Jan 5, 2021
by Rekha Nair
#Bangalore opines, #Cloudnine Hospitals, #Dean at St.John’s Research Institute, #Director Lifesciences & Healthcare, #Dr. Arvind Kasargod, #Founder, #Group Medical Director, #Managing Director, #mFine, #Mr. Gerd Hoefner, #Mr. Rajagopal Rudraraju, #Mr. Sojwal Vora, #Mr.Prasad K, #Mr.Tony Raj, #NASSCOM Centre of Excellence, #Raghuram Janapareddy, #Senior Vice President & National Head of A&H Claims, #Siemens Healthcare Pvt. Ltd., #TATA AIG, #Vice President and Group Head – Supply Chain and Procurement at Manipal Hospitals
Authored by Raghuram Janapareddy, Director Lifesciences & Healthcare, NASSCOM Centre of Excellence, including the excerpts from his conversations with Industry Experts and Healthcare Practitioners
Often the challenges for digital adoption in hospitals are beyond the benefits of technology innovation. With mammoth transformation comes the responsibility of tackling these challenges effectively. Often enterprises should weight the impact of opportunities that can make the challenges dull enough to tackle.
Challenges
– Most of the times the digital solutions lack appreciation of the end-to-end business scenario
– Often the solutions do not go through adequate validation process – faces internal resistance
– Lack of Interoperability leading to the need for complex integrations
– Lack of adequate change management and continuity of commitment for solution enhancement from the vendors
– Transactional approach vis-à-vis long term commitmentimpacts the vendor relationships
– Unclear value creation to all stakeholders, if they are not involved in the adoption journey
Pathway for Opportunities
– Start with the pain points and business needs to solve rather than fitting the innovation into the existing solutions stack
– It is worth doing smaller pilots and validate solutions in own environment, rather than depending on external validation proofs
– Ensure the new solutions seamlessly integrates into the existing clinical workflows
– Insist for solutions that are more intuitive and enable self-learning, rather than seeking extensive handholding
– Avoid long and free pilots, that impact the solution providers commitment which indirectly impacts the success of adoption.
If data is the new oil, then healthcare data is rocket fuel
As the organizations move ahead with digital transformation and automation, there will be an explosion of data and exchange of this data within and across the organizational boundaries. Healthcare data being categorized as critical data under data privacy rules, the healthcare institutions often take time to decide on new solutions that generate, transfer, or expose the patient data.
In my opinion, the hospitals or healthcare institutions working on digital transformation should have clear data exchange policies, pre-defined data interfaces through APIs and clear healthcare data standards. This helps in optimizing the solution integration. Often the challenge is to decide on cloud solutions vs. on-prem deployments. Organizations need to be wary about but not unnecessarily worry about cloud solutions. As such a lot of data is lying outside the organization in unstructured and dis-integrated format. There are enough and more solutions available to arrest the data theft, ensure data privacy and enable sharing of non-PII data set. (PII – Personal Identifiable Information)
Calling out on the loopholes and charting a way forward with data, Mr. Gerd Hoefner, Managing Director, Siemens Healthcare Pvt. Ltd. quotes, “While the data generated from imaging and clinical analysis in healthcare institutions is increasing exponentially, in many instances, analysis is not effective.” In his opinion, “digital transformation can help healthcare providers by enabling workflow optimization. Though still in early stages, AI is helping healthcare providers analyze,advance the quality and value of patient care, by making medicine more personal and precise. In the future, digital twins will enable delivering the right treatment at the right time to the right person and ensure people remain healthy.”
According to Mr.Prasad K, Founder, mFine(a virtual medical consultation platform), since the beginning of the lock down due to COVID Pandemic, more than 90% of Doctors in India would have already used tele-consultations and digital transcriptions. He opines that India has the highest calibre to automate the healthcare systems. As per him “Our country has potential to leapfrog care systems of west and go towards a better, cheaper healthcare for all – with deep digitization of data, ubiquitous connectivity and portable and consumer owned health records.”
