Mukesh Arora was in a bind: his throat was so sore from infection that he couldn’t utter a word, let alone swallow food. His regular ENT (ear, nose and throat) specialist had gone abroad for a medical conference and he didn’t know of any other in his neighbourhood. He surfed the web for help and discovered, to his momentary relief, that he could fix an appointment online with a specialist at one of the hospitals not far from where he lived.
Hospitals, especially in India, have for long cut a sorry figure in terms of their digital savvy and use of information technology (IT) to be on par with their counterparts in sectors such as banking and telecom.
According to Tirupathi Karthik, CEO of Napier Healthcare, a Singapore-based provider of software solutions to the healthcare industry, “As compared to a global average of 2–2.5% of income spent on IT by healthcare providers, or even 6-15% being invested in IT in other sectors within India, anecdotal data from multiple sources indicate that healthcare providers in India rarely spend more than 0.5% of their annual revenue on information technology.”
But things have been changing for some time, albeit at a pace slower than many would want.
Leading the change are large hospital chains such as Apollo Hospitals Enterprise Ltd, Max Healthcare Institute Ltd and Fortis Healthcare Ltd.
Prodded on by the need to take control of their sprawling operations—which span dozens of hospitals in multiple cities—on the one hand, and the rising expectations of tech-empowered consumers on the other, these modern hospitals are setting the template for healthcare in India.
High time they did so. “If you looked at the hospitals in India around 10 years back, they were very basic in terms of tech infrastructure. Besides, independent doctors got what they pretty much wanted. This led to lack of control with the management and poor visibility into the entire treatment and costs hospitals had to bear,” says Varun Gera, founder and chief executive of HealthAssure Pvt. Ltd, a primary healthcare aggregator that has partnered with almost 2,300 clinics, including diagnostic labs and hospital OPDs (out-patient departments).
He says that somewhere along the line hospitals had to work as hospitals and it could no longer be the case of “doctors having their own way of doing things”.
While part of this doctors-management clash had to do with egos, a more significant role was played by IT—the lack of it in the early days and increasing enablement as time went on. It is the clinical protocols, organisation-wide processes and use of IT tools through which hospitals, particularly those with a corporate road map to grow fast, could gain better control, get visibility into how treatment is given, and embrace more standardization for better healthcare outcomes across their chain of facilities.
Once processes and IT tools began to be adopted, hospitals moved on from using basic networking and hospital information systems (HIS) to looking at electronic medical records (EMRs) and other advanced deployments for improving efficiency as well as patient care.
According to research firm Gartner Inc., Indian healthcare providers are set to spend $1.2 billion on IT products and services in 2016, including telecom services.
Among the key areas in which hospitals are increasingly focusing their IT efforts are online doctor appointments, data capture of patients visiting the hospitals and applying analytics tools to get insights into their operations.
One of the large hospital chains investing big time in IT is Apollo. “One of the things we have done is enabled online appointment for doctors. Earlier, less than 10% of our patients came by appointment. Now at Apollo almost 50% of patients are coming by appointment,” says Sangita Reddy, joint managing director, Apollo Hospitals.
That is a huge change in terms of avoiding the chaos resulting from a lot of patients just landing up at its hospitals all over India. It also allows Apollo to focus on the more important task of clinical care rather than manage hordes of patients shuffling from one department to the other on its premises.
More significant change is afoot through the use of data analytics for both clinical and non-clinical insights. “We are collecting about 55% of all our patients’ clinical data electronically, which is enabling us to create a digital warehouse. This digital warehouse, in turn, is enabling us to do data mining and use this data in different ways,” says Reddy.
These efforts are helping Apollo in workflow prediction, staffing, communication, etc., and helping the organization turn into a data-driven enterprise.
One of the key areas in which analytics is being applied at Apollo, according to Reddy, is the use of predictive analytics for clinical purposes. “We have pioneered the concept of personalized health check-ups in India: instead of a common check-up, it is customized based on analytics of data of almost 1 million patients that have visited our hospitals over the years,” she says.
The “decision tree” for providing healthcare is being evolved based on scenario building through matching a particular medicine with a particular disease or condition that previous patients had encountered. The result is quicker treatment with improved outcomes.
“The analytics tool enhances the effectiveness of the medication that doctors choose,” says Reddy.
On the question of the acceptance of such tools by the medical fraternity, she says, “We use these predictive analytics tools in a recommendatory manner, so it’s not forced on the doctors…and we have found a very high degree of acceptance.” Currently being used in its large hospitals, Apollo will soon extend its use to other hospitals as well.
There is a lot of scope for improvement in the way hospitals in India operate and use IT to manage operations and deliver healthcare in a seamless manner taking into account the intricacies involved in settling health insurance claims. According to Gera, “The whole focus now is on getting the data out and efficiency of operations. The way hospitals operate currently is much fractured, as there are multiple complexities involved in their operations.”
And while technology cannot do everything for hospitals, the right tools and processes can make a big difference to the quality and speed of healthcare delivery in India.
Among the tools for improving or aiding clinical outcomes, International Business Machines Corp.’s Watson cognitive computing solutions for healthcare are being considered by many hospitals in India. One of the first to implement it is Manipal Hospital Enterprises Pvt. Ltd. According to IBM, Watson for Oncology is now in use by oncologists at six locations in the Manipal Hospitals network to “provide information and insights to physicians to help them identify personalised, evidence-based cancer care options across India”.
If the past decade signified the modernisation of hospitals in terms of physical infrastructure, medical equipment and the like, the next one is likely to be defined by integration of multiple IT tools, advanced analytics solutions, health monitoring devices and Internet of Things—under which medical devices, computer systems, smartphones and diagnostic equipment will share data with each other in real time for individualised, improved healthcare.