HL7 India Elections are on

Currently the Governing Council Elections are going on at HL7 India.
The new team will be formed by the 18th of March.
Formal hand-over take-over from the previous team will take place during the second AGM of HL7 India to be held in Bengaluru on Thursday May 12, 2011.
We are looking forward to greater activities of HL7 India over the next two years. It will be instrumental in changing the landscape of health care information exchange, not only in India but also in the neighboring region.
The MoHFW, Government of India's Expert Committee on EMR Standards is about to submit its Interim Report to the Ministry.
So, in near future lots of exciting things can be expected in eHealth in India.

Tablets will revolutionize the way you receive healthcare

Tablets such as the iPad are all set to revolutionize the way each and every one of us receives healthcare.

Tablets have several advantages vis-a-vis a PC. These include

1. A sleek touch-screen interface that allows for quick navigation. In addition, the tablet is always "on" whereas it takes at least several seconds to switch on a laptop. General practitioners, typically see patients within 3 minutes. For these doctors every second counts and only a tablet can provide the speed they need.
2. Extreme portability. The iPad is the size of a small file that can easily be carried from place to place.
3. Thousands of apps that perform simple functions very efficiently.
4. Similarity to Smartphones. Smartphones are becoming more and more prevalent and within a few years we will find that most new phones are touch-screen capable. Someone who's used a Smartphone will find it easy to make the switch to a tablet even though they might not have used a tablet before.

As against the pros the cons of tablets are few with high cost and slow processing power being the main ones. With tablets out in the market for only about a year costs will rapidly decrease.

So how will tablets help everyone get better care

1. Get better information from your healthcare provider. Doctors will be able to show you videos and images details about your illness. Say you are going in for a cataract operation. The doctor could show you how the surgery is performed and why it is very safe.

2. Provide better input to your healthcare provider. Say you've had a spinal surgery and are going to meet the specialist for a follow-up. While you wait to see the specialist you could be completing form and diagrams which indicate the amount of discomfiture you are in. The specialist would use this information to track your recovery over a period of time.

3. Your healthcare provider will have all your relevant medical information available at his/her fingertips. This to me is by far the biggest benefit of using tablets. Say you have an injury playing football. You get an X-ray done and then go to see your doctor. When you see the doctor, he/she will have not just your X-ray but a history of all the injuries you've had before, any other illnesses you currently have, your allergies, the prescriptions you currently take etc. All this on a tablet to ensure that you get the best care possible.

That day is not too far........

Hospital Management and Technology

Healthcare in India is a a fairly dis-organized sector. At the same time, it continues to receive a lukewarm support from government. As can be expected, a few private institutions have started playing a key role in bringing about much required transformation in this sector. And not very surprisingly, they are leveraging technology to bring about this transformation.

More and more doctors are preferring to play critical role in 'management' of the hospitals. They realize that just providing care to patients by right diagnosis is not enough. With growing incomes in India, patient demand for an 'experience' at hospitals is growing. It' not about the medical treatment alone - but how did the ward boy treat me, what kind of food was served to me, was my medical claim processed quickly, was my bill settlement done on time, did I receive the right kind of advise, what kind of doctors participate in a hospital, do I get my medical records when I get discharged.....all of this plays a factor in people' minds when they visit or get admitted to a hospital. All of this calls for a serious effort spent on 'management' of hospital and it' resources.

Hospital management are getting smarter. They realize that - Healthcare also has to be dealt with smartly. Smart use of technology can not only save money but also deliver better results to the patients - thereby giving them an 'experience'!!! After all, who does not want a happy customer!!!!

The need for Employee EHR (eEHR)…

An Employee Health Record refers to any health / medical -related information created, obtained, or maintained by the organization regarding an employee’s physical or mental condition. This may include –

-          Results of medical exams and tests (Scans, Pathology Tests)

-          Medical History

-          Insurance Documents

-          Hospitalization Documents

-          Medical Certificates / Doctors’ Notes / Opinion of other Healthcare Providers, etc.

