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“Digitally Enabled” Healthcare Models – Indian
Context
XIII NATIONAL SEMINAR: HOSPITAL , HEALTH CARE
MANAGEMENT AND MEDICOLEGAL SYSTEMS
6th and 7th May 2011
The contents of this document are proprietary and confidential to Infosys Technologies Limited and may not be disclosed in whole or in part
at any time, to any third party without the prior written consent of Infosys Technologies Limited.
© 2011 Infosys Technologies Limited. All rights reserved. Copyright in the whole and any part of this document belongs to Infosys
Technologies Limited. This work may not be used, sold, transferred, adapted, abridged, copied or reproduced in whole or in part, in any
manner or form, or in any media, without the prior written consent of Infosys Technologies Limited.
Information in this document is updated as of Feb 20, 2010
Contents
• Digital Technology in the context of healthcare
• Digital Technology enablement in Indian Context
• Successful Healthcare IT models / trends across the globe
© 2011 Infosys Technologies Limited
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“Digital Technology” is the confluence of Medical Equipment Technology,
Operational Technology and Information & Communication Technology (ICT)
Enterprise Applications
Data Analysis & Visualization Apps
IT Infrastructure
Communication
Interface
Medical Equipment
© 2011 Infosys Technologies Limited
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Challenges in Digital Enablement
• Tremendous volumes of data from different and disparate
sources
• Data security and privacy
• Data visualization and intuitive user interface
• Remote access of data
• Adoption / usage
• Conviction on business and societal benefits
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Healthcare expenditure constitutes 6.1% of country’s GDP
• Expenditure increases 15% every year
• Technology intervention to reduce the drain on country’s
resources
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Application of Digital Technology needs to looked at from 3
perspectives
Pharma
Private Hospitals
Societal
Healthcare
• India is a paradox - world class hospitals providing state-of-the-art healthcare
while 700 million people in semi-urban and rural deprived of such facilities
• Digital Technology adoption is very different across these 3 perspectives
• Pharma – Promote innovation and accelerate drug discovery. Bring more
structured approach to clinical trials.
• Private hospitals – Motivation is higher bottom-line. Basic systems in place,
however structured approach / investments in digital technology missing
• Societal healthcare – Motivation is to solve societal problems. Lot of
initiatives, however efficacy is questionable.
© 2011 Infosys Technologies Limited
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Digital Technology for “collaborative” drug discovery
• Open Source Drug Discovery Portal
• Help collaborate and hasten discovery of drugs for malaria,
tuberculosis etc.
• TB is the leading cause of death from bacterial infection. An
estimated 370,000 deaths due to TB occur each year.
• Tries to follow the success of open source models in IT (Linux,
Web) and apply the same model for drug discovery
• OSDD contains
• Sysborg 2.0: A Wiki based genome annotation service
• Computational Resources for Drug Discovery (CRDD) is a platform for
open source tools for drug discovery
• TBrowse: Integrative genomics map of Mycobacterium tuberculosis
• OSDDPUB: Open Access Repository Document Repository
• OpenScience: Metadata archive and Search engine for Open Access
theses and dissertations
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Private Hospitals – Digital Technology Enablement
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Benefits from Digital Technology enablement
Integrated Clinical /
Financial BI System
•Combines traditional data sources (such as general ledger, HR, cost accounting and
claims/revenue data) with rich clinical data systems
•Improves resource utilisation, Patient throughput, Proactive defect prevention
Patient throughput
and Logistics
management
•Delivers value by providing real-time, hospital wide visibility into operations
•Technologies such RFID for person and asset location; voice over IP for "everywhere"
communications
•Improves resource utilisation and Patient flow
•Reduces turnaround time, OPD/ER wait time, discharge time
Wireless Healthcare
Asset Management
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•Usage of RFID / Zigbee
•Timely delivery of care, scheduling preventive maintenance etc.
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Benefits from Digital Technology enablement (contd.)
