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HIMSS ASIAPAC12 CONFERENCE17-19 SEPTEMBER 2012 
MARINA BAY SANDS, SINGAPORE
STATE OF HEALTHCARE IT IN INDIAAMIT MISHRAEXECUTIVE MEMBER, HIMSS INDIA 
10/13/2012 
2 
©2011 Healthcare Information and Management Systems Society
India Healthcare Landscape 
•Public Healthcare Infrastructure 
•Public Health Programs 
•Private Healthcare Infrastructure 
•Demand Supply Gap 
•Complexity and Challenges 
•Growth Perspective 
•Healthcare IT Spending in India 
•The Way forward 
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©2011 Healthcare Information and Management Systems Society
Healthcare Infrastructure 
Private Healthcare Public Health Programs –GOI 
Public Healthcare 
Not For Profit Org / Other Healthcare Org 
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©2011 Healthcare Information and Management Systems Society
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States of India Number of Hospitals 
Mizoram,Nagaland,Pondicherry,Himachal,Manipur,Meghalya,Goa >10 
Orissa,Chandigarh,Haryana,Bihar 11-50 
Assam,Punjab,MP,Karnataka,UP 51-100 
Rajasthan,Gujarat,Kerala 101-200 
Andhra Pradesh , Tamilnadu,West Bengal, Delhi, Maharashtra < 200 
Source: Research Paper of Ramesh Bhatt and Nishant Jain, IIMA
Spending on Health 
10/13/2012 ©2011 Healthcare Information and Management Systems Society 6 
Health expenditure ratios a 
Member 
State 
Total expenditure 
on health as % of 
gross domestic 
product 
General government 
expenditure on health 
as % of total 
expenditure on health 
Private 
expenditure on 
health as % of total 
expenditure on 
health 
Out-of-pocket 
expenditure as % 
of private 
expenditure on 
health 
2000 2008 2000 2008 2000 2008 2000 2008 
USA 13.4 15.2 43.2 47.8 56.8 52.2 25.5 24.4 
Germany 10.3 10.5 79.8 74.6 20.2 22.0 54.8 53.9 
UK 7.0 8.7 79.3 82.6 20.7 17.4 64.6 63.7 
Sri Lanka 3.7 4.1 48.3 43.7 51.7 56.3 83.3 86.7 
India 4.6 4.2 27.5 32.4 72.5 67.6 92.2 74.4 
Source: WHO
10/13/2012 
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©2011 Healthcare Information and Management Systems Society The density of doctors per 10,000 populations in India is 6 as compared to the world average of 11.5, while the density of nursing staff in India is 13 per 10,000 as compared to the world average of 28.4. 
India is a signatory to the Millennium Development Goals (MDGs). 
World Health Organization report that India needs to add 80,000 hospital beds each year for the next five years to meet the demands of the population. 
The Urban and Rural Divide: Although about 70% of India’s population lives in the rural areas, it accounts for only a meager 15% share of the cumulative healthcare resources
Complexity and Challenges 
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©2011 Healthcare Information and Management Systems Society 
Rational Use of Drugs 
Inadequate accessibility to affordable quality services 
Low Government funding & lack of efficient execution of schemes & initiatives 
Shortfall in Health care infrastructure and Workforce 
Dependency on Paper Records 
Costs Continue to spiral
Growth Perspective 
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©2011 Healthcare Information and Management Systems Society
“Information systems at any McDonalds's are more advanced, and more useful, than those in your doctor’s office.” Fast Company –April 2006
Healthcare IT Spending in India 
10/13/2012 
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©2011 Healthcare Information and Management Systems Society 
Source :SHS
HIMSS India Study Highlights 
10/13/2012 
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©2011 Healthcare Information and Management Systems Society
The Healthcare IT …User Experience 
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©2011 Healthcare Information and Management Systems Society
Reasons of dissatisfaction 
•HIS is not user friendly as all systems are not fully integrated 
•Limited user interface and lack of customization 
•Outdated technology, unsatisfied with vendors, limited support 
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©2011 Healthcare Information and Management Systems Society
Barrier for Health IT adoption 
Lack of sufficient funds 
Lack of human resources 
Lack of strategic plan for computerization 
Return on Investment of computerization cannot be quantified 
Lack of clinical guidance 
Unsuccessful implementation of computerization projects 
Providers cannot meet requirement for products and services 
Lack of legal and policy support 
Lack of support from hospital administrators 
10/13/2012 
21©2011 Healthcare Information and Management Systems Society
Slow Adoption … 
Cost is an issue 
System is not ready and doctors and staffs are not willing to use HIS 
Lack of supporting infrastructure 
Hospital expansion 
Lack of IT literacy among Medical & Para-medical professionals 
Lack of Govt. determination to introduce HIS in hospitals 
Government policies 
Phase-wise implementation of HMIS in Govt. District Hospitals 
Training issues, lack of capacity building program for clinical staff 
Resistance of staffs 
10/13/2012 
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©2011 Healthcare Information and Management Systems Society
Suggestions…. 
