Tag Archives: EMR

Information Technology Orientation For Starting Hospital Administrators

3 May

Information technology and computer science tools are definitely the most rapidly growing segment of the world ecosystem. The development in the sector permeates every human activity; social, economic, cultural, religious, political, professional, personal and healthcare. Information technology has radically altered the way many people work and think. Information Technology has made a significant difference to the Quality and Standards of Life. Learning some of the common IT application an individual can carry out any activity of your work life simpler and easier.

There is a rising awareness about the need for better healthcare in India. The demand for healthcare is growing with the increasing affordability of Indian middle class, a new breed of patients have emerged with enhanced expectations for better quality of healthcare, both patients and doctors exposed to international healthcare setting demand more, number of insurance players playing a key role, net savvy population, more number of independent hospitals have made the healthcare market more competent and complex.

Over the years, technology has touched a new zenith and now it is not constrained to developed countries. Developing countries such as India have kept pace with the world in modern technology. Healthcare professionals can no longer disregard the application of information technology to healthcare because they are key elements for competing in complex healthcare competition.

The major component that can give an edge in terms of patient care and effective decision making is IT support. Today’s corporate hospitals compete on the basis of the technology with investment in it being the major benchmark.

Technology in healthcare has brought better therapeutic & diagnostics delivery of services,  integration to various components of large healthcare providing entity, very similar to that of any other sector like manufacturing and banking sectors. Healthcare IT has huge potential in India as the hospital are emerging, growing up and healthcare workers want to upgrade.

When a fresh post graduate with medical and non medical background entering in the market searching for a job in the healthcare administration side with little or no knowledge on IT, he has to be a part of  following job codes

Job code 1 He joins an ongoing cooperate hospitals that has an established IT infrastructure, enterprise wide software and a well integrated system. The hospitals have already invested heavily on IT applications and using them successfully, the expectations from a fresher to perform in the new setting are high. To deal with this situation the fresher should be oriented with basic operational domain knowledge as well as trained by application specialist.

Job code 2  When a fresh post graduate joins a hospital from the scratch (for a new hospital which is in the inception/ setting up stage). The fresh post graduate has to plan, coordinate, budget, execute, install, and train the employees, built an entire IT system for a new hospital for which he should have a sound knowledge of IT application in his post graduation as a core subject.

Job code 3 When a fresh post graduate joins a consultancy and suppose the consultancy is working on an IT project for an established hospital or a new hospital. The fresh post graduate has to work with IT vendors and make a decision regarding the IT infrastructure. He has to plan, budget, execute, install, and train the employees built an entire IT plan for a new hospital and act as a facilitator, catalyst as a change agent

Job code 4 When a fresh post graduate has mobilized enough funds to start his own hospital as the owner he has to make a  tough decision regarding  IT infrastructure .He  should know his budget, requirement and growth prospect .He can plan the entire schedule by himself or take the help of  IT consultant

Job code 5 This is the toughest of all the jobs codes, you are working with existing software and reported some modifications either want to add new features or replace it you have been assigned this duty to select , administer , execute, train, budget the entire program( he has to act as a change agent, motivate the staff and convince the management ). It is very risky. The individual may have little or no knowledge of new technology and application. The success of the project depends up on you which involves time, money and efforts.

What Are The Software Options?

As a fresh post graduate who is in the future going to be an administrator should understand few basic principals about IT software either to go for (Build software vs. Buy software) or (Make decision vs. Buy decision). This is the most important and curtail of all the decision of IT infrastructure.

If it is Make decision then it is development of software in house which follows SDLC (System Development Life Cycle)

If it is Buy decision then checking out your hospital requirements, listing out various vendors who supply readymade software product on contract basesevaluate their features, select the best from the available, install the software, train the employees with application specialist, have a backend support with vendor.

 

Basic Check List Elements

Check list 1    The first responsibility that the administrator has is to ensure is that the software which is being used has an End-User-Licensing-Agreement. It should not be pirated one

Check list 2 The administrator should instruct the IT manager to have all the detailed about hardware, software, number of computers, date of manufacturing, their warranty period, when was the annual maintenance contract renewal (AMC), when is it to be renewed and so on. This all should be maintained as a hard and soft copy.

Check list 3 The administrator should instruct the IT manager to have total control over the network, support your system with a good firewall which scans each piece of data that goes out or comes in, a good antivirus with daily updates with Malware and spam mail options, a sound multi-level authorisation to ensure what data is viewed only by authorised personal. Site-blocker software should be installed which blocks illegal browsing sites.

