Wednesday, October 28, 2009

Regulating private healthcare Hospitals, Clinics Must Register, Follow Standards

Nirmala M Nagaraj, TNN 26 October 2009, 03:17am IST
http://timesofindia.indiatimes.com/city/bangalore/Regulating-private-healthcare-Hospitals-Clinics-Must-Register-Follow-Standards/articleshow/5161243.cms

BANGALORE: After three decades of lobbying, the private health sector had to finally give in. The final notification of Karnataka Private Medical

Establishment(KPME) Rules, 2009, has been approved by the ministry and has been gazetted in the first week of October. With this notification, now hospitals have to register and maintain the standards as outlined in the notification. The rules are aimed at regulating private medical establishments, including clinics, diagnostic centres and alternative medicine centres to ensure that people get quality healthcare. The new rules stipulate minimum standards in terms of physical infrastructure, technical know-how and staff qualification to set up a private healthcare institution. More importantly, the rules will make it mandatory for private hospitals to display the rate charts. The rule covers all forms of medical practices __ from allopathy, ayurveda, unani to homeopathy. The efforts to regulate private medical establishments in the state began in 1976. Health and family welfare deputy director H C Ramesh said: "Due to lot of pressure from the private medical establishments, regulation was delayed for more than three decades. Now, with the gazette notification of the rules, the Act will be implemented in the state.'' Though there is a list of Karnataka Medical Council-registered doctors, the actual numbers are not known. This was evident during the recent chikungunya and H1N1 flu outbreak __ lack of list of private medical practitioners affected the disease-prevention programme. WHAT DOES IT MEAN? For registration which is mandatory, all private medical establishments __ from clinics to hospitals __ should ensure clean and hygienic surroundings, proper lighting, ventilation, adequate/hygienic sanitation facility, proper maintenance of medical records, standard bio-medical waste disposal system, accessibility to attending doctors and qualified staff appointed in proportion to number of patients treated in a day. REGISTRATION While the registration fee under allopathy for medical clinics is Rs 1,000, a nursing home with more than 2,000 beds has to pay registration fee of Rs 2 lakh. There is concession in fee for charitable and non-profit hospitals. For alternative Indian system of medicine, it is Rs 500 for clinic and dispensary, Rs 2,000 for hospital with 20 beds and more and Rs 10,000 for diagnostic centres with advanced facilities. The registration is valid for five years. Hospitals have to be registerd within 90 days from the date of the Act coming into force. At the district level, a regulatory committee is formed. It comprises deputy commissioner, district health officer and an Indian Medical Association member. STANDARDS From comfortable seating arrangements for patients in reception to examination room having minimum area of 125 sq ft and consultation chambers equipped with basic investigation facilities, standards have been set for the hospitals. "There are several hospitals functioning without basic infrastructure and medical equipment and there are several hospitals functioning without qualified staff. So, we have listed mandatory basic equipment and required qualified hospital staff. Private medical establishments have to display charges to all the services rendered," said health and family welfare deputy director H C Ramesh. QUOTE HANGER We are glad to have KPME rules as this will check quacks. With registration made mandatory, we will get to known as to how many private medical establishments are there in the state. __ Karnataka private hospitals and nursing Home Association vice president P S Premnath There is need for regulation as the environment of accredited healthcare promises patient safety. And the rules need to facilitate reform in the healthcare sector and should be covered by good governance for efficient implementation. __ Wockhardt Hospitals Group CEO Vishal Bali It is a welcome move as the rules will bring in quality, standard and accountability in healthcare. Along with patient safety, it will stop mushrooming of private hospitals without proper infrastructure and staff. It will assure quality players in healthcare sector. __ Manipal Hospital COO and Medical Director Dr S C Nagendra Swamy.

Tuesday, October 20, 2009

Why does healthcare cost so much

Abstract: We try to understand the nature of spending in healthcare. We will uncover alternativse to rein in the inflationary trend.

