Healthcare: Leapfrog growth is ahead

The emergence of corporate hospitals has changed the dynamics of health sector, says Ajay Shankar Sharma, Co-founder & CEO, Srishti Software. He spoke about the current trends in healthcare technology, in a chat with CIOL's B.V.Shiva Shankar, while foreseeing a Leapfrog growth in the next five years, on the lines of Banking and Telecom. Excerpts:

CIOL: What potential do you see in Indian market for healthcare technology?

Ajay Shankar Sharma: The most fundamental property affecting the Indian healthcare sector is the multi-faceted demographic and socio-economic profile of the country.

In India, deployment of IT has not started with full force as yet. Various hospitals are using very rudimentary software. Lack of awareness and investment constraints are the main inhibitors. In India, the Healthcare market is not driven by IT. Right now the IT adaptation is at a very nascent stage and it is a supply driven market.

The emergence of corporate hospitals on a larger scale is another important development. The corporate entry into healthcare is important for the professionalism of hospital management. Till recently, modern management systems had not penetrated most healthcare institutions, with some notable exceptions. Most hospitals would organize their resources and manpower within structures that had evolved rather than been designed. The processes would be structured to ensure multiple points of control rather than patient convenience.

Information capture would be rudimentary and information rarely integrated beyond that required for reporting purposes, because of which any databased quality control would not be possible.

With corporate entities entering the healthcare sector, they are introducing managerial practices and tools, which they had been using for long, in the hospitals that they are promoting. Competition for attracting patients has started and hospitals have realised that IT can be effectively used as a tool by them. This trend has already started. Indian healthcare technology market is poised to be Rs.1000 crores plus by 2012.

CIOL: How do you compare this with Europe and USA market?

AS: The structure within which healthcare is carried out varies from country to country - and sometimes even within national boundaries.

In western countries, hospitals started deploying IT in the early 90's. Hence, awareness is very high there. Apart from satisfying patients, hospitals have to comply with various standards and regulations, like DICOM- 2, HIPAA. Thus, in these countries, standards and regulations drive IT investment.

In India, it has just started. Leapfrog growth is expected in the next five years, on the lines of Banking and Telecom.

CIOL: What can catalyze the development?

AS: Government has to play its role to encourage deployment of IT. Standards and regulations are to be formulated. It will enable data transfer between hospitals on the lines of BFSI and Telecom.

There are clear challenges within the current healthcare ecosystem that must be overcome before the healthcare revolution is realized.

      The challenges are:

•  Low reach / inaccessibility as well as insufficiency (where available) of quality
  
  care to the most economically backward areas.
•  Presence of specialist doctors is restricted to the metro and class-A cities
•  High focus / risk of under-utilization of capacity (beds, doctors, nurses)
•  Fragmentation of isolated bits of patient and medical know-how across entities
  
  in the ecosystem
•  Lack of a one-point complete patient record
•  High Cost / Low Productivity due to bottom-up re-creation of diagnosis/analysis for
  
  every instance

Thus, the following developments will have to necessarily take place in the healthcare industry:

• Alternative delivery model to multiply reach
•  Integrated electronic patient record system (EPR) - This helps in capturing of information and maintaining continuity and granularity
•  Alternative transaction models
•  Remote diagnosis or Tele-medicine and follow-up procedures

CIOL: Which cities are fertile for this market?

AS: Bangalore and Mumbai, because of their professionalism,y have immense growth potential. Bangalore has already been projected as health tourist destination. Patients from various parts of world, including UK and USA, are coming here. Patients from developed countries need EMR (Electronic Medical Record), so that they can claim medical reimbursement and health insurance. This calls for IT deployment in hospital administration and management. We have been talking to various hospitals. Various vendors are offering different solutions, and have started pushing their products.

CIOL: Tell us about Bangalore scenario, in particular?

AS: Bangalore, being the IT Capital, has been very receptive towards technology adoption. Hospitals like Manipal, Narayana Netralaya, 7th Day Adventist and many more have deployed IT solutions. Apart from these private hospitals, some of the government hospitals have also started adopting technology for their administration and management. Jayadeva Hospital has implemented HIMS for billing, lab management, storage etc.

CIOL: What are the main inhibitors for technology deployment in healthcare?

AS: In hospitals, doctors and administrators are the decision makers. They are experts in their respective domains, but that doesn't mean that they are technology experts and IT savvy. Making them understand technology to suit their requirements is a very important task. At the same time technology experts or the vendors of the solution should have good knowledge of health sector as a domain. This calls for thorough training, and it is time consuming. In the healthcare segment right now there is hesitation to invest on technology. ROI justification is one of the inhibitors.

CIOL: Tell us about your products.

AS: PARAS, Srishti's next generation healthcare solution suite, supports modern healthcare services and additionally future-proofs delivery models and emerging trends that would soon dominate this sector. Built on the philosophies of addressing a complete healthcare ecosystem plus a powerful tool-kit approach, the solution is the answer to the need for a one-stop technology for healthcare.

Srishti's integrated Healthcare solutions provide the ability to support modern healthcare services, additionally future-proofing initiatives, delivery models and emerging trends that would soon dominate this sector. Built on the philosophies of integration of the entire spectrum of healthcare technology enablers plus Srishti's powerful tool-kit approach (that makes healthcare services avoid constraints from technology limitations), PARAS is the answer to the need for a one-stop technology for healthcare.

Srishti software offers a complete healthcare information management system (HIMS) which involves implementation of clinical system for managing EPR and development of clinical care pathways. This clinical system can be integrated seamlessly with the hospital administration system

Integrated electronic patient record system (EPR) - This gives the complete demographic information of the patient i.e. age, name, sex, etc., patient's present illness information which includes details on present illness, history, medication, consultant notes, etc.

PARAS toolkit facilitates remote diagnosis or tele-medicine. This separates point of care and diagnostic resources, hence enabling healthcare providers to extend their reach to geographies where such resources are not available to patients.

CIOL: What would be the future trends in this regard?

AS: Healthcare is undergoing a distinct movement along a logical trajectory from its historical focus on acute care i.e. dealing with immediate and severe outbreaks of illness, to chronic care, continuous care for long term illness that may reduce acute cases to preventive care, i.e. care focused on early detection and treatment of illness, including immunization, ultimately to predictive care, i.e. not waiting for early signs of illness but predicting and thwarting it before the illness has the chance to take root. This revolution would move us away from a curative drug based healthcare towards consulting/service based healthcare with focus on lifestyle, and adapting behavior to prevent cut out the roots of any instance of illness.

In coming five years India will have 5 million medical tourists. Right now Thailand has biggest number of medical tourists. Singapore is right now way ahead of us.

As a futuristic move we will see the following three developments taking place

• EMR as a Smart Card
•  EMR on Internet at the third part site
• EMR with insurance companies or third part agents.