Healthcare — IT makes it better

Identification of key performance indicators will help evolve dashboards in hospitals, observes Dr S. Manivannan, Joint Managing Director, Kavery Medical Centre and Hospital, Tiruchi ( >http://bit.ly/F4TManiDr ). Every department can have its own KPIs and add them to their dashboards, so that the team members can focus on important functions rather than wasting time on trivial matters, he notes, during a recent interaction with Business Line . “A comprehensive dashboard consisting of financial and clinical KPIs will help the CEO in monitoring the health of the organisation easily. For, anything that cannot be measured cannot be monitored.”

We continue our conversation over email.

Excerpts from the interview:

In what areas of healthcare do you see a great potential for information technology to make a difference?

Personal health records (PHR) and patient portals can be seen as one of the future trends in healthcare IT. This will help the patients and the caregivers to access relevant data from anywhere in the world.

Patient safety — impacted by drug errors, identification errors, wrong reporting of test results and so forth — is an area wherein technology can play a significant role. Modern-day hospitals are willing to invest in IT systems to reduce these potentially fatal errors.

ERP systems, which are popular in the manufacturing sector, have made inroads in the bigger healthcare organisations. These solutions help in smooth handling of materials, apt financial reporting systems, and human resource management. Future hospitals will not hesitate to invest in good ERP solutions, I feel.

Mobile health is one other area. Many new applications in smartphones and iPads will help the patients track their reports and receive reminders even when they are on the move. Inside the hospital, these apps can help the caregivers to enter the data at the point of care delivery, which reduces documentation errors.

A practical example of IT implementation in a hospital and the value it created?

Let me share with you my experience, in Kavery Medical Centre, where we installed HIS software eight years ago. After implementation of good material management module, we were able to reduce the consumption of consumables to one-fourth of the earlier consumption. Also, we were able to maintain the expenditure at the same level, in spite of doubling the bed capacity. Motivating the staff to strictly adhere to online indenting system created a discipline among the stakeholders, and hence achieve the target.

Any pharmacy in a multi-speciality hospital will have more than 6,000 varieties of medicines. Many of these medicines have a short lifespan. If they are not used or returned to suppliers in time, there erode the margins. Here, too, the IT system helped us keep track of slow-moving and non-moving items, based on which interventions were done at the right time. Currently, we have only eight days of sales as stock in pharmacy. Best inventory practices helped us use existing resources optimally and increase the margins.

Government-sponsored insurance schemes and other TPAs offer lower packages for regular surgeries. A good IT system helps us track the consumables usage for every patient, prevent unwanted usage, and hence operate within the limits.

What are the steps in IT implementation from the hospital's perspective?

Identification of a suitable vendor is the first step. We have to map our requirement, try to freeze the platform which suits us, call for quotes, see their existing customers and assess their service capacity, and take professional help in choosing the right vendor.

Before implementation, gap analysis is to be done thoroughly to assess the level of customisation required. Masters have to be identified and frozen beforehand. Cut-off date for implementation has to be identified and the whole team has to be motivated to be part of this process.

After implementation, regular review should be done to asses the gaps and implement corrective steps as and when required. Post implementation, a suitable team must be identified for maintaining the software; initially, help from vendor should be obtained.

Too much emphasis on cost-cutting will not help in identifying the right vendor. If more time is spent on gap analysis, less time is needed for implementation. Freezing of masters will avoid confusion in future reports. Maintenance can be in-house or outsourced, depending upon the capability of the team.

How do you find doctors using IT in their regular work?

Earlier, doctors shied away from computers. Now, most doctors use the Internet for communication purposes. Yet, they do not allocate time to use computers in their daily work schedule.

Accessing laboratory reports, using PACS system to see radiology pictures, and telemedicine are a few of the areas that have caught the attention of doctors. Illegible prescriptions lead to dispensing wrong drugs. Many doctors now prefer using online prescriptions, which reduce errors and also the waiting time in the pharmacy, as the prescription goes directly to the pharmacy. Smartphones and iPads will lead to the development of new apps to help doctors track patients' condition even when they are on the move.

If healthcare institutions are able to explain to the doctors how IT can reduce the waiting time and improve the quality of care, the future is bright for healthcare IT.

Suggestions to Indian IT industry on the healthcare areas they must focus on.

Lack of standardisation is the biggest hurdle in developing new products in healthcare IT in India. If the industry could lobby to bring in some standards, similar to HL7 in the US, adoption of IT will be faster.

Developing SAS models will help small and medium healthcare enterprises to adopt IT systems.

IT companies should focus on gap analysis before quoting and implementing their software. When they do not spend time on this exercise, higher customisation is required, which leads to delayed implementation and also customer dissatisfaction.

IT industry should educate healthcare professionals about the benefits of using IT systems, as very few professionals are aware of the newer technologies.

Developing good business intelligence tools for hospitals will help these companies in convincing the CEOs about the benefits of IT integration.

>dmurali@thehindu.co.in

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