Check list 4 A sound backup and recovery program is very important. (Offsite backup is preferred).

Check list 5 Check the various insurance options for IT which include (Insurance for the entire hardware and software installed in the system and even the user is supposed to be insured. (If you are not aware of the insurance policy then hire an insurance broker)

Check list 6 Plan the IT– infrastructure by seeing the existing workload, technology up gradation etc. A definite amount of budget should be allocated to the IT- Manager. A maintenance budget and an operational budget

Check list 7 Regular training programs should be conducted for the new employees, as well as for the existing ones. Eemployee feedback should be taken about IT and evaluated by the administrator and IT manager.

Check list 8 An easy to navigate, light, perfect, interactive website or portal should be maintained by hospital IT-Department. This can be browsed on any browser.  All the employees should possess an Email for any form of internal communication.

Note: The document has not covered the technical details of various elements like firewall, backup, recovery, browser, portal, insurance broker etc

.

Syed Murtuza Hussain Bakshi

Associate Professor

Department Of Hospital Management

Owaisi Hospital and Research Center

murtuza_in21@yahoo.commurtuzain21@gmail.com

Mobile: – 09948662135

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Quality of health information on the internet – Indian Students Perspective

2 May
Authors:

Dr Birpreet, Dr Amarjeet Singh, Dr Manoj Kumar

Bhojia Dental College and Hospital,

Budh, Distt. Solan, Himachal Pradesh, India

E mail: docbirpreet@gmail.com

Learnings from Japan: National Health IT Networks are required

26 Apr

The past few days have involved almost all of us praying for Japan which was ravaged by a severe earthquake and tsunami. Japan’s most powerful earthquake in 140 years struck the north-east coast on March 11th 2011, triggering a massive tsunami leaving behind many homeless and stranded. (Information and Situation Report from WHO)

As we continue praying for hope in Japan, we are also learning all we can about how disasters can impact the way we live and seek to improve. Sadly, Japan now faces severe logistical problems and with the latest news on the mishap at a nuclear reactor, the situation only seems to be getting worse. While Japanese officials have more pressing issues on their hands, a problem that will arise as time progresses will be that those left alive may find themselves without their medical records. Natural disasters wipe out everything — including paper medical records as well as computer and communication networks.

In this time of national crisis, it would have certainly been helpful for Japan to have a robust Healthcare IT network in place. A collaborative one where it is easy to share data, which is securely backed up redundantly in multiple locations that would leverage geographical diversity as a means of countering nature’s unpredictability: Geographical Division Multiplexing if you please.

While Japan does have a Healthcare IT strategy setup, with benefits and stimulus funds, it is relatively new and yet to mature. Health data digitization and Electronic Record Keeping is still in its infancy. Japan does not boast of large scale Electronic Medical Record coverage.

Wouldn’t any country ride out disasters better with health data sharing in place? This should be taken as a wakeup call as well as a learning lesson by all nations which haven’t yet devoted time and money to setting up Nationwide Health IT Infrastructures.

India for one must be looking at learning from this.  Having a Nationwide Health IT Strategy should be treated as important as a Tsunami Alerting System (TAS). Purists will argue that a Nationwide Health IT System is not intended for alerting and helping contain situations like the TAS. And they are not completely wrong.

In many cases it has been observed that long term benefits are eventually forgotten. Instead, this concept of “Long Term benefits” must be replaced with Pre-planned Goals which must be “Sought” on maturity of a model.  Now, any system can provide a set of benefits directly on implementation, and an additional set when it has matured.

Similarly, the use case of using a Nationwide Health IT System for predicting and alerting requires a certain amount of usage at first.  A sophisticated and mature Nationwide Healthcare Network built using technology can identify the emergence of possible pandemics. Trends in symptoms can help identify risk areas, and collaborative diagnosis can help is sharing treatment plans and improving them.One must understand that if maturity of a network is required for additional goals and since that takes time, one must seek to implement early.

Links of Interest
WHO Page on Environmental Health in Emergencies
WHO page on Myths and Realities in Disaster Situations

Date: 26-04 2011

Author: Nrip Nihalani

About: Director, Plus91 Technologies (www.plus91.in). Healthcare IT and EMR company based out of Pune, India

You can read more of Nrip’s Articles at: wirelysis.blogspot.com

Medico legal and patient safety through information dissemination

15 Feb

Date: 15th Feb 2011

Author: Aditya Patkar

About: Marketing Head, Plus91 Technologies (www.plus91.in)

Why don’t Indian doctors use EMRs ?