I. Background
Over the last several decades, healthcare spending in the USA has steadily climbed. Although several attempts have been made to restrain the trend, none so far (regulation, public programs, voluntary effort by insurance companies, market competition) has had a lasting impact. The problem of healthcare spending is not a singular one and hence does not have a single solution. Unless the challenge is addressed comprehensively, we will continue to see symptomatic and short sighted reforms.
II. Who Pays
Most people believe that it is the government, employers or the business that pays for the healthcare. In reality, it is the individual who eventually pays all and any form of healthcare expense. Following are some of the ways:
· Employers don’t give healthcare benefits as they claim. They merely set aside a part of employee compensation (Cost to Company) to pay for the health insurance premium.
· Government collects taxes and funds its Medicare and Medicaid program. It is uses a number of channels like
o Income tax - FICA (Federal Insurance Contribution Act), Federal Tax, State Tax (not applicable in Texas)
o Sales tax – controlled by states on goods and services purchased.
· Patients pay additionally through deductible, copayments and other out of pocket expenses
III. Why does it cost so much
A brief analysis of soaring healthcare expenditure is presented below.
· In a typical care transaction, the consumer of medical services is not the payer. The patient does not know the cost of an episode of care and hence does not care. As a result the patients have no interest to monitor their spending or to maintain their health through preventive care programs.
· Patients want the best and the latest and not value-for-money. When it comes to healthcare, less expensive medical services or drugs are often perceived to be of inferior quality.
· Multi-payer system builds in inefficiencies and cost (claims processing, management overhead, and administration) that translate to higher premiums.
· Medical innovation raises cost of care. America is responsible for leading the majority of the medical innovations and path breaking research for the rest of the world to follow. However when new procedures and medicines are invented, the companies try to recover the cost of the innovation through high pricing. When patients want the most advanced medical care available, they land up paying more. The pharmaceutical companies charge more for their drugs in America. There are 3 reasons to it
o Novelty factor – The new drugs are marketed only in America for the first few years and are aggressively promoted.
o Drugs patents lead to market monopoly and high prices. There is no government control in determining the market price for the drug.
· Healthcare is a “superior” good. It means that those who can pay higher premiums demand disproportionately higher levels of care. Senior executives in Goldman Sachs who have $40,000/year “Cadillac” plans will demand five star hospital suites and state of the art services. However we must examine the rationale of providing the same level of care/luxury (not to be mistaken with outcome of care) to those having simple $8000/year insurance plan.
· A significant part of the national health expense is due to an aging population (Baby boomers) who have greater episodes of care and greater number of co-mobilities (meaning more complications and more cost of care).
· The uninsured either utilize emergency services or postpone their treatment. Using trauma centres to address routine illness is expensive for providers. They recover this cost by charging their insured patients more. Postponing medical care eventually leads to complication and warrants more expensive care being required in the future.
· Shifting care. Medical care has shifted from primary physicians to specialty caregivers and from in-patient to out-patient setting. Both have ramifications. Specialty care givers charge higher fees for the same service that could have been provided by the primary care physician. They will also be inclined to recommend higher number of high end test and procedures. With rising demand for out-patient services caregivers have invested in infrastructure and facilities. This cost is reclaimed through inflated fees.
IV. What may be our position to rein in cost
Each point in the previous section may be looked in greater detail for areas of improvement. For this paper we will focus on some of the most important ones.
· Empower primary care physician to treat patients for more medical conditions. Incentivize caregivers to keep patients healthy and not make money through a barrage of tests. Resolve the inequality in the number of primary care physicians and specialists. Put moratorium on building new speciality units.
· Encourage consumers to get value-for-money treatment and drugs. Encourage Health Savings Accounts (HSA). Mandate employers to put their contributions to the HSA and not combine it with the compensation. Exempt taxes for contributions to HSA. Get individuals to be aware of how much their cost involved in each episode of care.
· If insurance is mandatory, then allow the insured to purchase plans that where they will decide how to spend the indemnity value (how much for inpatient, drugs, dentist, diagnostics etc). This will motivate people to seek insurance and spread the risk. Regulate insurance sector to become not-for-profit. Mandate the insurance to do away with pre-existing conditions and denial of care.
· Regulate the drug companies by fixing price of drugs. Offer patents only for radically new drugs - the ones that enhance the quality of life significantly and not those that are mere alterations at a molecular level causing marginally higher benefits than an existing or substitute drug.
In sum, healthcare cost a result of interplay of several factors and must be dealt with holistically.