In India there are too many variations in medical devices within a single hospital and across a group of healthcare centres under single administrative control. These devices generate a lot of digital data, such as performance data, health records, radiology data, insurance data etc. As per Mr. Arpit Paliwal, Director – Happy Reliable Surgeries, “There are interoperability issues between hospitals for use of data due to lack of standards of data production. There is need to have an industry driven standard like DICOM which can transform the use of radiology data across the stakeholders”.
Managing the Change
Working in a unique combination of responsibilities, that of managing an in-house HealthTechAccelerator and also leading a research institute, Mr.Tony Raj, Dean at St.John’s Research Institute, Bangalore opines that “The common barriers for digital adoption in the health sector include end-user resistance, prevalence of disparate and dis-integrated legacy systems, lack of availability of trained resources (or health informaticians) in digital health, concerns about data privacy and security”. He feels that there is a lack of the long-term vision and unawareness of benefits of digital health amongst many decision makers in the healthcare industry. Typically, software systems are built by engineers for use by physicians and healthcare professionals. It is important to involve physicians and healthcare professionals from the early design stages to help reduce end-user resistance and to incorporate clinical processes and workflows into the applications. He states that “All the systems built and used in India should quickly adopt the standards recommended in National Digital Health Blueprint release by Govt. of India. This helps in data interoperability and can greatly aid in meaningful research by effectively using clinical data for improving patient outcomes”.
As per Dr. Arvind Kasargod, Group Medical Director, Cloudnine Hospitals, “The grand goal of a issuing digital health card and health data digitization may remain an illusion in the Indian healthcare scenario if fundamental changes are not insisted in the way documentation is done in the out-patient care, as is done for inpatient care. The outpatient documentation is largely the responsibility of the patient. National Medical Council should mandate that outpatient digital documentation as a responsibility of the care provider”. However, he also opines that it is not an easy task to accomplish as most of health care is outpatient care and is provided by private practitioners. There is no motivation for these private practitioners to maintain digital patient records, as there are no outpatient insurance incentives for them. Hence he recommends that “the government regulations should be more stringent and should be implemented first in the government healthcare delivery system. The private players should be then brought on board using incentive vs. penalty strategy. The insurance companies should also be made to align with this strategy”.
Few healthcare delivery organizations have overcome the early challenges in their digital transformation journey and moved ahead of the curve. According to Mr. Sojwal Vora, Vice President and Group Head – Supply Chain and Procurement at Manipal Hospitals“we have always been at the forefront of the digital curve in care delivery – for example; digitising prescriptions, digitally auto-managed nursing/porter call systems, remote monitoring of key medical equipment, automated communication on pre-peri-post procedures via WhatsApp to name a few”. As per him patient centricity is the key parameter in digital transformation. To this effect they released a Patients App to provide an end-to-end healthcare experience – from video consultations to viewing medical reports.
National Digital Health Mission is creating well-articulated and throughout standards and guidelines for an interconnected digital health ecosystem in India. There is a need for the Providers and Payers to quickly adapt to this new environment in order to reap the benefits this digital ecosystem brings.Mr. Rajagopal Rudraraju, Senior Vice President & National Head of A&H Claims, TATA AIG adds“with quick adoption of guidelines and standards across the stakeholders, the care process will improve upon in multiple dimensions – better data portability, easier availability of past medical records & history, increased accountability, and most importantly faster healthcare claims processing. Seamless flow of information will not only improve efficiency, but also create transparency which is the cornerstone of trust between providers, payers and patients.”
Summary
Though it is a cliché to say that Indian Healthcare Delivery is at an inflexion point, I believe we are really on the concave path. The healthcare delivery in India has beenstretched beyond its boundaries during the recent pandemic, and both the private and government healthcare institutions have scaled up to the challenge. There is an increased appetite for technology adoption. Only time will tell, if there is enough power to digest the change.