•“Should be user friendly and staffs should be provided need based training” 
•“Hospital should go for Computerized HIS as early as possible” 
•“Sensitization of Doctors and staff to use the technology by using various medical professional association such as IMA, FOGSI etc” 
10/13/2012 
23©2011 Healthcare Information and Management Systems Society
The Way Forward… 
10/13/2012 
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©2011 Healthcare Information and Management Systems Society 
NEED OF HEALTHCARE IT STANDARDS 
NATIONAL STANDARDS FOR INTEROPERABILITY 
NEED OF A PUBLIC HEALTHCARE INFORMATION SYSTEM 
TASK FORCE FOR HEALTHCARE INFO SYSTEM 
IT TRAINING -HEALTHCARE PROFESSIONALS AT MED-schools 
THE EARLIER THE BETTER
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©2011 Healthcare Information and Management Systems Society
May be a UNIVERSAL ADAPTER 
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©2011 Healthcare Information and Management Systems Society
Standards and Interoperability 
•Standards provide a common language and set of expectations that enable interoperability between systems and/or devices. 
•“Interoperability” describes the extent to which systems and devices can exchange data, and interpret that shared data. For two systems to be interoperable, they must be able to exchange data and subsequently present that data such that it can be understood by a user. 
10/13/2012 
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©2011 Healthcare Information and Management Systems Society
Importance of Standards and Interoperability 
•Standards bring technological, economic and societal benefits. 
•Healthcare dependency on information 
•Benefits in figures 
•GBP 2.5 billion-annual contribution standards make to the UK economy 
•80%-percentage of world trade impacted by International Standards 
•AUD 100 million-benefits to Australian economy from sampling standards in the mining industry 
•84%reduction in transportation time due to standardization of container transport : source ISO 
10/13/2012 
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©2011 Healthcare Information and Management Systems Society
India’s Imperatives for Standards 
•Effective Management of limited Usable Healthcare Resources 
•Population > Data > Information 
•Languages and Dialects 
•Cost–having many differentcompeting ways of doing the same thing can becostly. Examples of this are the large number of different mobile phone power sockets; or where everycomputer supplier developed a list of allergies from scratch. 
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©2011 Healthcare Information and Management Systems Society
•Safety–for example specifying the minimum safety requirements for a baby car seat; or the safest way to present an allergy alert on acomputer screen. 
•Health Insurance 
•Medical Tourism 
•Measurement of health status, performance monitoring, and the achievement of national performance targets. 
10/13/2012 
30©2011 Healthcare Information and Management Systems Society
NEED OF A PUBLIC HEALTHCARE INFORMATION SYSTEM 
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TASK FORCE FOR HEALTHCARE INFO SYSTEM 
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IT TRAINING -HEALTHCARE PROFESSIONALS 
10/13/201234 
©2011 Healthcare Information and Management Systems Society
THE EARLIER THE BETTER 
•Need of Healthcare IT Standards Specifically designed for developing Country like India where the HIT is still in nascent stage. 
•Eliminate waste and duplication while ensuring that patient information is available at the point of care, eliminating unnecessary tests, enabling more informed decisions and improving the quality of care. 
