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ICT Use in Medicine: Healthcare takes the digital route

March 06, 2019
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The healthcare industry is realising the power of information and communications technology (ICT) and is gradually warming up to new technologies. Technology trends such as digital patient engagement, use of internet of things (IoT) solutions for pre-diagnosis, deployment of robotics and artificial intelligence (AI) solutions to improve healthcare professionals’ productivity, and access to virtual healthcare or telemedicine are set to significantly disrupt the healthcare industry. Meanwhile, the scope of big data analytics in the healthcare industry is also immense. Technology leads of enterprises operating in the healthcare space share their views on emerging ICT trends in healthcare, the status of technology adoption and the future outlook… (from left to right- Abhimanyu Bhosale, Co-founder and chief executive officer LiveHealth; Sumit Puri,chief information officer (CIO), Max Healthcare; Ashokkan V.R.S., group CIO, Columbia Asia Hospitals)

How have the ICT requirements of the healthcare industry evolved over time? What are the key ICT solutions used by your organisation?

Abhimanyu Bhosale

ICT remains a key growth driver for emerging markets. Healthcare is one of the major ones. Typically, ICT requirements start with infrastructure and capacity building, followed by the reliability and quality of ICT solutions available in the market.

We are now seeing not only more cloud-based solutions as compared to when we started in 2013, but also better quality solutions such as real-time logistics tracking, online point-of-sale systems and mobile-based solutions. So as technology adoption and infrastructure improve, better solutions are evolving to leverage the new capabilities.

At LiveHealth we are using a range of ICT solutions. Apart from a complete information management system, a customer relationship management (CRM) system and an EMR system, we are offering business insights with the help of analytics and AI tools. In addition, we have IoT services in place to automate and manage remote medical devices. We are investing in product development on different adjacent areas. In many such areas, we are the first organised player to build and offer these kinds of solutions. Automation is one of our key focus areas, where we are automating operational processes inside a laboratory, and speeding up the turnaround time by 40 per cent.

Sumit Puri

There has been significant improvement in connectivity, which allows anytime anywhere access to customers and employees. IoT combined with telemedicine is a big innovation, which is going to become important as we go forward. IoT devices transmitting vitals accurately to doctors from remote locations will become critical and will assist in the creation of a connected healthcare ecosystem. At Max Healthcare, we are focusing on telemedicine in a big way. We have created a personalised patient portal, which gives access to all reports and digital health information placed in a centralised repository. It creates a digital health vault for a patient where you can link the family members on the same portal and have their reports uploaded as well. This can be done not only for reports generated at Max Hospital but also for reports from other hospitals. We are also looking at telehealth to improve the customer experience in remote locations across the country. At the same time, we are exploring ways to engage with corporates and schools.

Ashokkan V.R.S.

Like every industry, the healthcare industry, too, has undergone many changes through the implementation of various IT systems. Healthcare as an industry deploys very specific solutions that empower hospital operations, as well as common industry solutions such as enterprise resource planning (ERP), analysis and reporting. Some of the key requirements that have emerged are documentation on the go, instant alerts through notifications, workflow efficiency/productivity automation, and intelligent analytics for care delivery and decision-making. The emerging trends in the healthcare industry are powered by technologies such as cloud computing, mobility, AI and IoT.

Columbia Asia believes that IT powers operations to optimise care delivery. We use our proprietary hospital operating software, which has automated hospital operations in a relative value scale, out-patient (OP) processes by 98 per cent and inpatient (IP) processes by 75 per cent. Our proprietary software consists of various modules and functions that relate to hospital information system (HIS), electronic medical record (EMR) and ERP. We also use radiology information system, picture archiving and communication system and laboratory information system to power our ancillary department functioning. New-age solutions that have been deployed in our enterprise are PowerBI-based business intelligence and analytical reporting, a patient engagement platform that provides a patient portal/app and a physician app (in progress), which are interconnected with the HIS/EMR to provide a seamless experience. Columbia Asia has also invested in IT security to support the organisational vision. We have implemented both traditional anti-virus solutions and also top-end data leak prevention systems. Columbia Asia is the first hospital chain to implement digital signature-based document authentication for key documents such as prescriptions and discharge summaries.

What is the scope of big data analytics, AI and IoT in the healthcare industry? What are your plans for leveraging these technologies?

Abhimanyu Bhosale

The scope of these technologies in the healthcare landscape is huge. These technologies enable many new functions which were not possible earlier. We are using AI to improve medical certainty during reporting of lab results. Through AI we are able to help doctors automatically validate results considering a wide range or variance in reporting parameters.

Sumit Puri

This is the age of personalisation and the power of choice has shifted to consumers from organisations. We are using singular systems like electronic health record (EHR), HIS, ERP, CRM application and e-prescription applications, which help us in creating a very effective data warehouse that can create an integrated and personalised view of all our customers. We have begun to leverage this information for big data analytics to enhance patient safety. For instance, we have partnered with research institutions like Deakin University, Australia, to create a machine learning (ML) algorithm for predicting the possibility of readmission of heart attack patients. We are also exploring possibilities of leveraging AI for improving productivity. For instance, we are looking at how AI can help radiologists examine CT scans and MRIs. We are also exploring robotic process automation, which is helping us in financial reconciliation. We are deploying national language processing for enabling structured data for e-prescriptions for doctors that are entering unstructured data in prescriptions to further improve MIS and patient safety.

Further, IoT-based applications complemented with bike ambulances or smart ambulances have helped us in improving point-of-care diagnostics. These help us transmit vital information of patients and optimise route times on a real-time basis to our command centre for patients in transit. With an average of 15 minutes reach-time of bike ambulances and 30 minutes of ambulances in the National Capital Region, we have been able to facilitate saving of almost 130 lives in the last 10 months, along with our operations command centre with this innovation.

