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2.4 Deployment of eHealth @ CMC Vellore , India by Prof. Joy John Mammen


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Deployment of eHealth @ CMC Vellore , India by Prof. Joy John Mammen, Dy Director IT Planning (CMC Vellore), CMC Vellore, India

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2.4 Deployment of eHealth @ CMC Vellore , India by Prof. Joy John Mammen

  1. 1. CMCVELLORE Deployment of eHealth at CMC Vellore Joy Mammen MD Professor & Head Department of Transfusion Medicine Christian Medical College Vellore 21-10-2016 THIT, Chennai, India
  2. 2. CMCVELLORE Conflict of Interest • Advisory Board of SocIT Pvt Ltd • Palampur, Himachal Pradesh • Provides health information management systems – currently primarily focusing on rural health sector • No financial interest 21-10-2016 THIT, Chennai, India
  3. 3. CMCVELLORE Over a century… 1900 1924 1941 2016 The Christian Medical College, Vellore, seeks to be a witness to the healing ministry of Christ, through excellence in education, service and research21-10-2016 THIT, Chennai, India
  4. 4. CMCVELLORE Year ending 2015 • 2800+ beds • 2.4 million out-patients • 130000 in-patients • 9000 staff • NABH Accredited • NABL Accredited Labortories* • Over INR 1000 crores turnover • More than INR 150 crores in charity • Two locations – additional site in progress 21-10-2016 THIT, Chennai, India VELLORE
  5. 5. CMCVELLORE History of core IT development in CMC 1970 – First data processing unit (Punch card used in payroll) 1983 – PDP-11/SN-23 mini computer+ 5 terminals (used for batch processing of jobs in billing) 1984 – First microcomputers (used for OP/IP bills, lab systems) 1988 – CHIPS started; Novell network with FoxBase / FoxPro and Access databases used for early HIS 21-10-2016 THIT, Chennai, India
  6. 6. CMCVELLORE 1980s – Analytical automation of labs, beginning with Biochemistry; Centralized lab reporting; 1990s – Internet services to residential campuses started Process automation of labs including barcoding 1998 – PACS in Radiology (GE Centricity™ ); ethernet network across OPDs and wards to view images History of core IT development in CMC 21-10-2016 THIT, Chennai, India
  7. 7. CMCVELLORE 2000 - 2010 Oracle™ introduced in CHIPS First iteration of Clinical Work Station deployed Administrative software development Migrated to a CISCO switched network Interconnected campuses; SMS Patient safety: Common bar- coding systems developed for specimen collection 2011 - 2016 • CMC Chittoor connectivity • Oracle™ business continuity • CMCPACS2 set up for imaging requirements of multiple departments • Upgrade of Video- conferencing bridge (Polycom) • Centralised storage / private cloud storage 21-10-2016 THIT, Chennai, India
  8. 8. CMCVELLORE Opportunities to learn 21-10-2016 THIT, Chennai, India
  9. 9. CMCVELLORE 21-10-2016 THIT, Chennai, India
  10. 10. CMCVELLORE Model • Reflecting core values – Institutional Vision & Mission • The Patient • Leadership • Driven by need/demand • Resource constraints– minimize external dependencies 21-10-2016 THIT, Chennai, India
  11. 11. CMCVELLORE What does it take? • People • Medical • Information Technology – specialists • Administration • Users • Dr. Philip Korula, MCh (Plastic Surgery) • Insight • Hard work • Constrained resources • External advisory resources 21-10-2016 THIT, Chennai, India
  12. 12. CMCVELLORE What happens to cost? “HIT is associated with a 1.3 percent increase in billed charges (p-value: 5.6%), and there is no evidence of cost savings even five years after adoption. Additionally, HIT adoption appears to have little impact on the quality of care, measured by patient mortality, adverse drug events, and readmission rates.” Leila Agha* Boston University: Published in final edited form as: J Health Econ. 2014 March ; 34: 19–30. doi:10.1016/j.jhealeco.2013.12.005. “We find EMRs do not reduce the rate of patient safety events. However, once an event occurs, EMRs reduce death by 34%, readmissions by 39%, and spending by $4,850 (16%), a cost offset of $1.75 per $1 spent on IT capital. Thus, EMRs contain costs by better coordinating care to rescue patients from medical errors once they occur.” Inquiry. 2011-2012 Winter;48(4):288-303. Encinosa W & Bae J. (AHRQ) 21-10-2016 THIT, Chennai, India
  13. 13. CMCVELLORE Timelines, anyone? 21-10-2016 THIT, Chennai, India • In house team • Highly customised software • Change management • Changing goal-posts
  14. 14. CMCVELLORE What has not (yet) worked for us • Integration of “best of breed” applications • Platform independence • Out-sourced development • Utilization of data beyond essential services • Monetizing product/data/knowledge • Education • Research • Image analysis, Natural Language Processing, Data Mining, UI studies, GIS 21-10-2016 THIT, Chennai, India
  15. 15. CMCVELLORE What’s left… • Standards • Authentication • Unified patient identification • Obsolescence… • Continuous improvement vs Don’t fix it unless its broken! • Opportunity cost 21-10-2016 THIT, Chennai, India
  16. 16. CMCVELLORE Acknowledgements • Dr. Vinu Moses, Professor of Radiology, Member IT Committee • CMC Consultation 2016 (IT Group) • Mr. Ebenezer Sundararaj Head of Department, IT • The Team Back at CMC 21-10-2016 THIT, Chennai, India Failure is simply the opportunity to begin again, this time more intelligently. – Henry Ford Only those who can see the invisible can achieve the impossible. – Ida S Scudder