Information Technology has revolutionized healthcare delivery in several countries across the globe. It helps in the management of information as computers simplify the work of personal health information management for both doctors and patients. It also increases the avenues of communication between healthcare providers and consumers.
Computers and other electronic devices simplify the storage, sharing, and access of health information for healthcare providers in hospitals, labs, X-ray facilities and so on. The usage of computers for this application is called Health Information Technology (HIT) or Health IT.
HIT reduces paperwork, as handwritten medical records become a thing of the past. It reduces medical errors by transmitting accurate information electronically which eliminates the chances of miscommunication due to, for instance, a doctor’s bad handwriting.
Healthcare costs significantly decrease because doctors do not have to repeat medical tests if a patient changes from one to another. It also eliminates the storage space and staff time needed to maintain medical records. All such factors help in enhancing the quality of healthcare, as medical errors are reduced and accurate and timely information is provided to healthcare providers.
The important types of HIT used in the healthcare system are personal health records (PHRs), electronic health records (EHRs), and electronic prescriptions (e-Rx).
A personal health record (PHR) is an online document that portrays a person’s health and that of his family members which can be used for up-to-date references. The PHR includes everything related to patient health like children’s immunizations, the last physical exam, major illnesses and operations, allergies, and a list of family medicines.
An electronic medical record (EMR) is a computer-based document which is similar to a paper medical chart showing health information from the doctor and healthcare providers. The information encompasses a person’s health conditions, allergies, treatments, tests, and medications.
EMRs can be shared between the doctor, other specialists, labs, and imaging facilities that provide X-rays, CT Scans, and MRIs. This helps in collaboration between healthcare providers to arrive at the appropriate treatment method and medicine. This improves medical care delivery as it also includes alerts for drug allergies and other associated problems.
Electronic prescriptions or e-prescriptions (eRx) allows electronic prescriptions to be electronically sent to the pharmacy thereby avoiding human errors in reading a doctor’s writing. Electronic prescriptions help avoid harmful drug interactions as doctors will already know the medications that are being taken.
Also popular are CPOE, a medication ordering and fulfillment system, and clinical decision support systems (CDSSs), which both provide physicians and nurses with real-time diagnostic and treatment recommendations. Picture archiving and communications systems (PACS) capture and integrate diagnostic and radiological images from various devices like X-rays, MRIs, CT scans, etc. in a centralized medical record.
HIT in India
Integrating IT into the healthcare system in India was a daunting task but has been successfully implemented in most cases. Healthcare is now considered a multi-disciplinary system which encompasses IT.
“Whether it be in the field of diagnosis, investigations, treatment, documentation, retrieval of information, access to state-ofthe-art knowledge, medical instrumentation, teaching, research, etc., IT has made a major difference,” emphasized Krishna Ganapathy, co-founder of the Telemedicine Society of India.
IT improves patient care as it enables processes and systems to be introduced and repeatedly monitored via standard operating procedures and audit processes. IT provides real-time and relevant information to both patients and doctors, thereby enhancing the standards of healthcare. Also the increase in computing power results in an exponential reduction in costs. The healthcare IT market in India has grown 200 – 300 percent in the last 10 years.
India is striving to achieve the target “ehealth for all by 2020,” which is a realistic goal given the technological advancements in the country. The growth in mobile telephony and ICT in India will result in several short-term and long-term benefits considering HIT. For example, a patient’s hospital stay can be reduced by up to 39 percent with the improved use of IT.
The Indian government and some state governments are leveraging Telemedicine to provide healthcare to far-flung areas. The formation of the Telemedicine Society of India, the Medical Informatics Society of India, and the launch of e-Health journals are fast promoting the use of HIT wherever possible.
The Government of India has launched the Health Management Information System (HMIS) portal which helps collect local health data and converts it into real-time information such as management indicators and trends that can be graphically represented for better understanding in reports.
In India, HIT implementation is backed by GE Healthcare, Intel, Hewlett-Packard, Cisco Systems, Qualcomm, Microsoft, Google, IBM, Computer Sciences Corporation (CSC), Perot Systems, TCS, HCL Satyam, and many others.
Already Teleradiology is making a great impact while still in its infancy. It enhances radio diagnosis by using optimized communications channels and advanced image acquisition techniques. Teleradiology involves the transmission of digital images acquired through CT scans, digital X-rays, MRIs, etc., to the radiologist through a secure encrypted system.
Sankara Nethralaya, a well-known eye hospital, has revolutionized eye care by implementing new technology in every way possible. All patient records are available online on a secure system which can be accessed from any of the hospital’s centers. Arvind Eye Care uses teleopthalmology to talk to patients in remote areas to discuss cases.
PHR and EMR adoption has been advocated by several healthcare and insurance providers. PHR platforms like Google Health and Microsoft HealthVault allow members to access and store personal health information online. Microsoft is striving to promote several of its healthcare offerings in the country.