E-visits / Video
visits
Home Health
Monitoring
Integrated Clinical
Data Repository
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•Structured, secure messaging between a patient and a provider for a well -defined and narrow
range of consultations, such as for nonemergency questions, prescription refills and routine
chronic disease management
•Enables cost reduction, increased patient satisfaction and improved clinician productivity
•Enables specialist interaction from rural areas
•Transmission of patient data to clinicians
•Improvements in the quality and timeliness of care, improve the accessibility of care, and reduce
travel time for patients and clinicians
•Aggregation of granular patient-centric health data usually collected from multiple-source IT
systems and intended to support multiple uses
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Societal Healthcare – some Digital Technology interventions
• Telemedicine
• Enables remote medical diagnostics and services
• Key is “reliable” and “fast” communication infrastructure
• Huge reduction in costs and time
• Emergency Health Services
• Intelligent routing of ambulances using GPS
• Call center data analytics for improvement in service levels
• IMR / MMR reduction
• Usage of mobile based supply chain management
• Integrated Disease Surveillance
• “Data analytics” to find out trends of communicable disease spread
© 2011 Infosys Technologies Limited
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Summary of key Issues in Indian healthcare and how technology
can help
Key Issue
How Technology can help?
Lack of awareness and health/nutrition
education
Patient enablement through portals,
mobile applications and social
networking sites.
Shortage of facilities leading to
overcrowding
Remote healthcare, Tele-consultation,
self-service kiosks
Severe shortage of trained health
personnel
Automation of care processes, optimal
utilization of skilled staff
Lack of accountability
Easy to search and analyze electronic
medical records
Rural/Urban differential
Telemedicine for rural outreach
Affordability
Reducing cost of care through
integrated IT, data sharing and increased
patient safety
Insufficient IT funding
Monitor benefits realized from IT
investments
© 2011 Infosys Technologies Limited
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Global Healthcare IT models
Best practices that could be adopted by
India
The contents of this document are proprietary and confidential to Infosys Technologies Limited and may not be disclosed in whole or in part
at any time, to any third party without the prior written consent of Infosys Technologies Limited.
© 2011 Infosys Technologies Limited. All rights reserved. Copyright in the whole and any part of this document belongs to Infosys
Technologies Limited. This work may not be used, sold, transferred, adapted, abridged, copied or reproduced in whole or in part, in any
manner or form, or in any media, without the prior written consent of Infosys Technologies Limited.
Information in this document is updated as of Feb 20, 2010
Successful Healthcare IT Models : Healthcare Information
Exchange
CONFEDERATED
CENTRALIZED
Data Users
Central
Database
Migrating all the
data f rom
dif f erent
systems in all
the dif f erent
locations to
Centralized
Repository.
This would be a
monumental
ef f ort - time
consuming and
a bit expensive
but once done
you will have a
true centralized
repository.
Data Users
E
Data Sources
Legend:
E
Data Sources
Firewall
© 2011 Infosys Technologies Limited
E
Edge Proxy
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In this you
would need to
maintain a
clinical
metadata and
access
selectively and
as required the
data from each
local system
with the use of
EMPI and
Edge proxy
servers.
FEDERATED
Data Users
E
Data Sources
Keep all the
data in local
repositories
and extend it
to all the
hospitals and
clinics f or
use. Involves
lesser cost
investment
to begin with.
Successful Healthcare IT Models : Healthcare Performance
Management
Real Time Alerting
Role & User
Configurability
• Real Time Alerting and
Notification features
• Process, Financial,
Performance, Quality
• Compliance KPIs with threshold
monitoring.
The Infosys solution provides
role based access to the users.
Access to the respective
dashboards / UI screens /
features are defined through
the roles.
Customizable
Dashboards
Data Analytics and
Forecasting
The Infosys solution
dashboards provides for role
based data access,
representations, default setting,
user preferences etc.
• Supports problem analysis
paths and “what if” analysis
through drill downs and
scenario development
• Integration of forecasting
models provide Predictive
Modelling capability
Complete
Interoperability
The Infosys solutions achieves
interoperability with Provider
systems irrespective of the data
feeds native to the respective
applications.
