IT will transform healthcare

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This article is written for Modern Medicare on the Role of IT in Indian Healthcare system. This article talks about the policy changes in India for Healthcare IT, Telemedicine and mHealth ( Digital Health )

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IT will transform healthcare

  1. 1. Policies & Regulations: IT-enabled systemsTransforming the way we deliver healthcareIndian healthcare will remember the year 2012 for two major policy changes; government’s decision toincrease the healthcare spending to 2.5 per cent of the GDP and its decision for a move to ‘Universal HealthCoverage’ for all citizens. What the practitioners, providers and patients are missing out is the fine print orrather the blueprint of one major change that will follow during the implementation of this mega scheme.Let us scan the details.T he big change that will follow this year’s development on healthcare by the government is the implementation ofnationwide, patient wise IT-enabledsystems. So, let us look at the twodocuments related to healthcare policythat touch upon this very important topic,ie, the use of IT.Spurring growthAccording to the High Level Expert GroupReport (HLEG) on Universal HealthCoverage for India, “We envisage thatover time, every citizen will be issued anIT-enabled National Health EntitlementCard (NHEC) that will ensure cashlesstransactions, allow for mobility across thecountry and contain personal healthinformation. Such a card willalso help the state to trackpatterns of disease burdensacross the country.” Recently, the 12th Five YearPlan document has been released and let 20.98. A composite Hospital Information 6. Financial management in theus examine the fine print of this document. System (HIS), when fully operational, public health system to streamline According to the ‘Twelfth Five Year would incorporate the following: resource allocation and transfers, andPlan (2012–2017) Social Sectors, Volume 1. Universal registration of births, deaths accounting and payments to facilities,III, which has a dedicated section on and cause of death. providers and beneficiaries. Ultimately,‘Information Technology In Health.’ 2. Nutritional surveillance, particularly it would enable timely compilation of among women in the reproductive age the National Health Accounts on an20.97. Information Technology can be group and children under 6 years of age. annual basis.used in at least four different ways to 3. Disease surveillance based on reporting 7. A national repository of teachingimprove healthcare and systems: by service providers and clinical modules, case records for different1. Support public health decision making laboratories (public and private) to medical conditions in textual for better management of health detect and act on disease outbreaks and audio-visual formats for use programmes and health systems at and epidemics. by teaching faculty, students and all levels. 4. Out-patient and in-patient information practitioners for Continuing Medical2. Support to service providers for better through Electronic Medical Records Education (CME). quality of care and follow up. (EMR) to reduce response time in 8. Tele-medicine and consultation3. Provision of quality services in remote emergencies and improve general support to doctors at primary and locations through telemedicine. hospital administration. secondary facilities from specialists at4. Supporting education, and continued 5. Data on Human Resource within the tertiary centres. learning in medicine and health. public and private health system. 9. Nationwide registries of clinical60 I January 2013
  2. 2. IT-enabled systems establishments, manufacturing units, Digitising healthcare supply system on the lines of Tamil Nadu drug-testing laboratories, licensed We know that all sectors, be it banking or medical services supply corporation. This drugs and approved clinical trials railways are any other sector, has benefitted is certainly going to digitise the supply to support regulatory functions of immensely by deploying IT. Using IT chain in public healthcare system the government. end to end - from centre to the village “Never too old, never too bad, never too10. Access of public to their own health level, is the key to success of the 12th Five late, never too sick to start from scratch once information and medical records, while Year Plan targets for healthcare. IT will again,” said Bikram Choudhury, and it is preserving confidentiality of data. bring out transparency, which will lead to time Indian doctors start using IT in their11. Programme monitoring support for accountability in healthcare spending and daily practice. National Health Programmes to help better outcomes for providers. IT can be It is also clear from the government identify programme gaps. used for: documents that private sector will also 1. Setting the targets at the central , state, provide healthcare facilities under public 20.99. To achieve these goals, regional, district and village level financing and would be reimbursed undercomputers with Internet connectivity 2. Timely review and corrective actions various Public-Private Partenership (PPP)would be ensured in every Primary 3. Disease surveillance, epidemiology models. Insurance companies will demandHealth Centre (PHC) and all higher and planning real-time system for adherence to treatmentlevel health facilities in this plan period. 4. Instant disbursal of funds and online protocols, online pre-approval, paymentConnectivity can be extended to sub- approvals to ensure that the decisions & accountability. This cannot happencentres either through computers or are taken with the speed needed in without IT. Even individual doctors whothrough cell phones, depending on their case of healthcare emergencies have to reimbursed by the government willstate of readiness and the skill-set of need to have the IT systems. It will nottheir functionaries. All district hospitals be a surprise if India also implements thewould be linked by tele-medicine No one will remain untouched ‘accountable care guidelines’ & ‘meaningfulchannels to leading tertiary care centres, from using IT in the next 3 use of IT’ in healthcare, on the line of theand all intra-district hospitals would US healthcare system. years in healthcare. It isbe linked to the district hospital and “All great changes are irksome to theoptionally to higher centres. time to accept this reality human mind, especially those which are 20.100. The role of the Ministry of and start adopting IT in attended with great dangers and uncertainHealth and Family Welfare (MoHFW ) daily practice starting with effects,” said John Quincy Adams, andwould be to lay IT system standards, patient registration, EHR the IT adoption is not going to be easyand define indicators which would be to prescription or even but is unavoidable. The government mustopenly shared. States will be funded start a ‘bridge course’ (online 3–6 months follow-ups.for their initiatives in this field at duration) for healthcare professionalsprimary or secondary levels through to enable a smooth adoption of IT forthe National Health Mission. Health doctors. Also, the newly constitutedsurveys would be annually conducted UID has already been allocated to 210 National Commission for Humanto generate district level information million people and cash transfers will be Resources in Health (NCHRH) muston health status, which will also serve happening across 51 districts from this consider including IT (health informatics)to verify the accuracy of routine health year. It is very likely that UHC will be in the medical curriculum for doctors andinformation system. based on National Health Entitlement also for paramedics. Having a close look at these two Card (NHEC). This should serve as a The first major change IT broughtpolicy documents and taking into wake-up call for our doctors who have was in communication, next big changeaccount the changes that Unique till now desisted from using IT in their IT is bringing is in cash transfer forIdentity (UID)– Aadhaar card has daily practice. They might be late, but for subsidies from the government and thedelivered for direct cash transfers, it is sure, no one will remain untouched from next big change IT will bring would beclear that next big change would be in using IT in the next 3 years in healthcare. in healthcare delivery. Wait for the goodhealthcare. With an expected budget It is time to accept this reality and start times to come!of ` 2.8 lakh crore for healthcare, it is adopting IT in daily practice starting with (office@rajendragupta.in)very important that the government patient registration, Electronic Healthplans to spend about 2 per cent of the Records (EHR) to prescription or evenhealthcare budget on IT (expenditure follow-ups.on m-Health & telmedicine excluded) Rajendra Pratap Gupta& digitise healthcare. Let the good ‘IT’ times roll… International Healthcare Let us examine in detail the scope of The 12th Plan document also suggests all Policy and Retail Expertdigitisation in health. states to have an online procurement and January 2013 I 61

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