An eEHR means that all of the above can be accessed through a computer – may be on a local machine or over the internet.

Looking at the most obvious reasons – promoting employee wellness, preventing spread of communicable diseases, reducing stress load – on the whole creating a health / safe working environment - most organizations understand the importance of monitoring employee health.

Hence companies generally mandate at least, a once a year, health check-up for its employees.   Some companies also opt for a more segmented approach – advising health check-up for employees depending on their age, work load, etc.

Managing the records is really important – to ensure systematic control from creation or receipt through processing, distribution, maintenance, retrieval, retention, and final disposition.

However, taking care of all these in physical files can be quite a task,,, for both employers who have low attrition rates (will have a lot of accumulated information) as well those with high attrition rates (you will have less papers but more files).

Walk in – need for eEHR – accessing / managing these records through a computer can make life simpler. For starters – no more file cabinets, all information is stored in one place, can be easily searched and retrieved. You don’t have to worry about losing a file – it just seems much more organized. Moreover, if the system is web based, you will higher flexibility – sharing of records will become much of easier and there will no geographical limitation to the access.

Having said that - the system must take care of the security concerns – file encryption, audit trails / logs can be some measures taken.

Nonetheless, eEHR certainly seems like a good support tool for employee management. 

ACM forms a SIG on Health Informatics

From today, a new Special Interest Group has been formed by ACM on Health Informatics: SIGHIT that is concerned with the application of computing and information science principles and techniques, and information and communication technologies, to address issues in healthcare and the delivery of healthcare services as well as the related social and ethical issues. SIGHIT emphasizes the computing and information science-related aspects of health informatics and provides a forum for the creation, sharing, and management of knowledge and techniques as a strategic resource for improving the field of health informatics and its impact on people's lives.
I am fortunate to be the first Editor for its biennial Newsletter - SIGHIT Record that will be published every year in March and September.
Hoping to be enlightened on various health informatics activities that will ultimately help in changing our healthcare delivery systems for the better.

Getting Indoor Papers after Patient’s Discharge

When discharged from the hospital after being treated successfully, the patient and relatives feel relieved that they may not have to come back. However, they soon realize that they will have to return (may be a few times) to the hospital just to get the requisite indoor papers to file their claim for health insurance.

This process of getting these indoor papers often becomes cumbersome and more so frustrating. Because it’s an interaction between 3 parties – the TPA, you and the hospital – it’s very easy to forget obtaining / sending an important record simply due to communication gaps.

Post-treatment care of the patient is really important; time and effort of the relative should be focused on patient support and care rather running around for papers. 

Wouldn’t it be great if we could get all the hospitalization records at home? – For starters it saves the travel trouble. It will be even better if you also get softcopies of the records – so that you can share them easily with the TPA and also keep them as record – becomes a part of patient’s medical history – especially helpful if he / she may have to be treated for some ailment in the future.

Use the internet for Doctor’s Opinion

Diagnosis of ailments as well as patient care in some parts of the world – West Africa, Central Asia, Middle East are still suboptimal.  Based on the good reputation of Indian doctors, various entities in India, including the Government are pushing the case for Medical Tourism.

Although the healthcare in India is far cheaper than any of the Western Countries; in absolute terms it can still cost a lot. Here comes in a scope for medium which empowers the patient overseas to gauge the need to come to India.

Consider this – I live in Addis Ababa, Ethiopia. I am a patient suffering from an advanced disorder and am consulting a specialist doctor from Mumbai. Won’t it be great if I can share my latest reports (done in my home town) with the doctor easily through the internet. This will not only keep the doctor up-to-date with my latest medical findings, but also enable him to promptly advise me whether I need to travel to Mumbai.

Sharing of records can be done via email. However, this may make it difficult for the doctor to compare the latest findings with the previous ones. So you need one place where you can store all your records, in the way the doctor wants to view it – so he / she can easily compare you current results with historical ones – this makes a case for web based EHR.

