Manish Ved, Director-Systems, Bombay Hospital Trust, on how technology will transform the healthcare space. By Satyaki Sarkar
During his 31 years in the IT industry Manish Ved has held a number of diverse roles. From being in charge of the computerisation of the accounts department to Assistant Head –IT at Camphor and Allied Products Ltd, to becoming the Assistant Manager at Bombay Hospital, before taking over as its Director-Systems, Manish has had extensive experience dealing with and adapting to the changes and developments in technology.
He’s seen new programming languages replacing others, new operating systems being developed, and a whole horde of other technological overhauls. This has given him a unique perspective on the workings of the technology world, the difficulties that plague it, and the possible changes to expect.
Smartphones will soon replacing computers
“As far as the new trend is concerned, everything is going mobile, so the goal in the hospital industry is to make everything available at the fingertips, of the patient as well as the doctors and management,” says Manish. “A few years ago the computer revolution took place, bringing with it an exponential growth in the computing and processing power of computers; now the move is towards mobile phones. Smartphones are the thing of the future, and very soon will probably even replace computers, with the unprecedented amount of processing power and vast functionalities that they will have. Today a patient likes to consult a doctor sitting in his/her work place or at home for small ailments. They prefer to make an appointment through apps rather then routing themselves through hospitals EPBAX or through the doctor’s secretary. They want their medical history to be portable and stored in an electronic format so that they can carry it wherever they want rather than carrying bulky papers and films. Hence it is necessary to adopt changes as per the changing needs of patients. There are hospitals that are rapidly changing and moving towards digitisation and patients need. But hospitals/nursing homes are doing it in their own way and in different formats.”
Finding the right medium for flow of info
“The biggest challenge we faced till now was to find an effective and efficient way of providing important and necessary information to management, doctors and patients on their fingertips. As far as patients are concerned, we are still working on it. However, when it comes to management and doctors we have almost completed it. We have developed an app that management can use to access all the information they need, with just a click. You get online information about number of beds that are currently occupied, vacant beds if any and their allotments, admission turnover time, number of admissions that have taken place on a daily, monthly, and yearly basis, the surgical turnover, number of complex surgeries performed, utilisation of OT complex and various diagnostic departments, revenue generation, consumption of patients consumables, like heart valves, hips, knees, etc. It also includes equipment downtime, bifurcating it as partial or total, and financial year-wise downtime of A class equipment to levy operational penalties if any. All this data is online and is accessible to management from anywhere using a mobile phone.
“Doctors get ward-wise information of their admitted patients and selective bi-directional reports of the patients on their mobile. We are adding nursing care and ICU modules to the same.”
Working together as a whole
“The involvement of top management is crucial for a CIO to be able to perform his functions to the best of his capabilities. Decisions like whether certain information is to be available only online and without the involvement of any kind of paperwork has to be taken by upper management. Once the approvals and red tape are dealt with, the job of a CIO becomes a lot easier. There are a number of departments that are involved, including Medical, HR, Biomedical, Purchase, Stores, Finance, and so on. In short, unless the entire organisation works together and speaks a common language, the goals are not going to be achieved. So the main challenge is to create a template through which understanding becomes very easy, and everybody is on the same page. Cross committees are to be formed for exchange of information and SOPs, practices and processes needs to be defined because the more you communicate the more research can be done and knowledge gained, thereby making work a lot easier.”
“The next step should be completely integrated systems and a centralised database server for patient record. That is still a long way away because before implementation of any transformation, the decision/ruling has to come from the top, ie government. All hospitals, nursing homes should be asked to follow certain guidelines, protocols and rules that one has to strictly follow. From the patient’s prospective there should be a central database where all patients’ data should reside, and irrespective of which hospital the patient goes to all his medical history should be easily accessible. This will be the real transformation. The patient need not carry his medical history, as it will be stored centrally. He also should be able to access his own medical record using his Aadhar and password. The way things are changing and the way our government is taking initiatives to promote digitalisation, this is definitely going to become a reality soon, but it is still going to be a while before it does.
“Very soon it will be mandatory for all the hospitals to adopt Aadhar card authentication for patients in their daily functions, which itself will be a unique ID for the patient. Once that is done, the role of the hospital/ nursing home will be to push all data to the centralised database in the predefined formats. This big data then residing on the central server will have its own advantages and will help various industries in its own way.
“This is a change that will come soon. However, since every kind of advancement has both advantages and disadvantages, this will be the case here as well. Security threats are always a concern, and when big data comes in to play it will be all the more so. In order to prevent malicious or negative use, the government’s role, once again, will be very important. Strong polices will have to be built for data access to industries like pharma, implant manufacturers, etc. The government has already started regulating prices of various drugs, implants, etc. Similar initiatives are also being taken for patients’ blood requirements and so on. So centralisation as a whole will have both advantages and disadvantages, both of which have to be handled efficiently.”
Dealing with change
“Change is something that is constant in life. If you don’t accept change, you will get left behind. However, with the number of technological advancements, innovations and discoveries happening every day, you have to be extremely careful about the kind of changes you are incorporating, and whether your data is secure. For that matter, it is crucial to always stay up to date about everything that is constantly happening in the market, and the changes you need to incorporate. Artificial intelligence, which is coming up very rapidly, will also be useful in patient’s line of treatment. It will also be a challenge for CIOs to interface the same and capture relevant information out of it. So effective interfacing is going to be most crucial. As CIOs we have to keep up with technological changes. If for whatever reason we can’t, then we have to take help from other agencies and devise a way to remain in the market. But if you hold on to the past and stay rigid, then that will be your end.”