Friday, October 2, 2009

Issues with employer based health insurance

Abstract: We try to understand why current healthcare system threatens to crush the employer based insurance in the context of the changes in the industry. The brief gives the pros and cons and some suggestion as to what can be done to put it back on course.

I. Background
Modern employer based insurance emerged as a fringe benefit during the Second World War when the government implemented wage and price controls in private industries. It went on to become a dominant model of US mode of healthcare finance when the government allowed companies to get tax deductions for the expense of paying for insurance premium (IRS provision). The government did not tax the employees for receiving the benefit but the taxpayers were not allowed to deduct the cost of insurance if they got it on their own. The largest decline in the employer based health insurance was seen since the 2000s. However, even today, when employer based healthcare is under criticism, a high percent of the working individuals in the private sector are offered some form of health insurance financing through their employers (around 160 million people, 60% of the under-65 population).
II. Milestone legislation
Some key laws passed in the pass that were relevant to the employer based healthcare
· ERISA (Employee Retirement and Income Security Act) which did not mandate an employer to offer health insurance but instead regulated their plan only if the employer chose to provide one. A provision of this law allowed employers to escape state regulations and allowed them to directly pay for health benefits through self insurance. Self funding reduced employer overhead. It however undermined the broad risk pooling (A practice of pooling large number of people for health insurance plans which facilitated inclusive, inexpensive coverage). Smaller employers looked at the notion of consortium using MEWA (Multiple Employer Welfare Arrangements). This had the inherent risk of employees leaving the cooperative and causing an adverse selection bias.
· The proposed Health Security Act was perceived to be extremely complicated and government intrusive and was not passed. However, it gave rise to the idea Medical Savings Account. Along with variants like Health Reimbursement Account and Flexible Spending Account, these allowed for the employees to manage their own insurance accounts with some restrictions.
III. Employer Challenges
Healthcare has changed in terms of how much the medicines cost and how much it can do.
· Rate of rise in healthcare spending has outpaced the rate of rise of income, productivity and inflation.
· Advances in medical technology and drugs have given the ability to combat diseases and conditions (especially heart disease, cancer and stroke). This along with decline in tobacco use and increased cholesterol awareness has led to higher longevity.
· An aging population with higher episodes of care result in higher healthcare spending
· The insurance cost that was about 2 % in 1960 is now more than 10% of the compensation and the employers have to grapple with that reality.
· The healthy and young, working age population is opting to not have insurance reducing risk spread.
· Group premium is based on the claims experience – that is, the health history — of just that small group of employees. This is a nightmare for small companies.
IV. Employer Response
The employers had relied on managed care to keep the cost of healthcare down. Later they pulled back from it and shifted their efforts on imposing more cost sharing on individuals and creating plans that involve more management of disease and conditions. This included higher deductible, higher copayment, payment incentives to insurers for preventive care and disease management. Clearly these strategies have failed and the system is badly bruised.
V. Pros and Cons
· CONS of employer based insurance
o Can't move your insurance around. Locked into jobs that people may not necessarily want to keep.
o Employees can't see the stresses on the health care system because the employer is paying the premiums.
· PROS of employer based insurance
o Employer gives you a risk pool to buy into. Not rejected for pre-existing conditions or poor health.
o Employer contracts out with insurers, offering more choices, at a lower price, and with an administrative buffer - an HR person to turn to if the going gets rough.
o Employer offers an easy, centralized access point to the system. and give individuals a way to pool their purchasing power for better prices and treatment
o Lead the spread of wellness and prevention-focused programs, the management of chronic diseases, and the use of incentives to medical providers for better performance – these elements are not found in public programs like Medicare and Medicaid, which focus on reducing payments to providers
VI. Alternatives and Conclusion
We need not create a new world order but an intelligent restructuring and realignment of employer provided insurance.
· Health insurance “connector/exchange” that will match buyers and sellers, collect premiums and bill employers.
· Promote consumer directed portable health savings or reimbursement accounts. This allows employees to be informed about the cost of the healthcare. Alter the perception that health care costs only $10, (Copayment).
· Mandate employer based healthcare. Companies stand to benefit from a healthy workforce. Mandate preventive care programs via employers.
· Mandate health insurance for all citizens and legal immigrants to broaden the risk pool and bring the cost of healthcare down. Healthcare cost must be shared reasonably between employer and employees
· Have equitable insurance premiums based on ability to pay and demographics.

