Technology Innovation in Healthcare
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1 Technology Innovation in Healthcare Dr.Sumanth C Raman 12 May 2014 TCS Public
2 Principles of Healthcare Delivery Systems The Primary Driver of Healthcare Delivery Systems globally is Revenue Technology has many answers but the Healthcare Industry does not want to ask the questions Use of Technology benefits patients more than the Healthcare Providers Patient Empowerment results in demands and often fulfillment of better delivery systems A Paradigm shift in the management of Care from disease management to Health Maintenance is underway 12 May
3 Principles of Healthcare Delivery Systems Hospitals are predominantly Disease Treatment Centers and NOT health maintenance centers The Entire Healthcare Industry is constantly in Search of Disease as its existence depends upon it. (If there is not enough of it can we create it?) There is no incentive to use Revenue Neutral technology even if its benefits for Patients are demonstrable Simply put, the greatest of Technology will be used only if someone finds a way to make money out of it. 12 May
4 Health care Trends Drivers Global: Reduction of preventable medical errors The need for collaboration and documentation Compliance with government regulations Cost reduction and operational efficiency Shortage of healthcare delivery staff Direct investment in healthcare by government-led projects Digital diagnostic imaging Large-scale data storage devices and software that manages the life cycle of data Universal access, personal health record and patient empowerment 12 May
5 Health care Trends Inhibitors Healthcare staff reluctant to take on new software Lingering skepticism of the business benefits or return on investment of technology The role of trusted advisor fragmented among many departments or filled by an outside agent IT staffing level facing further reductions Growing liability issues Capital investment for IT projects and initiatives constrained Increasingly complex regulatory environment surrounding issues of patient privacy, data security and compliance Evolving technology standards Misaligned economic incentives 12 May
6 Gartner Healthcare Hype Cycle 12 May
7 Health care Trends (Gartner) At the Peak Personal Health Record Telepathology Healthcare Workforce Analytics Patient Throughput & Logistics Management (PTL) Pre-operative Charting and Anesthesia Documentation Within the CPR. Integrated Clinical/Financial BI Systems Patient Portals (Administrative and Financial Transactions Sliding Into the Trough Next-Generation Enterprise Patient Financial Systems (U.S ) Telemedicine Home Health Monitoring CPR Access Through Bedside Multimedia Terminal Generation 3 Computer-Based Patient Records Critical Care Information Systems Patient Self-Service Kiosks ERP (SOA) Patient Portals (Clinical) Telemedicine (Intensive Care Unit) E-Prescribing Wireless Healthcare Asset Tracking 12 May
8 Health care Trends (Gartner) Climbing the Slope E-Visits Remote Hosting Ambulatory Electronic Medical Records Computer-Based Physician Order Entry Emergency Department Information Systems Generation 2 Computer-Based Patient Records Disaster Recovery and Business Continuity Entering the Plateau Cardiology Imaging Systems Enterprise Patient Scheduling Systems 12 May
9 Key Components in the Healthcare Systems Patient Access Outcome Choice Governance Management Costs Long Term Conditions Population Demographics Population Management Retention Payor Innovation & Convergence With Life Sciences Provider Costs Resources Quality Services Payments 12 May
10 Retention, Growth and the Wellness Continuum Member retention and growth are value drivers for a Plan Members will be drawn and glued to a plan if the plan actively participates in a members health Information Knowledge Value Underwriting Risk Mitigation Predictive Analytics Fraud and Abuse Prevention Proactive Analytics Outcomes & Utilization Denials History Risk Identification and quantification Reactive Analytics of History Disease & Care Information Patient Information Provider Information Wellness management Care Management Disease Management Data Clinical Data Claims Data Member Data Provider data Patient Management 12 May
