accounts, academics, library and more. We have a 45 Mbps lease line fiber network in place across the institute. We have now being doing telemedicine consultation, and have been able to treat more than 500 cases across the country through it in the past 3 years. Live surgeries can now be telecast to anywhere in the world for others to learn. We have done that for countries like UAE, Germany, UK, France and USA.

While AIIMS has the most advanced equipment and technology to treat even the worst of cases, I must confess, we do not have any Hospital Information System in place. We haven’t been able to automate records, and patient and treatment histories to create a one-stop data warehouse that can be consulted by other experts.”

What is the future roadmap you envisage for the healthcare sector?

“Today, a patient gets all checks and tests done at the hospital he goes and all the others where he is referred from there. As a result, the same effort is duplicated at every place, wasting hospital resources, and time and money of the patient. The fiber network we have in place can really be made use of for doing this across all government institutes to begin with. For instance, an MRI done at say AIIMS can be beamed through one common network to an expert sitting at say G B Pant Hospital in Lakshadeep. Similarly, we should increasingly use more and more Artificial Intelligence and Knowledge based decision support systems to assist physicians. In fact, robotic surgery is actually doing that only.”

 

 

M K Vasanth Kumar
Executive VP – IT & Supply Chain,
GlaxoSmithline Pharmaceuticals

What, in your opinion, are the business objectives of using IT in the healthcare segment? How far does IT go to achieve these business objectives?
IT in healthcare is deployed to reduce cost of business operation, to improve sales force effectiveness, to enable regulatory compliance and to introduce new products faster. It does add value to top line by enabling sales force to improve their effectiveness, to bottom line through e-procurement initiatives and through Supply Chain efficiency. It plays major role in bringing new products faster by partnering with R&D, which impacts both top and bottom line.

Large national and international players are entering the arena. How do you see this in terms of the quantity and type of technology that would be needed to meet the demands of such a change?
As mentioned by you, MNC healthcare companies have recognized high quality of
Indian Talent and also the market potential due to implementation of Patent
laws. Hence many of them have started

1) to outsource IT & Finance processes and Clinical Trials;

2) to enter Indian market by partnering with Major companies; and
3) to source the material.

The major demand on IT will be to provide a secure, reliable, scalable and resilient infrastructure. Other requirements like ERP system, front & back end systems are highly standardized across the globe.

Which solutions/platforms are being used by GSK and for what type of needs?
We have a well-defined end-to-end business process supported by two ERP packages, JDE for Commercial and BPCS for manufacturing. For sales force automation, we have SFA and Sample tracking; for back office productivity we have employees self-service portal, HRMS, Notes Messaging and collaborative tools. We run several e-procurement sessions to make procurement process vibrant and transparent. GSK India does not have any R&D activities. However, we have set up a Clinical Data Centre at Bangalore for collating Case Reports, data validation and reports.

Tell us about the challenges you face while deploying anything new. How do you propose to overcome them?
The main challenges are in meeting the rising expectations of users in terms of quicker and economical
solutions, managing change and providing consistent and high QoS across multiple locations in a 24×7 environment. Another major challenge is to retain talent.

What is the future course of IT in the pharma sector?
There is a shift in disease pattern, from acute to chronic. Chronic diseases like Diabetes, Asthma, CNS are growing faster due to change in lifestyle. Pharma companies are gearing up to meet the challenges and IT will play a major role in reaching solutions to doctors and patients directly. The Retail boom and tax reforms will change the Supply Chain Model with the help of IT.
As more and more companies will outsource IT Infrastructure, the in-house IT teams will focus more on improving processes by partnering with business.

What are your security-related concerns?
Our security concerns are of the kind like any other large corporation operating. They include aspects like illegal access, ID management, and data & information loss. We have implemented robust and effective
security measures in line with corporate policies.

