The National Knowledge Commission (NKC) was constituted on June 13, 2005 "with the mandate of devising and guiding reforms that will transform India into a strong and vibrant knowledge economy in coming years," one learns from www.knowledgecommission.org. The `Events' page is `under construction', and the latest in `News' is a December 14, 2005 link to the Commission's Chairman Sam Pitroda's statement that knowledge is the key to prosperity.
"People have started coming to India for healthcare. A heart surgery costs here one-fifth of what it does in the US," Pitroda had pointed out. The same can happen in the field of knowledge, if we create the right infrastructure and strengthen our universities, he had postulated. Wish the Commission made more news, because the `knowledge edge' that NKC aims at is lofty, be it about creation, application or dissemination of knowledge.
Creation includes `domestic research and innovation in laboratories', such as Biocon's. Application of knowledge "will primarily target the sectors of health, agriculture, government and industry" and benefit from `a strong e-governance framework for public services'. And dissemination of knowledge banks on "using Information and Communication Technology (ICT) to enhance standards in education and widely disseminate easily accessible knowledge that is useful to the public."
On April 17, again, there was the World Healthcare Congress, held in the US. Among the early reports about the event, at the time of writing this, is one on www.prnewswire.com. It is about Microsoft's Health Plan initiative, supported by 22 companies, including Infosys and Tata Consultancy Services. "The initiative harnesses the collaborative power of Microsoft integrated enterprise and consumer technology platforms, and the deep industry expertise of its leading business solutions partners, to enable the types of knowledge-based decisions needed for transformation across the health plan industry."
That healthcare is a major worry is evident on the home page (www.worldcongress.com), where John W. Snow, Secretary of the Treasury, is listed as a speaker on `The Impact of Health Care Costs on the Economy'.
Healthcare and HIT systems
For those into health and IT, a must-read report is `Costs and Benefits of Health Information Technology', from Agency for Healthcare Research and Quality (www.ahrq.gov) of the US. The 154-page document assesses "the evidence base regarding benefits and costs of health information technology (HIT) systems".
What are the report's conclusions? One, "HIT has the potential to enable a dramatic transformation in the delivery of health care, making it safer, more effective, and more efficient." And two, "some organisations have already realised major gains through the implementation of multifunctional, interoperable HIT systems built around an EHR (Electronic Health Record)." The report, however, rues the lack of "generalisable knowledge about what types of HIT and implementation methods will improve care and manage costs for specific health organisations."
A section titled `the economic value of an EHR system' highlights that EHR systems are essential for improving the efficiency and quality of healthcare; and that implementation of an EHR system requires "substantial capital investments and organisational change."
Is there evidence that HIT makes healthcare more patient-centred? "Sparse," concedes the report. "The best evidence of such a change is the beneficial effect on preventive care of using computerised reminders to patients." Disappointingly, one learns that telemedicine and consumer health informatics also have limited evidence of benefit in the US.
"Evidence is much more limited about the health effects of more general, interactive health information technologies such as the Internet or e-mail, or the effect on patient trust and satisfaction of implementing HIT systems such as the electronic health record." Hope the situation is different here, so that we may be able to say HIT systems are a big hit.
Missing HIS
On health, a recent report from Frost & Sullivan (www.frost.com) notes that healthcare industry has witnessed an increased spending on IT with most of the hospitals and healthcare organisations shifting to electronically-based information systems.
Titled `Hospital Information Systems - Technology Assessment', the report defines a hospital information system (HIS) as "a computerised system that is designed to meet all the information needs within a hospital." HIS includes "diverse data types such as patient information, billing, finance and accounting, staffing and scheduling, pharmacy ordering, prescription handling, supplies, inventory, maintenance and orders management, diagnostic reports related to laboratory, radiology and patient monitoring as well as providing decision support."
Frost's functional model of HIS groups information requirements into three: one, operational including `up-to-date factual information that are necessary for day-to-day tasks'; two, planning, for `short- and long-term decisions about patient care and decisions about hospital management'; and three, documentation, `such as maintenance of records, accreditation and legal records'.
The report speaks of HIS' advantages as including: improved quality of patient care, better communications within the hospital, increased productivity, reduced costs, fewer errors, and enhanced ability to track patient records. "Today HIS and electronic medical records (EMR) have become the minimum prerequisites for delivering quality healthcare," it declares. Akin, perhaps, to EHR that AHRQ speaks of.
Healthy growth of health
"Healthcare is estimated to be one of the key industries fuelling the software industry growth over the next five years," predicts Frost.
"According to reports by IDC, the North American healthcare industry would be spending more than $5 billion on software products each year." And, hold your breath, "investments would increase to $156 billion in 2009."
Gartner's prediction, cited in the report, is that the US spending on healthcare IT is estimated to be close to $40 billion in 2005; and it's growing at a compounded annual growth rate (CAGR) of 7 per cent. Frost estimates that the European HIS market stood at $3.1 billion in 2003, with a promise to reach $6.3 billion by 2010.
What's happening here? "In the Asia-Pacific region, numerous HIS implementations have taken place across various hospitals in Australia, Japan, South Korea, Singapore and Malaysia. However India and China have been lagging behind in terms of technology adoption."
Though India is `the hub of HIS software and development activity', Frost observes that Indian hospitals have been `very late in realising the advantages of IT'. Not a healthy thought, that.
Further reads
An April 17 story on www.tmcnet.com about HIT's costs and benefits, speaks also about `patients' rights to keep their medical records private'. Tim Christie's report on The Register-Guard (www.registerguard.com) , dated April 9, is titled `Technology To The Rescue: Hospitals invest in digitising medical records to cut deadly errors.'
A quote cited by Christie reads: "In the heart of healthcare today, the most important tool a physician can have is accurate, good clinical information to make a good clinical decision." True, we need to keep the right information flowing through healthcare's veins.
A worrying report, though, is on www.eetimes.com: Rick Merritt's `Embedded experts: Fix code bugs or cost lives,' dated April 10. He cautions that in software embedded in products such as pacemakers and car safety systems, `one wrong bit out of 100 million can cause people to die.'
Merritt says that a large software system of more than a million lines of code "may have as many as 20,000 errors, 1,800 of them still unresolved after a year."
Autor: D. Murali
Quelle: The Hindu Business Line, 24.04.2006