Deployment on hand
held devices
• The Infosys solution provides
deployment on handheld
devices at multiple levels –
• Simple alerting
• Application hosting on
handheld platform
• Interoperability with native
systems
© 2011 Infosys Technologies Limited
Workflow Manager
Workflow Manager allows
hospitals to define workflows
and KPIs will very little IT
intervention
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Successful Healthcare IT Models : mHealth
Care Coordination Services in a Software as a Service (SaaS) model
• eConsultation
• Telemedicine
• Home Health
• Post operative care
• Chronic disease management
• Appointment scheduling
Physicians
Pharmacies
Patients
•
•
•
•
Search physician, pharmacy, lab
Prescription Refill Request
Pre-registration forms
Personal Health Record
• Patient Diary
Communication
• Medication Compliance
Management
• Generic alternatives search
• Drug interaction check
Service Provider
Hospitals
Payers
Pharmaceutical
• View drug label information
published by pharma
• Payor formulary check
• Claims status check
• Quote generation
• Eligibility check
• Procedures cost comparison
Nurse
© 2011 Infosys Technologies Limited
• Pharmaco-kinetic inputs to Pharma
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Widget
Framework
Pref erence
Services
Localization
Services
Security
Services
Pref erence
Service
Master Data
Management
Services
Notif ication
Services
Common Horizontal Services
Gateways
Messaging
(Sync and
Async)
Webservice
(REST,
SOAP)
Integration Services
Adapters
(FTP, HTTP)
Wiki
Content
Aggregation &
Syndication
Reviews
Rating
Tags
Social Analytics
User Generated
Media
Search
User Profile
Management
Discussion
Forums
Blogs
Successful Healthcare IT Models : Health 2.0
APIs
• Health education
content
• Chronic care references
• Patient discussion
forums
• Review and ratings
• Continuing Medical
Education
• Webinars
• Online Chat
• Wiki
• Micro-communities
• Campaign Management
• Physician surveys
• Clinical trial feedback
• Webinars
• Physician Discussion
forums
• Sentiment Analysis
Successful Healthcare IT Models : Health 2.0
• Clinical cases.org is a blog site offered by physicians from Cleveland
clinic and featured with BMJ.
• “Ask Dr Wiki” is a collaborative knowledge platform for Physicians,
nurses and residents. It is moderated for content posting by
physicians thereby increasing authenticity of clinical content.
• Offers weekly podcasts of latest happenings at the Hospital so that the
community can be aware about newer initiatives and participate in them.
• They offer RSS feeds subscription for latest news in John Hopkins as well.
• MGH attempted social computing with success in neurology with their online
community BrainTalk dedicated for epileptic patients and their care givers.
• This community helped patients and care givers to unfold myths about epilepsy,
treatment options about epilepsy, experiences from fellow patients.
© 2011 Infosys Technologies Limited
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Successful Healthcare IT Models : eProcurement
© 2011 Infosys Technologies Limited
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Successful Healthcare IT Models : Disease Management
Physician Portal
Member Portal
Wellness Tools
Care Plan Management & eConsultation
Mobility Platform
Device Integration
Patient Diary
Target Setting
Healthcare Data Repository
Interoperability Layer
Electronic
Medical
Records
CPOE
© 2011 Infosys Technologies Limited
Admission
Discharge
Transfer
Laboratory
Information
System
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Pharmacy
Information
System
Ancillary
Systems
THANK YOU
www.infosys.com
The contents of this document are proprietary and confidential to Infosys Technologies Limited and may
not be disclosed in whole or in part at any time, to any third party without the prior written consent of
Infosys Technologies Limited.
© 2011 Infosys Technologies Limited. All rights reserved. Copyright in the whole and any part of this
document belongs to Infosys Technologies Limited. This work may not be used, sold, transferred,
adapted, abridged, copied or reproduced in whole or in part, in any manner or form, or in any media,
without the prior written consent of Infosys Technologies Limited.
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