11 Healthcare Themes Wellness Management Move customers for reactive to predictive care / disease management Preventive spend vs. curative spend Operationalzing Policy & Strategy Tools to Enable the Implementation of Policy and Strategy within The Healthcare Management Tier and Measuring its Effectiveness Business Intelligence Analytics Decision Support Technology Enabled Care Creative use of Smart Technologies to support the Patient Care Process and Improving Outcomes Cost Predictability Predict and manage cost of care Continuous Risk assessment and mitigation Fraud and abuse prevention and management Self-Service enabled customer directed health plans 12 May
12 Patient Centric Healthcare - Convergence EMR Framework Demography hbids Framework WebHealth Center Medical history Personal Information Convergence & Analytics Analytics Genes Health Information Payer- Provider Convergence Patient Bio R&D Diseases Bio Appliance Insurance Drug-Device Personalization & Convergence Drugs Clinical Trials Drug Safety Fraud Management Hospitals Devices RFID Tracking Hospital Management Remote ICU Doctors Smart Chair Silicon Locket CDSS Med Pad 12 May
13 Healthcare Provider 12 May
14 LSHC Solutions Focus Increase access to care Decrease cost of care Improve outcomes by enhancing quality and optimizing services Decrease medical errors Make care provision patient friendly Empower patients Analytics, Data warehousing and BI Dashboards and portals EHR, HMS, CDSS, etc. Service orientation and quality processes implementation Fraud and abuse management Integrated HIS and inter-operability Enhancing patient-centric Healthcare is one of the top 10 outcomes oriented themes that TCS will focus on 12 May
15 Devices Medical devices with remote monitoring capability ECG (single, three and twelve lead) Smart Chairs Glucometers May
16 Ambulatory Patient Care Services Silicon Locket May
17 Ambulatory Patient Care Services - SmartChair May
18 How it works 1 6 Patient Repository Doctor s Diagnostics Consultation History Patient with Holter 3 Patient gives Back to Doctor/Hospital 4 DSS MMCard carrying ECG Data Hospital Management System 14 Patient-ECG Repository in Hospital 1 Hospital/Nursing Home/Doctor s 5 Hospital Administrator 10 GSM Modem 15 Ethernet 2 Holter given to Patient for ECG recording 3 4 ECG recording 24 hrs ECG viewer s/w & DSS annotation Diagnostic & Medication Internet 8 Remote Video Consultation Doctor PC 11 Consultation Server 12 Doctor s Mobile 13 GSM Tower 14 Doctor 12 May
19 WebHealthCentre.com 12 May
20 WebHealthCentre Telemedicine( supported by Audio/Video Conferencing facility) Online consultation Clinic Online Health and Medical Record management Online Health Parameters tracking system DICOM Viewer and Converter for handling medical images Online Appointment scheduler Online Lab Reports viewer Student Center The Site also offers elaborate information on Health topics like Alzheimer s disease, Alcoholism, Beauty disease, Diet & Nutrition, Eye care, First aid, Oral care, Insurance etc Acupuncture, Siddha Medicine, Homeopathy, Yoga, Ayurveda etc Health Directories, Appliances and Appliance Directories, Drug Information Blood Donation and stock management Health and Medical Calculators Health centres like Acidity, Allergy, Chicken pox, dengue etc AIDS, Cancer, Cardiac, Diabetes, Mental Health, Neurology etc Web site is India s first Multi -Speciality, Multi- Institution participation online consulting facility where doctors and patients can access some of the leading medical institutions in India for medical advise Site Launched on 1/25/2000 Exceeds 3 million hits/month 40,000 unique visitors each month. Approximately 700,000 pages viewed per month has completed more than 26,000 Tele consultations currently stores more than 45,000 Medical records online. First Indian & Healthcare portal to be Microsoft passport based Authentication enabled. Global Implementation Usage Data spans 16 countries U.S., India, Canada, UK Key modules like Appointment scheduler and Lab tool functions in.net environment 12 May
21 Internet Interface Webhealthcenter.com 12 May