10/13/2012 
35 
©2011 Healthcare Information and Management Systems Society
Better… 
•Telecom Industry India 
–Telecom Centers of Excellence 
–Development Organization of Standards for Telecom in India 
–Telecom Sector Skill Council 
•World’s Reputed Clinical Staff 
•World’s Recognized IT resources 
10/13/2012 
36 
©2011 Healthcare Information and Management Systems Society 
AneeshChopra: ‘There’s never been a better time to be aninnovator’
THANK YOU 
10/13/2012 
37©2011 Healthcare Information and Management Systems Society

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State of healthcare it in india

  • 1. HIMSS ASIAPAC12 CONFERENCE17-19 SEPTEMBER 2012 MARINA BAY SANDS, SINGAPORE
  • 2. STATE OF HEALTHCARE IT IN INDIAAMIT MISHRAEXECUTIVE MEMBER, HIMSS INDIA 10/13/2012 2 ©2011 Healthcare Information and Management Systems Society
  • 3. India Healthcare Landscape •Public Healthcare Infrastructure •Public Health Programs •Private Healthcare Infrastructure •Demand Supply Gap •Complexity and Challenges •Growth Perspective •Healthcare IT Spending in India •The Way forward 10/13/2012 3 ©2011 Healthcare Information and Management Systems Society
  • 4. Healthcare Infrastructure Private Healthcare Public Health Programs –GOI Public Healthcare Not For Profit Org / Other Healthcare Org 10/13/2012 4 ©2011 Healthcare Information and Management Systems Society
  • 5. 10/13/2012 ©2011 Healthcare Information and Management Systems Society 5 States of India Number of Hospitals Mizoram,Nagaland,Pondicherry,Himachal,Manipur,Meghalya,Goa >10 Orissa,Chandigarh,Haryana,Bihar 11-50 Assam,Punjab,MP,Karnataka,UP 51-100 Rajasthan,Gujarat,Kerala 101-200 Andhra Pradesh , Tamilnadu,West Bengal, Delhi, Maharashtra < 200 Source: Research Paper of Ramesh Bhatt and Nishant Jain, IIMA
  • 6. Spending on Health 10/13/2012 ©2011 Healthcare Information and Management Systems Society 6 Health expenditure ratios a Member State Total expenditure on health as % of gross domestic product General government expenditure on health as % of total expenditure on health Private expenditure on health as % of total expenditure on health Out-of-pocket expenditure as % of private expenditure on health 2000 2008 2000 2008 2000 2008 2000 2008 USA 13.4 15.2 43.2 47.8 56.8 52.2 25.5 24.4 Germany 10.3 10.5 79.8 74.6 20.2 22.0 54.8 53.9 UK 7.0 8.7 79.3 82.6 20.7 17.4 64.6 63.7 Sri Lanka 3.7 4.1 48.3 43.7 51.7 56.3 83.3 86.7 India 4.6 4.2 27.5 32.4 72.5 67.6 92.2 74.4 Source: WHO
  • 7. 10/13/2012 7 ©2011 Healthcare Information and Management Systems Society The density of doctors per 10,000 populations in India is 6 as compared to the world average of 11.5, while the density of nursing staff in India is 13 per 10,000 as compared to the world average of 28.4. India is a signatory to the Millennium Development Goals (MDGs). World Health Organization report that India needs to add 80,000 hospital beds each year for the next five years to meet the demands of the population. The Urban and Rural Divide: Although about 70% of India’s population lives in the rural areas, it accounts for only a meager 15% share of the cumulative healthcare resources
  • 8. Complexity and Challenges 10/13/2012 8 ©2011 Healthcare Information and Management Systems Society Rational Use of Drugs Inadequate accessibility to affordable quality services Low Government funding & lack of efficient execution of schemes & initiatives Shortfall in Health care infrastructure and Workforce Dependency on Paper Records Costs Continue to spiral
  • 9. Growth Perspective 10/13/2012 9 ©2011 Healthcare Information and Management Systems Society
  • 10. “Information systems at any McDonalds's are more advanced, and more useful, than those in your doctor’s office.” Fast Company –April 2006
  • 11. Healthcare IT Spending in India 10/13/2012 11 ©2011 Healthcare Information and Management Systems Society Source :SHS
  • 12. HIMSS India Study Highlights 10/13/2012 12 ©2011 Healthcare Information and Management Systems Society
  • 13. The Healthcare IT …User Experience 10/13/2012 13 ©2011 Healthcare Information and Management Systems Society
  • 14. Reasons of dissatisfaction •HIS is not user friendly as all systems are not fully integrated •Limited user interface and lack of customization •Outdated technology, unsatisfied with vendors, limited support 10/13/2012 14 ©2011 Healthcare Information and Management Systems Society
  • 15. 10/13/2012 15 ©2011 Healthcare Information and Management Systems Society
  • 16. 10/13/2012 16 ©2011 Healthcare Information and Management Systems Society
  • 17. 10/13/2012 17 ©2011 Healthcare Information and Management Systems Society
  • 18. 10/13/201218 ©2011 Healthcare Information and Management Systems Society
  • 19. 10/13/2012 19 ©2011 Healthcare Information and Management Systems Society
  • 20. 10/13/2012 20 ©2011 Healthcare Information and Management Systems Society