Thursday, October 1, 2009

Health IT spending in India

The article is from expresscomputeronline.com... good read
http://www.expresscomputeronline.com/20090907/expressintelligententerprise05.shtml
Vertical Focus
Focus On: Healthcare
N Geetha examines the business challenges faced by CIOs in the healthcare vertical and looks at how technology is being used as an enabler.
Escalating growth immunities
Arpan Gupta Principal Analyst, IDC
Thanks to various government stimulus packages in the offing, the healthcare vertical is poised for growth. Arpan Gupta, principal analyst, IDC India stated that the turnover of this industry vertical was Rs 150,000 crores and that it was expected to grow at a CAGR of 20% over the next five years. Urban areas are showing a growth curve, while the rural sector is yet to show momentum in the healthcare sector. However, derivative industries such as healthcare insurance, healthcare services and equipment manufacturing companies are growing strongly.
A report from Technopak Advisors, an independent research body, found that healthcare which was a $35 billion industry in India, was expected to reach over $75 billion by 2012 and $150 billion by 2017. Confederation of Indian Industry found that with this sector growing in a linear fashion and that the demand for hospitals and beds was on the rise. Investments to the tune of $50 billion are expected to be made annually for the next 20 years. The stimulus package by the government as part of its National Rural Health Mission program, which allocated $2.42 billion in its recent interim budget, should drive the healthcare industry in a positive direction.
Another indication from a recent study done by FICCI along with Ernst & Young spotted various opportunity areas for investors in the healthcare sector including medical infrastructure, which would call for an investment of $77.9 billion and medical equipment that is projected to reach $4.97 billion by 2012. Clinical trials are on track to become a $1 billion industry by 2010 while the health services outsourcing sector was expected to grow to $7.4 billion by 2012. Healthcare vertical CIOs are aligning their strategy with the growth of their industry and organization. For instance, Suresh Shenoy, CIO of Wockhardt finds aspects such as economic upward mobility, overall structured healthcare awareness, healthcare insurance penetration, growth in population in general and patients from overseas etc., fuelling growth. "Wockhardt Hospitals witnessed an overall growth of 25% during fiscal 2008-09 and we have set a target of 25% for 2009-10," pointed out Shenoy.
Focus on: Healthcare
Top business challenge: Constrained budgets, growing demand for healthcare facilities, disparate IT solutions, lack of skilled labor and the need for quick turnaround time in order to offer better care to patients
Solution: Focus on advanced IT tools, increase workflow efficiency and improve resource management
How it can help: Healthcare Information Systems (HIS), Clinical research trials tools, EMR, PACS, telemedicine, collaborative tools are some of the IT solutions that are available for this sector
Manish Gupta, CIO of the Rs 100 crore Health Care Global Enterprises Ltd. (HCG), the cancer care provider, viewed healthcare's growth as having a fixed component, which was recession and disease proof and a variable part that depended upon doctors, population, disease breakouts, lifestyles etc.
According to Gupta, the factors that were propelling this sector's growth included individual awareness, collective decisions on healthcare, government push, micro-insurance schemes, public private partnerships etc.
Dr. R S TyagiDeputy Director & Head - Computer Facility, AIIMS
HCG clocked 25% organic growth during fiscal 2008-09 and it has a 40-50% revenue growth target with at least 30% growth in margins targeted for 2009-10. The encouraging factor that Dr R S Tyagi, deputy director & head computer facility of All India Institute of Medical Sciences observed that it was the government's drive towards making existing hospitals into super specialty units, which would result in the extensive use of IT infrastructure.
As for growth, Dr Tyagi maintained that the hospital had been provided with additional land and financial resources to open a second campus on 350 acres of land.
Srikanth Raman, CIO of the Bangalore-based Narayana Hrudayalaya expected explosive growth for hospitals with more facilities coming up in Kolkata and Jamshedpur. "Currently we have a 500 bed accommodation in Bangalore and have a target of going up to 30,000 beds soon," said Raman. Ricky Bedi, CEO of Bangalore-based Teleradtech, the technology arm of Teleradiology Solutions, found that the industry was growing at 15% and that there was an upward movement that would result in hyper-growth of almost 200% within a couple of years.