18 Oct

Date: 18th October 2010

Author: Dr. Aniruddha Malpani

About: Medical Director, Malpani Infertility Clinic (www.drmalpani.com)

 

Why do Indian doctors continue practising in exactly the same way their seniors did 40 years ago ?

A major lacuna is the poor quality of medical records which most doctors keep. The medical record is the heart of clinical care – and yet it’s extremely poorly maintained in Indian clinics today. The majority of doctors do not even bother to store and keep their patient’s medical records – they just write down their opinion on their letterhead and hand it over to the patient. Usually, this is just a laundry list of tests the patients needs to do and a hand written illegible scrawled prescription – without even a mention made of the clinical findings or what the diagnostic impression is ! While it’s good that the patient owns his own records, what happens if the patient forgets to get his records for the next visit ? This creates a lot of frustration for the doctor, who berates the patient for his carelessness – but the damage is done ! Wouldn’t it make much more sense to keep a copy – and give one to the patient if he wants it ? Is this a lot of hard work ? Not anymore ! In the old days, one would have to make carbon paper copies or provide xeroxes, but using electronic medical records, this is now very easy to do !

Clinical care protocols are very similar in the US and in India. This is hardly surprising – after all, patients are the same the world over , and most will need the same kind of treatment. However, while most Indian doctors will provide exactly the same standard of medical care a doctor in the US does, why is there such a big difference in the way they keep medical records ?

In the US, every medical encounter is carefully documented ! Perhaps this was originally done for protecting against lawsuits for medical negligence; but today, the US government is making it compulsory for all US doctors to use EMRs – not just to improve the quality of care, but also to reduce costs ! Why don’t Indian doctors use exactly the same approach to documenting their clinical care ? Are they too busy to do so ? too lazy ? or do they feel it’s not important enough ?

Why do most doctors in India not bother to document their clinical encounters well ? Why is medical record keeping still shoddy and badly done in most practises ?

If Indian doctors understand the clinical importance of keeping good quality medical records, then why are they so reluctant to use EMRs ( electronic medical records ) ? In the past, it was true that PCs were very expensive; and that few doctors would afford them. Also, many older doctors were not very computer -literate; and the software programs which were available for medical record keeping were very doctor-unfriendly ! A combination of computer-unfriendly doctors and doctor-unfriendly software meant that most doctors were quite disillusioned with EMRs and were not willing to use them.

The good news is that things have changed dramatically ! Technology has improved; computers have improved; and Indian medical software companies such as Plus91 ( in which I am an angel investor) are realising the importance of mapping the doctor’s clinical processes and respecting his work-flow so they are now making EMRs which are doctor-friendly and which enhance his productivity !

So why aren’t Indian doctors rushing out to buy these , given the fact that they are inexpensive and can help them to improve the care they provide to their patients ?

Partly, this is because of the unhappy experiences doctors have had with Indian medical software in the past. It was the computer-savvy early adopters who were the first to lump on the IT bandwagon 10 years ago, to try to use computers to improve clinical care. Unfortunately, they burnt their fingers, which is why they are reluctant to try again.

As a consequence, most doctors do not know any one else who is using EMRs; and because they have little exposure to practise management skills during their training, they still do not understand the value an EMR can provide to their life.

Another major problem is that Indian doctors are not willing to pay for this. This is because they have been completely spoilt by the pharma companies . Because they are so used to getting everything free from pharmas, they are not willing to pay for anything at all ! This means EMR companies find it hard to sell their products – but if they do not generate revenue, how will they be able to produce good software ?

Please remember that your patients form the heart of your practise – and your patient’s medical records are worth their weight in gold. If you keep them carefully; update them religiously; and share them with him, you can show your patient that you have all his medical details on your fingertips. This will help to inspire confidence in your clinical skills . Patients will rave about how well-organised you are – and this word of mouth marketing will help you get more patients, as it differentiates you from other doctors.

Also, by keeping your patient’s records, you are creating a lot of patient loyalty and “stickiness” . If your patient is confident you know all about him because you have all his medical details, he is going to be very reluctant to switch doctors – after all, who wants all the hassle of explaining his medical history all over again to a new doctor ?

However , if you do not keep your patient’s records; and the patient has to start explaining everything which has happened to him every time he sees you, be is likely to lose confidence in you very quickly ! ( That doctor does not even remember my name – forget about my medical problems !)

Hospitals in India have started documenting medical care electronically; and boutique medical clinics and chains have also started doing so. This is very heartening progress – and doctors who do not start doing so soon are going to find they will start losing their patients to computer-savvy doctors ! You need to move with the times – or you will get left behind !

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