This may be applicable in B and C-tier towns in India as well – when a patient needs to looks for a doctor in a metro for an opinion.

EMR Standards

The Ministry of Health and Family Welfare, Government of India, has recently constituted an Expert Committee for setting the Indian Standards for Electronic Medical Records.
The First Meeting was held in New Delhi on September 30, 2010.
Following some introductory discussions, three sub-committees have been formed for: (i) Standards (ii) Data Connectivity and (iii) Data Ownership. The respective sub-committee members are interacting among themselves during the intervening periods too.
The second meeting will be presided over by the Secretary of Health and Family Welfare, Government of India.
Hopefully by the end of its tenure there would be set guidelines for practicing e-health in India.

When you are on the move -

I travelled to Delhi last week. Before I took my flight, I was already feeling early symptoms of fever, but wrote it off as common cold.

However, the day after I reached Delhi, I was down with temperature. The following day, I visited a Doctor. Being, my first visit, he took 15-20 mins just to understand my history, my allergies, and more since sinusitis has been troubling me since a while.

Considering the prevalence of malaria and dengue nowadays, the doctor asked me to do a CBC and some other tests. I had got these tests done just 2 days before for my insurance - Obviously, I had not expected the illness and hence was not carrying my reports. I didn't even recall the results. So another round of tests was unavoidable.

One may concur, if you have fever, even if you sitting for as little a 15-20 mins,,, you body starts paining. I was at the clinic for around an hour, first the waiting , and then the consulting.

Fortunately, my tests were negative (the results only came out in the evening, so I had to visit the doctor a second time), and doctor suggested it was just a viral.

The point here is - a lot of time got consumed here just to get to the diagnosis, which would reduce substantially if I would be carrying my medical history and my reports. Obviously it’s not practical to carry your medical file everywhere you travel, but certainly if it is available on a chip, or a cd or even on web - it should be greatly helpful.

Paper Records Management...is outsourcing a solution to end the woes?

Paper records are generated by all businesses. Be it the part of the processes, like forms for telecom companies, banks, financial institutions, etc or the mandatory papers such as financial, tax papers, vouchers, ledgers etc., and papers just keep on piling, I just don’t want to be in a situation where I have to fear the loss of my important documents.

Only if I had an alternative arrangement, I would have freed up my costly real estate space and utilised for more meaningful purpose rather than using it for dead storage.

What a mess these papers create, once the record keeping goes even a little out of sync.

Oh I literally waste my personnel in just maintain my records!!!

These questions must be bugging many a businesses, especially where the real estate and man-power cost are spiralling up.

Wouldn’t it be fantastic if we had an option of outsourcing these non-core works?

Physical Storage of documents at distant place by a specialised firm is just the right answer.

Just imagine for an educational institute, it may free up space for additional classrooms or labs, for a hospital it might free up space for additional beds, or equipments.

If I need to summarize the need for Physical Storage of Documents at Distant Place, I would put it as

1. Tedious process of management, storage and retrieval of the paper-based documents
2. File and document storage issues and related cost of realty
3. Paper Document handling issues
4. Paper transportation costs while routing/ sending/ distributing the documents to various personnel across the group
5. Rising Printing, Faxing, Photocopying, mailing and courier (distribution) costs
6. Tedious Audit Process and rising audit cost
7. Tedious process in linking of the various documents
8. Tedious process of tracking files and documents and related comments/ annotations

And what benefits do I derive from it? Well to put it in simple words would be.

1. Savings in realty cost for Storage of documents
2. Minimized turn-around time for key organizational processes
3. Organized Documentation and hence faster document search resulting in savings in time and increase in productivity
4. Safety against Natural disasters and loss of Paper documents
5. Sharing of Documents online, thereby reducing the distribution costs.
6. Savings in Manpower cost for manpower related to storage and management of documents
7. Facilitates security and integrity of documents, hence minimizing chances of fraud and illegal activities.
8. Overall improvement in Enterprise productivity and management of corporate knowledge