Digitising Hospitals
A veteran in
the IT service industry, J. P. Dwivedi is currently the Chief
Information Officer of the Rajiv Gandhi Cancer Institute in New Delhi and is
well-equipped to answer your queries.
P. Dwivedi is the Chief Information Officer of the
Rajiv Gandhi Cancer Institute in New Delhi. He is a senior leader in IT service
industry with 21 years of experience working in India, UK, USA and Singapore.
He has vast experience in various sectors including healthcare, finance and
investment banking, HR, hospitality, car rental, energy, retail, telecom
manufacturing and railways.
1.What are
the key ways that healthcare organizations can use mobile technology to make an
impact in patient care in India?
Mobile technology has provided tremendous help to
both the doctors and patients. Enabled by several smart applications, the
doctors receive current appointment list on mobile, they can give appointments
and check their schedules. Doctors could be notified on several events e.g. the
patient getting admitted, patient getting discharged, any abnormal lab or
radiology results etc. Moving a bit further, doctor can access patient records
from anywhere and order a new medicine or stop some of the medicines currently
being given to the patients.
The patient experience has tremendously improved in
many progressive hospitals with the use of mobile technology. Patients receive
appointment confirmation, appointment cancellation, lab and radiology results,
reminders for taking medicines or any screening due. The relatives may be
informed when patient gets a bed after admission. A notification can go to
relatives when patient is due for discharge. Finally patient could be empowered
by having entire medical record either on the cloud or in a portable media to
provide continuity of care wherever the patient goes.
These are few of the examples where mobile
technology is currently being used. The possibilities are endless.
2. How can
healthcare organizations implement mobile technology in a way that caters to
all sections of society?
Implementing mobile technology does not cost a
fortune. Smartphones are seen everywhere with every strata of people. The
industry needs a lot of standardization and collaboration amongst various
healthcare providers in the interest of the patients.
3. What
percentage of its budget should a healthcare organization allocate to
Information Technology?
There cannot be a standard formula as every
organization is different. However, rule of thumb is around 2-3% of total
revenue in Operational Expenditure and around 1-2% in new projects and capital
expenditure (except during initial set-up).
4. How can
older institutions keep up with the advancements in technology? What are the
steps involved?
It is not wise to throw away what you have and
embrace the latest. Technology is just a means to realize the vision and
strategy. The itch to have the latest does not always make a sound business
sense. On the other hand sticking to what you have can make your organization
sluggish and backward. One has to tread the path of technological advancement
carefully. Technology strategy has to be fully in synch with business strategy.
The areas where better diagnosis, better treatment, better patient experience,
patient cost saving are concerned, one must be open to embrace new technology.
Similarly, if collaborating with other hospitals requires technology upgrade,
it makes sense to go for it. However, in the areas of minor operational
efficiency gains, look & feel, employee experience etc., one should go
relatively slow.
Technology is
a big enabler for any transformation
5. How can
organizations with IT department in place keep pace with the changes in
technology?
Every organization needs an in-house IT department.
The size of IT department would depend upon various factors e.g. In-house vs.
Outsourcing policy, management’s vision, ability to take pains in managing
risks, business continuity etc. Even if you outsource everything, at least a
group of core team would be needed to make sure the vendors do not take the
organization for a ransom. IT is less about gadgets and more about people. The
employees must be regularly trained and exposed to the latest technology
available in the Industry. The policies should be employee friendly to the
extent that they are motivated and engaged. Most important factor is the role
of the CIO in keeping the in-house IT team and key vendors engaged and forward
looking. A continuous evaluation of what better could be done with existing
technology and what should be changed is needed. Even if a change is required,
it should neither be abrupt, nor dead slow. One must master the art of change
management. That is the real job of IT.
6. Does IT
implementation give an organization an edge over its competitors? If yes, how
so?
Absolutely. Technology is a big enabler for any
transformation. It has been the case for ages. However, the advantage is
temporary only until others catch-up. Thereafter, it becomes a survival point.
No one can even survive without equivalent or better technology as being used
by competition.
7. What is
the best way to deal with staff who is resistant to incorporate technology?
Most of the resistance comes from a need to learn
new things. There are several ways to break the patterns. Technology should be
introduced in gradual and systematic manner. It is like any other change
management project where you need to identify champions, implement changes in
peripheries as pilot projects, encourage, empower, incentivize, instruct,
demand (whatever works?). There is no single formula.
8. What
should be done to ensure safety of patient records and other confidential
information?
This is one of the most important aspects while
considering electronic health record implementation or even digitizing paper
records. Stringent access control procedures must be put in place. These
procedures must be periodically audited. Overall end point protection is very
important. Every single access of the Electronic or digitized records must be
requested, approved and documented for future reference for maintaining
confidentiality and integrity of patient records.
9. Are there
any best practices we can follow (any hospitals, helathcare organistaions that
have successfully integrated IT).
Technology is a big enabler both in biomedical
engineering and in information technology areas. Today, there is no alternative
to embracing technology. Days are gone when everything was written on paper and
give to the patient (to keep or lose). Enduring continuity of care is extremely
important to ensure quality of care delivery outcomes.
Today, there
is no alternative to embracing technology
Several hospitals are aiming to become paperless.
One example of real (nearly) paperless hospital is ‘Columbia Asia’. Tata
Memorial Hospital Calcutta is another example of near paper less hospital. Many
leading hospitals of the country have embraced technology to a great extent.
We at Rajiv Gandhi Cancer Institute & Research
Centre have taken several steps in integrating technology with the
processes. In some areas, we have accomplished excellent results. Whereas, in
some other areas, we still have a significant distance to cover. We have
automated patient workflow starting from appointment till all the orders, lab
and radiology system integration, reporting and even notification to patients
along with reports being made visible to the patients on their computers /
mobiles. Nursing records are being maintained online and clinical records are
being transcribed alongside the digitization of the paper records.