Ashokkan V.R.S

Big data analytics, AI and IoT are seen as boons for this industry as they help provide early detection/care to the community. The three Vs of data in the healthcare industry – volume, velocity and variety – make an ideal sector for technology implementation. We have been hearing doctors/physicians say that each patient is unique, and hence treatment needs to be personalised. Big data analytics solutions in my view will help achieve this objective. The early detection and decluttering of unuseful data through IoT and AI rule sets will significantly improve the productivity of hospital operations. IoT-powered devices coupled with cloud computing applications will help manage the growing data sets and provide critical/ remote care. At Columbia Asia, we have conducted a couple of pilots in these technologies. We are gearing up internally to put them to use in the coming years. Our IoT pilot is aimed at reducing the data capture effort of our nurses and improving their availability for actual patient care. The AI pilot on radiology has improved reporting accuracy and radiologist productivity.

What roles are telemedicine and m-health playing in the delivery of healthcare services in India? What is your outlook for these services?

Abhimanyu Bhosale

The existing and rapidly growing demand in the healthcare sector can only be met by implementing newer, effective and innovative technology solutions. Telemedicine and m-health are evidently playing a crucial role in bridging this demand gap. These solutions provide the ability to treat patients remotely in most regions of the country. They also provide convenience in healthcare, which is the most sought after element for urban folks. Telemedicine and m-health have made healthcare easily accessible, convenient and cost effective. In my view, innovative technology implementation is the key to transforming the entire healthcare ecosystem and providing a better quality of life to everyone.

Sumit Puri

We have significant number of super specialist doctors of tertiary and quaternary specialities like oncology, neurology and cardiology at the Max Healthcare Group of hospitals and with the help of tele-consults and m-Health, we can actually percolate that knowledge to the remotest corners of the country. A person can get access to the medical advice at the click of a button. This teleconsultation process can be further improved by AI, possibly for triaging and initial diagnosis of patients based on the initial symptoms entered and patients’ vital information, which can then be supplemented further by specialist doctors. The recent launch of the Ayushman Bharat scheme complemented by tele-consults can facilitate health insurance services and benefit the un-insured population in a big way. The insurance assistance will also help get more of the uninsured rural population into the fold and encourage them to visit a primary healthcare centre. In the absence of specialist doctors at remote locations, these centres could be manned by trained nurses, paramedics or AYUSH doctors, who could use technological assistance to give a more specialised initial diagnosis to patients that can be augmented by senior specialist doctors through tele-consults.

Ashokkan V.R.S.

Accessibility and availability of care in the remote areas of the country has been a long-standing issue at the state and country level. With the increasing reach and availability of telecom infrastructure, telemedicine and m-health solutions can find a path to reach the rural masses. These solutions will also help patients stay continuously engaged with their care providers to seek support when needed and not when diagnosed.

A large engagement programme at the state and central level should be enabled by health authorities to elevate care delivery to the next level. In this regard, the Ministry of Health and Family Welfare has initiated various programmes and has also published electronic health record standards. However, industry veterans feel that more is required for a country like India to see through a decent adoption rate.

What are the challenges in managing the IT/telecom infrastructure and deploying new technologies? How can these be resolved?

Abhimanyu Bhosale

The lack of basic supporting resources and technology adoption and unskilled manpower are some of the major challenges. The cost of improved infrastructure to support new advanced technology is still high. With better accessibility to infrastructure, which includes electricity and the internet, most providers will be able to substantially improve their quality of care, and reduce their costs and efforts. The other two challenges can be resolved by customer education and by helping them be more equipped with the skills required to understand and use innovative technologies.

Ashokkan V.R.S.

As compared to a decade ago, the infrastructure has improved phenomenally. It is imperative to note that stable connectivity has been a problem for most enterprises and not just for healthcare enterprises. Affordability and availability of stable infrastructure enabling a connected India is a must as we move towards the adoption of new-age technologies. Capacity building is the only way for solving such huge demands for a country like India.

What are the upcoming technology trends that will shape the healthcare industry in the next few years?

Abhimanyu Bhosale

One of the biggest technology trends that has the potential to take healthcare services to greater heights is AI. It has the ability to drive higher levels of precision and greater predictability in diagnosis, which can help in early diagnosis and treatment, and the timely prevention of diseases. It is a logic-based ever-evolving technology that uses data science and analytics to deduce the next course of action.

Sumit Puri

I see a lot more focus on prevention. Technology will play a bigger role in terms of customer engagement, allowing them to take charge of their own health, with health organisations supplementing that effort through timely interventions and personalised advice. I do see several collaborative partnerships in the healthcare ecosystem. For example, Max Healthcare has started forging partnerships with health insurance institutions as well as with fitness band providers, which creates a connected healthcare set-up for a patient to reduce lifestyle-related diseases through personalised, timely information. At the doctors’ end, technologies like ML and AI will help in reducing the non-standardisation of practices in the medical arena. Today, many technology use cases are prevalent in critical areas such as oncology, cardiology and pregnancy for enabling standardised treatment protocols based on clinical outcomes, which will get refined further by iteratively introducing standards for clinical procedures and further dissemination and improvements in our clinical knowledge base.

Ashokkan V.R.S.

Alhough AI, IoT and cloud have been there for close to a decade now, these are still to become the trends that will take the healthcare industry to the next level of care delivery. Along with these technologies, I personally see blockchain joining this bandwagon to support data inconsistency issues that surround the industry.

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