CIOs opined that it was time to pull up their sleeves in making IT the critical component of the anticipated growth. So far, IT has not made sufficient inroads in this vertical because of the conservative nature of the industry.
Under pressure
Suresh Shenoy CIO, Wockhardt
While CIOs across industry verticals are challenged over how to align technology with growth, CIOs in the healthcare sector face the challenge of convincing the top management that technology can be an enabler for driving business. The adoption of advanced IT tools has been minimal in this sector barring a few top medical institutions. Cost is obviously the deterrent here.
Bedi observed, "My greatest business challenge is to bring down the cost of, and optimize the quality of, care. The end goal is customer satisfaction irrespective of what impact my workflow automation creates."
"How do I evolve the best integrated model for better patient information using any technology, that is the challenge," he added.
The crucial challenge for Narayana Hrudayalaya's Raman was the question of putting in place an effective communication process about the ethos of quality care within an organization.
"Given the various applications that run in isolation, the challenge is to have a central infrastructure, and to have a real time information flow," said Raman.
It would be strange to find that, across the healthcare institutions, IT is not looked upon as a catalyst for growth. If an investment is proposed for some IT deployment, the management looks at opting for fresh medical equipment rather than IT.
IDC's Gupta found that CIOs in this industry vertical were burdened with increased overheads, the imperative to ensure quick turnaround time for treatments and constrained about going beyond the basics of IT.
Wockhardt's Suresh Shenoy felt that there was great pressure owing to the slowdown.
"Growth-related pressure is on two accounts, one is that the existing IT infrastructure needs to give a better RoI against major limitations and the second is the need to invest in additional IT systems. Balancing the two is difficult," maintained Shenoy.
The critical business challenge for Shenoy was to capture every small cost at the point of delivery given the complex cost structure with lots of shared services. Shenoy found that activity-based costing such as evaluating which product or service offering isn't easy to do.
While Dr. R S Tyagi did not see growth as a challenge with more funds coming into the fold, selecting a stable solution provider to work on consistent basis streamlining the entire IT infrastructure remained his biggest challenge.
HCG's Manish Gupta's key challenge is always whether the patient or the payer (insurance, government, or employer) is willing to spend for early detection, preventive care, and new technology.
Gupta's other challenge internally was to ensure quick turnaround time in the hospitals. From a technology point of view, he opined that most institutions found sourcing care protocols-based software, mobile phone-based care delivery and tele-health care etc. to be a tough task.
Despite the challenges and priority constraints, CIOs have managed to add the required IT services into their portfolio to drive demand.
IT in Vogue
Ricky Bedi CEO, Teleradtech
Bangalore's Teleradtech has seamlessly integrated radiology with IT to providing consultancy services to hospitals, diagnostic centers, customizing, deploying, maintaining and supporting the PACS (picture archiving and communication systems) and RIS (Research Information Systems) solutions.
Bedi has deployed medical information systems, health information systems and an in-house developed instant messaging system while ensuring that redundancy is built in.
"It was imperative to ensure that the technology improve the workflow within the organization," maintained Bedi. Bedi went in Smartris.Net, a Web-hosted RIS platform with integrated PACS and billing system on a unified database, supporting a RIS-driven workflow.
While facing the integration-related challenges with no standardized process, Bedi is focused on creating a platform with collaborative tools such as unified communication to integrated and enable the active use of EMR and Lab management systems by its clients. By deploying these applications, Bedi ensured that the productivity of radiologists improved, enabled single system access for patients, reduction in resource consumption and overheads for managing the workflow, besides easy maintenance and quick turnaround on implementation changes owing to the configurability of system.
