IT in hospitals

Discussion document

9/17/16

Surprisingly, the level of IT deployment in Indian hospitals is very low!

Key findings
1)

Overall IT deployment intensity is low, no more than level 3

HIMS application in Indian setups. Usage mostly
concentrated to the Operational part of HIS (Administration
and Financial functions). Limited usage of systems like:
- Clinical Information Systems (CIS)
- Decision support systems (DSS)
- Management information system (MIS)

2)

Among deployed solutions utilization is surprisingly low,

limited to certain key functions like:
- Front desk & billing
- Payroll Mx
- Financial Mx
Less emphasis on modules related to holistic patient care in
terms of providing knowledge to patient, tracking real time
activities, use of artificial intelligence to support clinical
decisions etc.

3)

Backup, .. and add-ons are virtually absent

HBA Research across various

hospitals in the country and
comparison with repository of
Global best practices

As a result of non usage of IT, the average Indian hospital pays a heavy
price upto 15% bottomline erosion
MODELLED

Typically 70-80,000 for a tertiary setup

Using IT for better pricing &

higher share of wallet

-25-30%

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~10% cost
reduction by
standardizatio
n &better
inventory Mx

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Reduction in costs by ~10-15 % due

to improvements of manual or
clerical tasks & streamlining the
workflow

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Consumabl
es
Manpower
Reduction
in medical
errors,
reduced
LOS

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realized

Improved charge
capture & better
pricing strategies along
with elimination of lost
charges & a decrease
in outstanding days of
receivables
3

Why do so many IT deployments fail ?

Causative factors

Description

Deploying without a vision

and a cause

Why, really do we need IT ?

Treating IT as a product
deployment

Assuming that technology will solve the problem

Electronifying bad
processes

IT without BPR, re-organizing around patient

No buy in from end users,

lack of adequate Change
Mx practices

Prototyping not done with end users, persistence of the

Design-Reality gap

Lack of professionalism

Team lacks qualified people to buy-in & implement HIS

4
4

The vision less versus the sighted

Typical aspirations
I want my hospital to be
paperless

I want to see a live dashboard at

the click of a button

Best Practices

Make it about
the patient

Make it about
care

I want to track patient facing

processes/activities in real time &
eliminate delays
Make it about
efficiency

Knowledge, primarily about

diseases, but also, for example,
about the effects of drug interaction,
to support diagnosis and therapy

Empowering individuals &

communities with timely and
understandable health-related
information, and drive improvements
in quality of services

Improving governance, mobilising

new resources, and ensuring
accountability in the way they are
used

Is IT what you need ? The sanity-check checklist

The Sanity Questions

Description

What problem to you want

to solve?

Clearly define the goal you want to achieve and articulate

your target quantitatively & qualitatively

Why does this problem exist?

Understand the root causes of why the challenge exists

and what is needed to solve it

How will IT help address

this problem/help achieve
this aspiration?

Ascertain that technology is what you need! IT cannot

solve your people, policy & structure issues

What are the key

processes, resources,
incentive and mindset
changes required?
Are we ready to make an IT
solution successful?

Address the problems that are the key to the solution

before deploying IT (e.g. rectify bad processes first)

Ensure training of staff and alignment of incentives to

use IT

6
6

Evaluating IT solutions in healthcare setups

1) Define your
functional needs

6) GO!
Constitute
implementation
office

5) Shortlist vendors and

negotiate commercials

2) Ascertain potential
infrastructure
configurations

3) Draw up spec sheet,

invite vendors

4) Do a like-to-like
comparison, prioritize
crucial, desirable,
optional needs