Standardization of data and processes across hospitals is important in order to enforce the use of PHR, EMR, and so on. A Hospital Information Management System (HIMS) enables seamless interconnectivity between the various departments of the hospital, thereby reducing the use of paper. Although such initiatives are becoming prevalent in larger cities in India, it is already taking root in smaller cities as well.
Mobile health (mHealth) initiatives are being launched in earnest by many companies. Apollo Telemedicine Networking Foundation has started pilot studies in collaboration with Ericson in Tamil Nadu, Bhutan, and Bangladesh. There is a need to reach good medical facilities to remote villages for which Hospitals on Wheels have been introduced with emergency and basic medical facilities.
In order to take IT to the core of the medical profession it is necessary to update the medical curriculum with IT studies included in it. Also, IT in Healthcare should be taught to IT students. Virtual skills laboratories which showcase simulated surgical procedures on virtual patients are also required.
Apollo Hospitals in India has leveraged the services of Tata Consultancy Services to give its patients a Universal Hospital Identification Number (UHIN). Using this number the medical records of the patient can be accessed from any location. HealthHiway, an Apollo Hospitals and industry initiative, provides a comprehensive National Health Data Network to enhance day-to-day processes in a healthcare system encompassing patient services, clinical outcome and financial health of user companies.
Using the network the healthcare community can interact and share data efficiently and securely. The HealthHiway initiative includes revenue management, learning management, performance management, decision support and knowledge management, and clinical information systems.
HIT in South Korea
In order to reduce operational expenses, improve services delivery, and to implement easy medical bill reimbursement, several South Korean hospitals have adopted HIT. The market in Korea was valued at US$92.8 million in 2009 which is expected to grow at a CAGR of 6.8 percent up to 2016.
Frost & Sullivan Research Analyst Amritpall Singh stated, “A major contributing factor to the high growth rate of the healthcare IT market in South Korea is government encouragement through disbursement of subsidies and creation of several policies, guidelines, and regulations.”
Developments in e-health in South Korea can be attributed to the advanced IT infrastructure present there. The country is evolving from telemedicine to ubiquitous healthcare (U-health) which involves self-care by patients supported by real-time monitoring by physicians.
Also Korea is growing as a favored medical tourism destination owing to the availability of specialists, modern facilities, and sophisticated equipment. These hospitals invest in healthcare IT, insurance reimbursement, and in electronic health record (EHR) applications.
In U-health, blood sugar content, blood pressure and body weight are monitored and recorded as a daily routine away from the hospital. Doctors can still perform real time monitoring of their patients, keep tabs of any diseases appearing, and prevent them. This helps Korean hospitals to avoid space and facilities shortages at the hospitals and lets them focus instead on treating patients with chronic illnesses.
Remote patient monitoring or RPM systems forming part of U-health in Korea allow patients to go about their daily routine while data on their health is being sent to physicians who keep track of their health. RPM is expected to reduce healthcare spent by US$197 billion over the next 25 years.
HIT helps countries like South Korea invest in infrastructure expansion. This eliminates the need to, for example, build huge hospitals with more beds. Hospitals in the country are encouraged to implement EMR systems.
Private initiatives are also encouraging. General Electric announced a US$6 million plan for five years to build the IT-based Uhealth research and development center in South Korea’s Incheon free economic zone.
Such a huge initiative faces difficulties in a shortage of IT professionals as more students opt for business and management studies. The government has reacted by engaging IT professionals from other countries and by launching IT-related courses through the Korea Advanced Institute of Science and Technology.
Since hospitals may not be able to integrate the new IT-based systems by themselves, it is imperative for the government to help hospitals incorporate new technologies and applications for healthcare professionals to follow. Korea looks forward to fully implementing its U-health program by 2015. However, the fact remains that 90 percent of the nation’s healthcare budget covers only 30 percent of the population.
A proactive HIT model offers more business opportunities for companies involved in medical devices, medical insurance and pharmaceutical drug manufacturing. IT enables a connected health information platform to deploy mobile healthcare services.
IT enables patient-centric preventive care, which is the need of the hour, as disease treatment is going to become more complicated with growing populations.
Also by 2050, 21 percent of the global population will be comprised of senior citizens, further straining the system. “So for longterm benefits, it is necessary to adopt preventive healthcare measures rather than focus just on disease treatment,” said Reenita Das, senior vice president of healthcare practice at Frost & Sullivan Asia-Pacific.
Telehealth enables instant recording of a patient’s data irrespective of the location. It allows healthcare providers to perform medical diagnoses from afar, saving time and cost and enhancing the productivity of physicians.
Recently-launched applications for smartphones also bring HIT within anyone’s reach and help to avoid congestion in hospitals.