  • 21. Barrier for Health IT adoption Lack of sufficient funds Lack of human resources Lack of strategic plan for computerization Return on Investment of computerization cannot be quantified Lack of clinical guidance Unsuccessful implementation of computerization projects Providers cannot meet requirement for products and services Lack of legal and policy support Lack of support from hospital administrators 10/13/2012 21©2011 Healthcare Information and Management Systems Society
  • 22. Slow Adoption … Cost is an issue System is not ready and doctors and staffs are not willing to use HIS Lack of supporting infrastructure Hospital expansion Lack of IT literacy among Medical & Para-medical professionals Lack of Govt. determination to introduce HIS in hospitals Government policies Phase-wise implementation of HMIS in Govt. District Hospitals Training issues, lack of capacity building program for clinical staff Resistance of staffs 10/13/2012 22 ©2011 Healthcare Information and Management Systems Society
  • 23. Suggestions…. •“Should be user friendly and staffs should be provided need based training” •“Hospital should go for Computerized HIS as early as possible” •“Sensitization of Doctors and staff to use the technology by using various medical professional association such as IMA, FOGSI etc” 10/13/2012 23©2011 Healthcare Information and Management Systems Society
  • 24. The Way Forward… 10/13/2012 24 ©2011 Healthcare Information and Management Systems Society NEED OF HEALTHCARE IT STANDARDS NATIONAL STANDARDS FOR INTEROPERABILITY NEED OF A PUBLIC HEALTHCARE INFORMATION SYSTEM TASK FORCE FOR HEALTHCARE INFO SYSTEM IT TRAINING -HEALTHCARE PROFESSIONALS AT MED-schools THE EARLIER THE BETTER
  • 25. 10/13/2012 25 ©2011 Healthcare Information and Management Systems Society
  • 26. May be a UNIVERSAL ADAPTER 10/13/2012 26 ©2011 Healthcare Information and Management Systems Society
  • 27. Standards and Interoperability •Standards provide a common language and set of expectations that enable interoperability between systems and/or devices. •“Interoperability” describes the extent to which systems and devices can exchange data, and interpret that shared data. For two systems to be interoperable, they must be able to exchange data and subsequently present that data such that it can be understood by a user. 10/13/2012 27 ©2011 Healthcare Information and Management Systems Society
  • 28. Importance of Standards and Interoperability •Standards bring technological, economic and societal benefits. •Healthcare dependency on information •Benefits in figures •GBP 2.5 billion-annual contribution standards make to the UK economy •80%-percentage of world trade impacted by International Standards •AUD 100 million-benefits to Australian economy from sampling standards in the mining industry •84%reduction in transportation time due to standardization of container transport : source ISO 10/13/2012 28 ©2011 Healthcare Information and Management Systems Society
  • 29. India’s Imperatives for Standards •Effective Management of limited Usable Healthcare Resources •Population > Data > Information •Languages and Dialects •Cost–having many differentcompeting ways of doing the same thing can becostly. Examples of this are the large number of different mobile phone power sockets; or where everycomputer supplier developed a list of allergies from scratch. 10/13/2012 29 ©2011 Healthcare Information and Management Systems Society
  • 30. •Safety–for example specifying the minimum safety requirements for a baby car seat; or the safest way to present an allergy alert on acomputer screen. •Health Insurance •Medical Tourism •Measurement of health status, performance monitoring, and the achievement of national performance targets. 10/13/2012 30©2011 Healthcare Information and Management Systems Society
  • 31. NEED OF A PUBLIC HEALTHCARE INFORMATION SYSTEM 10/13/2012 31 ©2011 Healthcare Information and Management Systems Society
  • 32. 10/13/2012 32 ©2011 Healthcare Information and Management Systems Society
  • 33. TASK FORCE FOR HEALTHCARE INFO SYSTEM 10/13/2012 33 ©2011 Healthcare Information and Management Systems Society
  • 34. IT TRAINING -HEALTHCARE PROFESSIONALS 10/13/201234 ©2011 Healthcare Information and Management Systems Society
  • 35. THE EARLIER THE BETTER •Need of Healthcare IT Standards Specifically designed for developing Country like India where the HIT is still in nascent stage. •Eliminate waste and duplication while ensuring that patient information is available at the point of care, eliminating unnecessary tests, enabling more informed decisions and improving the quality of care. 10/13/2012 35 ©2011 Healthcare Information and Management Systems Society
  • 36. Better… •Telecom Industry India –Telecom Centers of Excellence –Development Organization of Standards for Telecom in India –Telecom Sector Skill Council •World’s Reputed Clinical Staff •World’s Recognized IT resources 10/13/2012 36 ©2011 Healthcare Information and Management Systems Society AneeshChopra: ‘There’s never been a better time to be aninnovator’
  • 37. THANK YOU 10/13/2012 37©2011 Healthcare Information and Management Systems Society