The logistical framework for healthcare in India is daunting -- its system includes state, central and local governments, as well as private providers, serving over one billion people in both rural and urban locations. IBM Research is finding ways for information technology to make the system less of an obstacle course and more help to India’s vast population.
The healthcare highway is just the latest example of that dedication. In 2004, Nick Donofrio, IBM’s executive vice president of innovation and technology, met with Dr. A.P.J. Abdul Kalam, President of India and the two discussed healthcare issues for India. In response to that conversation, IRL prepared a report with the Technical Expert Council (TEC) North India, on how information technology could improve healthcare in the country, and submitted it to Dr. Kalam in March of 2005. He then connected IBM with the ministries of information technology and healthcare, along with other government bodies, which led to the healthcare highway initiative.
Officially called the National Health Information Highway, the system offers information technology to help reduce medical errors, improve efficiency, assist planning (locations of specialty hospitals or medical schools, crisis management, drug and equipment supply and budgeting, and more), and accelerate research and training (using diagnosis data to train medical students or using medical problems captured on the network to build test cases).
This program could not be more timely. Just a glance at the numbers indicates how big a market this industry provides. In 2002, India’s healthcare industry contributed five percent to the Gross Domestic Product (GDP) and employed approximately four million people. By 2012, it is projected to contribute 8.5 percent of the GDP. Healthcare spending in the country will double over the next 10 years with private healthcare contributing a large portion of this spending, rising from US$14.8 billion to US$33.6 billion. Because the traditional system of medicine is faced with escalating healthcare costs, the state health systems desperately need to improve efficiency in how they allocate and use health resources to combat the many problems the rapidly developing country has. These problems include infant and maternal mortality rates that are still high; basic reproductive and child health services, supplies and infrastructure needs that are unmet; and universal immunization of children against all vaccine-preventable diseases has not yet been achieved. In addition, the government is striving to achieve zero-level growth of HIV/AIDS, reduce mortality from vector- and water-borne diseases by 50 percent, and increase the use of public health facilities – all by 2015.
To effectively help with the above goals, the healthcare highway uses open standards, which allows all healthcare entities nationwide to work together. And, because the healthcare market is so cost-sensitive, the services are available on a subscription-based model, such as pay-per-use. Other healthcare highway capabilities include:
- facilitating electronic data exchange (which will automate the current manual process and reduce the time it takes to settle claims from the current four to six weeks)
- providing data standardization (which will allow for interoperative and collaborative networks)
- middleware-based (to allow flexible collaboration among multiple third-party administrators and hospitals nationwide)
- supporting information integration and extraction (to answer queries from the doctors and administrators)
- supporting hybrid client platforms and programming languages (to allow different TPAs and hospitals to be part of the network)
- using industry standard interfaces (so that cross-training and re-training won’t be necessary)
- offering security through an authorized data channel (so that only authorized personnel can access this highly confidential information)
- provide auditing, which is required by the IRDA, the insurance regulatory body in India.
Mobile end users can be patients or doctors. Information, such as blood type, medical history and other medical information, as well as insurance data can flow from them to the insurance company, hospital or pharmaceutical companies over the Internet or a wide area network (WAN).
Of course, when dealing with such personal information, security is an issue. The healthcare data stack has a data security and privacy tier that wraps all the patient data from Electronic Medical Records (EMRs), as well as proprietary databases of different healthcare organizations, such as hospitals, insurance companies, and more.
The benefits are wide-ranging. Insurance companies that need to process claims more efficiently; hospitals that require the support of Electronic Medical Records (EMR) and Hospital Information System (HIS), but have little or no IT infrastructure; hospitals with IT infrastructure that want to collaborate with other healthcare entities; pharmaceutical companies and educational institutions that intend to use the system for research and training; government organizations for planning and administration; and patients get improved healthcare delivery with persistent health records and remote delivery of healthcare, such as telemedicine. And while the recommendations in the white paper were driven specifically by problems in the Indian healthcare system, the technology is applicable to other countries that might be planning to deploy healthcare solutions on a national scale.
Five IRL researchers (Ashwin Srinivasan, Sumit Negi, Chandan D. Nath, Ponani S. Gopalakrishnan and Vishal Batra) are currently working with IBM’s Business Consulting Services on a pilot program with a large healthcare group. The team has faced a couple of challenges: building healthcare standards that are specific to India and convincing healthcare entities across the nation to integrate those standards into their business processes. The partnership IRL formed with a large hospital chain in India will facilitate the formation of a working committee, consisting of hospitals and the IT and Health ministries, to create health data standards for the country. IBM has already deployed Clinical Document Architecture (CDA) over the data grid to demonstrate standards-driven claim data exchange. And, as the first pilot program is progressing, other programs will be rolled out to two hospitals and two insurance third-party administrators.
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A few facts about India’s healthcare system:
- Health services in India are provided by the government through publicly financed and managed facilities. These services account for about 18 percent of the overall health spending and 0.9 percent of the GDP and are provided free of cost to the patients.
- A fee-levying private sector co-exists with public healthcare. It accounts for 82 percent of the overall health expenditure and 4.2 percent of the GDP.
- State, central and local governments share healthcare responsibility, but service delivery is a state responsibility.
- India is surrounded by the burden of both communicable and non-communicable diseases. Some infectious diseases thought to have been conquered have returned with a vengeance or have developed stubborn resistance to drugs. These include viral hepatitis, tuberculosis, malaria and pneumonia. Futhermore, HIV/AIDS, the ebola virus and food- and water-borne diseases continue to emerge.
Source: Indian American Council
Quelle: IBM Think Research, 03.04.2006