While there have been few accounts of IT deployments at Narayana Hrudayalaya, Raman said that applications such as HIS and ERP were used to scale up operations. While retaining the IT team was a challenge, most of it had been developed in-house.
The biggest implementation had been with regard to HIS software sourced from a Mumbai-based company and Raman had deployed Tally as a backend for accounting purposes. The hospital's IT spend would be less than 1% of its total revenues this fiscal. It has tied up with 250 units as part of its telemedicine initiative to provide quick care to the patients.
According to Dr Tyagi, AIIMS planned to allocate Rs 20 crores towards IT for 2009-10. So far, the major expenditure had been on security, networking and infrastructure. The institution has an internal LAN that hooked up 1,500 odd systems within the campus and IT is used for basic e-mailing. For its other premises, it is connected through a 42 Mbps WAN from ERNET.
Dr Tyagi and his 20-member team's priority has been to computerize the hospital. The applications currently being used at AIIMS include library information, patient registration, diagnostic information, billing, accounting, publishing of literature and other departmental systems.
"We have been using security gateway solutions from Cyberoam as well as Microsoft and Novell operating systems," remarked Dr Tyagi.
AIIMS has been using telemedicine and more than 300 locations are connected to 500 experts.
The Oncology specialist, HCG's Manish Gupta, did not take IT spend on desktops, servers, security and applications, which were anyway mandatory, into consideration. "Our spend covers medical equipment interfaces, custom developed hospital system, disease treatment protocol software, video conferencing, tele-radiology, medical image archival, IP based alerts/alarm instruments, unified communications, and of course the "backend" financial/inventory systems."
Gupta maintains that part of building automation and mobile phone-based spend is also managed by IT and technologies related to embedded systems, RFID and nano-technology is generating interest in healthcare IT.
Gupta argues, the IT spend is highly variable, but a minimum of 1% of revenue is spent and a lot depends on the size of hospitals and interconnectivity needs that, in turn, depends on the level of interaction between physicians.
EMR has helped the doctors and the management effectively. A lot of spending has gone towards clinical research and trials and HCG has deployed business intelligence to capture accurate data for analytical reports. Gupta said that the key business were deploying software related to care protocols, mobile applications, tele-health including teleradiology, tele-diagnostics and tele-medicine.
"HIS is the basic need for all the healthcare has been developed in-house," said Gupta.
Given the economic slowdown, Wockhardt's Suresh Shenoy witnessed pressures on spending as every penny spent needed justification. 2008-09 saw spending towards telemedicine, PACS, RFID, CRM and integration of medical devices and equipment to deploy a central HIS at Wockhardt.
Shenoy and his team focused on deploying Wipro HIS ERP, developed on Microsoft SQL Server to cater to the complete business process at each hospital addressing various functionalities like delivery of care, labs, pharmacy, blood bank services, IP and OP billing, procurement, movement and consumption of materials. "There are about 30 modules, all of them tightly integrated online."
According to Shenoy, while HIS is locally installed at each hospital site, its financial summary in terms of payments, receivables, and GL is captured globally through Oracle Financial ERP as HIS is integrated with this to create a dashboard.
From an infrastructure point of view, Shenoy has gone for a high-end server with cluster management and fault tolerant WAN connectivity, connecting all of the hospitals over a MPLS VPN that is part of Wockhardt's global network.
The other areas of deployment at Wockhardt included centralized Internet access security enforcement, biometric physical access control and integration with the attendance system, while Lotus Notes messaging was in vogue. For each reach, Shenoy opted for digital wireless telephony at hospitals.
Shenoy saw the benefits of integrating disparate systems, medical equipment resulting in labor effort savings and increased accuracy and better delivery of care to customers.