22 CLINICAL DECISION SUPPORT SYSTEM Healthcare Solutions Comprehensive tool that would provide support to the Medical professionals to make their Clinical Decisions more quickly, correctly and accurately. Knowledge base with a full set of diseases in a particular specialty with the associated symptoms, History, Physical Examination, investigations and medication A set of symptoms, history questions, Physical Examination findings, investigations reports and medications are mapped to one or more Diseases with a priority factor, which suggests the possibility of the disease for the defined set of parameters CHALLENGES No Universally accepted CDSS System in the Market Most Systems stop at Diagnosis stage Most systems do not allow the users to build rules Many are not self learning Not linked to Alert Engines COMPONENTS Administration Rule Building, Master data management Consultation and Patient Management FEATURES Reporting services and Trend Analysis Allow users to build their own rules and view them against inferences Self Learning as Volume of the data in the Data store increases Encompasses the complete patient flow until outcome Linked to an Alert Engine and Trend Analyzer Supports Multi level Drill down Supports Linkage to Electronic Medical Records Web based Application Anywhere / Anytime access Could be envisaged as a Knowledge Management tool Can be Configured to handle specific disease states Can be used as a diagnostic tool for screening Large Populations Can be used as a Trend Analyzer tool and a Net Doctor!!! 12 May
23 CLINICAL DECISION SUPPORT SYSTEM Healthcare Solutions 12 May
24 Trend Analysis and Pattern Recognition The CDSS facilitates Disease Trend Analyses and also complex multi parameter correlation studies to be performed. CDSS enables the search for patterns among Clinical Data and this is an area that could substantially aid medical research in finding clues to the treatment for a multitude of conditions. 12 May
25 BI Solution Demo - Operational 12 May
26 Nursing Analytics MAIN Financials Staffing Quality Nursing Analytics MAIN Financials Staffing Quality Total Expenditure Staffing Amount -Current Month: $2345 -Current Quarter: $ Current Year: $27999 Expenditure Distribution Inpatient Staffing Staffing Amount Budget Variance Patient 140 Satisfaction 120 Staff Utilization Employee Distribution (FTE/Contract) Amount Budget Amount Staffing Amount Staffing Amount 100 Cardiology Medicine Orthopaedics Pediatrics Department Actual Vs Budget Staffing Cost 0 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Service Line profitability 80 Nursing 60 Analytics MAIN Financials Staffing Quality 40 Staffing Amount Nursing Analytics MAIN Financials Staffing Quality Employee Distribution (Qualification) 20 0 Employee Turnover -Patient-Nurse ratio -Avg Employee Turnover: -% Overtime: Staffing Amount Staffing Amount Staffing Amount 80 Jan Feb Mar Apr May Staffing Amount Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Infection Control Waiting times (top 5) Employee Satisfaction 0 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Staffing requirement trend 12 May
27 DISEASE SURVEILLANCE SYSTEM Healthcare Solutions Wide variety of reports are available in the system which favor the authorities a speedy and accurate decision making process A full fledged GIS System provides information down to the Village Level and a concentration map gives an immediate idea on where the fresh cases are occurring from. The Dynamic Reporting Engine permits instant decision making and facilitates data analysis and mining to an extent not generally possible with simple MIS systems. Over 1100 Centers across the State of Tamil Nadu have been brought on to a unified platform at minimal cost and the results are an example of what is possible in E- Governance. The Internal Messaging system facilitates instantaneous communication between the various stake holders, mgmt (TANSACS) and other entities who are involved in this mission. The system is supplemented with an interactive feedback / grievance redressal system where in the stakeholders or users could escalate the issues pertaining to the data collection, collation, reporting and other general issues. Detailed Audit trail is being maintained by the system. 12 May
28 DISEASE SURVEILLANCE SYSTEM Healthcare Solutions 12 May
29 Summary Technology has many of the answers. The Healthcare Industry needs to start using the available Technology Models need to be developed to make the use of patient friendly Technologies in Healthcare profitable. 12 May
30 Thank you! 12 May
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