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“Digitisation in healthcare is still in the blueprint stage”

Pradeep Saha, Senior Vice President – IT, Max Healthcare, talks about the changing role of technology in hospitals.

With over 28 years of extensive IT experience in the healthcare space, Pradeep Saha has seen the industry undergo a vast transformation in the last few years. He leads the development of the hospital information system, operations, project management, and security at Max Healthcare. Here he talks about how hospitals are grappling with digital transformation.

Please tell is a little bit about your role.
“I’m one of the founder members of Max Healthcare, which is a chain of 14 hospitals. I’ve been in healthcare space since 1989 and have seen hospitals transform from completely paper-based setups to digital entities. Our roadmap is to make our hospitals completely digital and harness the power of IT to provide quality healthcare.”

Can you take us through that journey from paper-based to digital?
“The healthcare world was never a standardised one. Even today, though we have lots of standards in place, we can’t say all of healthcare belongs to the same standard. In the early 1990s we were at level zero in standardisation. Healthcare was totally dependent on how a doctor wanted to manage his patients, cost of treatment, etc. Nursing and pharmacy were dependent on doctors’ orders. OT management was run by surgeons. They never thought to see how all doctors could talk the same language. When automation was introduced we started putting some standards in place. The system became transparent to hospital authorities and patients. It’s still not totally transparent or standardised today, but this is the paradigm shift taking place. It’s a slow process, and we will get there.”

Since hospitals are still getting their digital foundations in place, how are they dealing with digital disruption?
“This is being discussed in many of our conferences. Unfortunately, one hospital talking to another is something that has still not yet happened in India. There is no sharing of case studies, data that is considered to be highly confidential, and there is no rule or government guidance to bring about uniformity. For example, to ensure the discharge summary of all patients from all hospitals should look the same. Forget about talking between two hospitals, within a hospital different specialities have different of discharge summaries. For any automation or digitisation you need logic, for which you need data, and for that you need a standard protocol. And we’re still not there in healthcare. That’s why others industries are way ahead in digitisation and we are still in the blueprint stage.”

So how does a hospital make use of new digital innovations while still grappling with basic IT infrastructure?
“So IT plays two important roles. One is IT as IT, as security, data centre, network, IT policies, etc. This is hygiene; as an IT head I have to ensure that there is no downtime because of server issues, network issues, there is no breach of data. Now IT is also required to enable the business. Business has a gamut of requirements that they prioritise and IT has to make a roadmap and accordingly cater to them. IT analyses the technology available and has to give full support to business in these areas.”

What role does IT play in enabling business or profitability when it comes to hospitals?
“There was a broad statement given by the US that maximum patients die because of clinical error. That’s when Obama took the decision to have 100 per cent electronic health records. There are many types of clinical errors. I’ll talk about one example, where we have helped our hospital ensure zero medication error, which is otherwise 30 per cent. This technology that supports clinicians and nurses, and finally the life of patients, is called bar coded medical administration (BCMA). It is a huge game changer both in terms of life and revenue. Let me explain how this works. The doctor prescribes a medicine in the electronic health record, which is sent to the pharmacy where the right medicine and dosage are placed in a packet. The label is printed from the prescription so there’s no chance of misreading. The packet goes to nursing and then the patient. When administering the drug the nurse uses a computer on wheels (COW) to scan the barcode on the medicine packet and the patient’s wristband. BCMA does cross matching and confirms that this is the right medicine, patient, dose and the right time. If any of these five rights are missing then there is an alert. All these things put together have brought down medication error, saved patient lives, cured patients faster, and helped them get discharged faster, leading to faster patient turnaround on that bed for more revenue.

“Another way IT can help is by reducing the percentage of hospital acquired infections (HAIs). HAIs are hidden medical errors that lead to patient mortality. This data is available with hospitals because patients get this after admission. So hospitals can use technology to set up parameters/conditions that create prompt alerts for doctors and nurses. These alerts warn that a patient is liable to get infection if certain things are not done. This is how technology supports business to ensure that HAI percentage comes down leading to a drop in mortality rate.”

What are some of the challenges IT heads of healthcare companies face?
“They have to understand the pain a patient will face in OPD if the system does not work for even a minute. If you go to a bank and they say that links are down you’ll probably wait or come back. If you are standing in an OPD queue and are waiting for a bill or report and you’re told the system does not work, you will experience grief. This physicality is a challenge as no system is 100 per cent fool-proof. So the IT head has to ensure redundancies are built in to the system to help during these times.”

What are the skills a healthcare IT leader should have?
“Today, often CFOs work as IT heads; so IT heads should also start working as CFOs. They have to justify whatever revenue benefits technology is giving to the organisation. We need to know the company’s budget and targets, and see how technology can support and ensure revenue generation. We have to learn how to bring value to the business. This is a new aspect of the role, which we all have to understand.”

Do IT heads have a role to play in marketing as well?
“Marketing has a very good tool in CRM. The main challenge of marketing is to not only to retain patients, but to engage more patients, not just when they fall sick. To engage with them when they want to know about healthcare, diseases, hospital, doctors, etc. So how to convert these leads into patients tomorrow is where the CMO and IT head come together and interact to ensure the right technology is being used.”

How relevant are big data and IoT trends in the hospital vertical?
“Hospitals have still not yet come to the stage of big data. There is huge data but much of it is still not digitised; it is still not captured in a full blown manner. It can only give you first and second level MIS. Our challenge at present is to automate more, to ensure that we have enough data to come up with the right tools to provide direction to the business and the doctors.”

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