2008-09 has been slow for most CIOs amidst stringent spending criteria, the current fiscal seems to be an exciting time.
IT Outlook
2009-10 could turn out to be a great deployment year for most CIOs in this sector. "Peer to peer collaboration is critical to address the demands effectively," said Bedi.
According to him, video conferencing, VoIP and the use of medical transcription were key to address business needs.
The key agenda that Raman would carry out would be to identify waste areas where costs could be trimmed using IT as a tool.
"My aspiration is to evolve a system where I can communicate to customers about our specialty offerings and services in an effective way with the use of IT," maintained Raman. "Since our growth plans are big, we would invest on IT, and the immediate need is to create a dashboard for providing real-time information using varied applications," he added.
Raman and his team are evaluating the possibility of outsourcing and deploying varied applications to suit their needs.
Dr Tyagi's agenda is to go in for a outsourcing model with a consultant suggesting varied applications and driving technological innovation at AIIMS.
"As we are getting ISO 21000 certification, it is mandatory to get the best security systems and applications which can increase our operational efficiency," remarked Dr Tyagi.
Gupta's thrust would be to deploy technologies that help the institution in the early detection of patient problems.
'I aspire to streamline operational processes in healthcare providers that are often ignored and unlike other industries, technology can build new business or customer base in hospitals," averred Gupta.
Gupta is keen to drive mobile technologies for his care providers (doctors, nurses, and I would even include patient's families) who are always short on time.
Mobile diagnostics is the focus area for HCG, besides Gupta aiming at building a model around imaging software integrated with SAP modules. "We would go in for varied modules from SAP and tweak it to our needs," said Gupta.
With some relaxation in IT spending during this fiscal, Wockhardt's Shenoy intends to align IT strategies with business strategies in a more efficient manner to make IT the major driver and a profit center.
While agreeing that IT penetration in the healthcare sector has been minimal restricting to basics, IDC's Arpan Gupta finds that the IT spend during 2008-09 had been to the tune of Rs 700 crores, which is likely to increase in this fiscal.
The popular solutions deployed include integrated billing systems, PACS, SOA to a certain and virtualization with a focus on telemedicine.
Cashing in on trends
As a technology trend, IDC's Gupta found that the evolution of subsidiary industries such as healthcare insurance, medical tourism, outsourcing and consulting services as the demand for healthcare is growing.
Besides this, from the IT infrastructure and applications point of view, Gupta found growth in networking, peripheral industry, software services and e-prescription applications and so on as the need for IT was growing amongst healthcare institutions.
Raman was keen on outsourcing and he expected health care insurance providers to drive the growth for IT as it involved effective communication.
Gupta expected that technologies related to teleradiology would be aspired for as there was a growing demand for this expertise, but there was a shortage of this community.
Dr Tyagi saw the deployment of storage and server consolidation on the rise with more data coming into the fold.
From a growth perspective, Wockhardt's Shenoy bet upon telemedicine, PACS, Integrations of Medical Equipment, ABCM (Activity based Cost Management) solutions which would be predominantly deployed across healthcare institutions.
With the Union Health Ministry mooting a proposal to set up a series of 'Medical Parks' all over the country to enable domestic health industry to manufacture health equipment at large scale, growth is assured. Besides, to encourage indigenous manufacturing, special economic zones have been initiated to make the industry competitive and regulate the market.
geetha.nandikotkur@expressindia.com

Health Management in India

http://www.ihmr.org/ - Institute of Health Management
http://www.iphindia.org/joomla/index.php - Institute of Public Health
http://www.who.or.jp/sites/bangalore.html - WHO, Bangalore
http://cghr.org/aboutcghr.html - Center for Global Health Research
http://www.hispindia.org/ - HISP India
- PHFI Newsletter
http://www.epos.in - EPOS India