 

 

Jyoti Bandopadhyay
VP-IT, Torrent Pharmaceuticals

What are the growth drivers in this exponentially expanding
sub-vertical of the healthcare sector?
The 20,000+ registered pharma companies with more than 70,000 field
professionals and 5000+ physicians in the country account for covering only
30-35% of the total Indian market. A huge 60-65% of it is still untapped which
comprises almost negligible tapped countryside. This is the biggest growth
driver.

What are the challenges that you face in reaching out to
such a vast market?

The main challenges include the fiercely competitive branded generic nature of
the market, and therefore, establishing your brand in this generic market. Price
control and patent laws are other challenges to that need to be tackled.

While a lot of IT infrastructure goes into data collation,
management and decision support, one needs to take care of scalability,
reliability and cost effectiveness while deciding on an IT solution.

What is the value addition that IT offers and the IT
framework that is being used in the industry?
Information technology ensures good quality and accuracy of information
being captured, and at a faster speed. In this industry, you need to update and
feed data frequently and regularly about retailers, distributors, sales,
clinical research, field data and much more. All this needs to be done from
multiple locations, and that is where IT acts as a business enabler. PDAs, Web,
cellphone and notebooks can be used for achieving this in no time. The
communication channel has improved and anytime anywhere computing has brought in
tremendous RoI generation capabilities. The IT framework brings in effective
sales and operational planning, enables sales force automation and better CRM
and customer satisfaction.

The tech environment should also be feasible for R & D and
clinical research where crucial information is generated. Back-end systems,
document management systems as well as data management systems that can handle
GBs of data while complying to healthcare regulations and regulatory bodies
should be used. For instance, clinical research data generated needs to be
collated and compared for various drugs and their potency, so that it can be
electronically submitted as a dossier to FDA. This requires a robust electronic
document management system in place that not only records but also analyzes
data.

How does your set up look like?
We have SAP R/3 for our ERP applications, an indigenous sales force automation
application running successfully for the past 3 years and having 2,500 people
using it within the organization, a scientific data mgmt system called
NewGenesis and an HR and personnel management system. A document management
system is being deployed right now and there is a central engine at Ahmedabad
that maintains our infrastructure. We use the same solutions at all our offices
across all geographies. We have outsourced the infrastructure management,
network management and all other applications.

 

Vamsi Chandra K, Dir and Head
Healthcare Practice, SRIT

What is your view of the healthcare industry through the prism of those who provide IT solutions?
The healthcare industry revolves around delivery of services to the doctors, nurses, research laboratories, pharmacists, healthcare units like hospitals and clinics (primary, secondary and tertiary) and the customer/ patient. The top rung makes extensive use of IT tools-ranging from ERP, digital imaging, decision support systems, BI, workflow engines, rules engines, healthcare CRM and more. And mid-sized businesses are focusing on applications like accounting as of now.

What are the various types of solutions that are being deployed across this vertical?
ERP and accounting are still the most popular solutions that are used by almost all. There are PRM (Patient Relationship Management) solutions, document management systems, knowledge management tools for clinical and administration utilities, tele-radiology solutions, clinical decision support systems, kiosks that give instant information in a queue-less environment.

How do you see the healthcare industry moving further?
The 1st generation comprised of the collection of all sorts of data and information that happened in the late 80s. The second generation (year 2000-2001) aggregated data and used it for report generation work. We can now expect the third generation to go proactive in terms of providing the best possible care to the patients. This can be seen happening by the end of this decade. Genomics and proteomics will play a larger part in enabling the healthcare sector with better tools and diagnostics. A lot of voice recognition using voice SDKs and advanced machine learning technologies will be used to collate data and help in diagnostics.

What challenges do you face and how do you counter them?
The unwillingness of users to use the new solutions and changing their mindset is one big challenge. While the younger lot adapts quickly, those of the higher age group are resistant to change. We do multiple trainings, hands-ons, send out videos for training, and use personal interaction to create a comfortable environment.

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