Susheel,
I do agree with you that there are quite a few doctors who are IT Savvy, but also look at the kind of hospitals that Ashwin is referring to. I also agree with him on this aspect. Even if many doctors are very tech savvy, there are still a few issues:
1. Doctors might be very tech savvy, but donot have the time to actually use a IT Solution directly. For example, entering a prescription into the computer while talking to the patient might be very time consuming and demotivating, compared to just writing it on paper and getting some one else do the entry into the computer.
2. Though the doctos might be tech savvy, the support staff might not share the same level of confidence or exposure to IT. Leading to reduced usage of IT solutions.
3. Most HIS solutions have a lot of benefits but most of them are intangible. A simple thing that I keep hearing from businesses, is "I am able to do most of the things fine enough, yes some time it is difficult, but other wise mostly it is ok. So why should i pay you for the product, esp when There are many other products available at a much cheaper rate". Even though the product is much better than others which are available in the market.
4. We have a solution that is Web Enabled, which has been deployed in hospitals with more than 800 OP visits per day and about 500 or more beds. Each day our product is used to enter more than 600 pharmacy issues and 1000 diagnostic registrations and reports. Every surgery that happens is recorded in the system and reports are available.
In the past one and half years of deployment the product has processed more than 250,000 patient records.
5. Before we developed this product we looked at care2x, (Actually we still help some hospitals deploy care2x). But we found it needs a lot of changes and stabilization to take the kind of load that we wanted it to handle.
6. The UI of care 2x needs to be changed majorly to make it more professional and also usable. We in our product use a lot of AJAX (XMLHttp) and such technologies, about 90% of our product is completely keyboard supported.
These small things go a long way to make a product usable. And Care2x is a long way from that.
Sarath. PS: Ashwin, good to hear from you after a long time :-)
Susheel John wrote:
On 4/30/05, *Susheel John* <[EMAIL PROTECTED] <mailto:[EMAIL PROTECTED]>> wrote:
Hi everyone
I beg to disagree on Ashwins point of few that there are not enough IT savy medical professionals/ other support staff in India.
There are hundreds of doctors who are capable of programming ( even to the extent of writing code in languages like C++ ), the problem is not the medical staff or their lack of knowledge, it is the IT service providers....they are just not able to meet the demands that come from these doctors.
Doctors need solutions that will help them save time and work efficiently, unfortunately all the currently available solutions decreases the work efficiency as it is so cumbersome to operate and actually wastes time ...the resistance is not because doctors don't know how to use software..it because they cant see themselves waste their precious time of something that decreases their productivity..
say for example if i were to use care2x..for my OPD scheduling and patient charts..I still need to fill out a prescription manually on paper ..because there is no online prescribing facility..so by doing that i am doubling my work..I fill out the details of the visit ( or encounter as it is called ) but then where will the prescription details of that visit be stored ..if I need to see that on the follow up visit ?..
Health care delivery automation does not follow the simple logic like that of banking or ticketing or any other software domains...it is this complex demand that the IT professionals are unable to meet. And as a cover up they always blame that the doctors dont know how to use computers and software solutions...
..if the docotors were not computer savy you would not be hearing of ROBOTIC surgery..which just hit the headlines today ..
For example, Are you aware that Medical informatics is a subject that is taught as part of the curriculum in some of the leading medical colleges in India ?..
Care 2x is a very robust solution but it needs a lot of modification before it can be functional in an Indian setting..
susheel
On 4/30/05, *Ashwin Naik* <[EMAIL PROTECTED] <mailto:[EMAIL PROTECTED]>> wrote:
Hello Everyone,
I noticed that there is considerable interest in Care2X
deployment in India, so i thought i will share my thoughts and
our experiences.
A. Number of implementations of Care2x are not substantial,
and also not much publicised
B. There is considerable amount of customization needed to
make Care2X suitable for local needs
C. Most importantly, Care2X is a comprehensive solutions for
HIS needs, but in India we are stuck with a unique problem of
not having enough IT savvy medical and support staff to
efficiently use the system. This is both because of lack of
time and education.
However, Care2x is a powerful system which can help integrate
the various departmental data in a single solution, not to
mention the world wide support available from dedicated
developers. We, at vaatsalya, promote care2x on our website
and are keen in developing it further.
Now coming back to whats possible and what we are doing.
We have looked at the HIS needs in India, considering the
fragmented health care industry and broken it down into
following sections
*A. Rural/Semi-urban single practice:* Typically a single
doctor working in a 300-400 sq. ft. with basic amenities.
Typically, doesnt even have an X-ray or a lab. Here we need a
very basic system which can capture the clinical information,
along with demographics and a referral system to higher
centres is needed.
/Key requirements:/
a) User friendly
b) Affordable/low cost of adoption
c) Training
*B. Polyclinic practice:* 2 or more doctors working together
sharing common staff, typically 15 - 25 beds. Doctors and
nurses are typically pressed for time, and WILL not enter data
into the computer. Has access to pharmacy, X-ray and
laboratory, and needs a system to capture clinical (Inpatient,
Outpatient), demographic, laboratory, pharmacy, radiology
information and a referral system along with billing and
insurance linkup.
/Key requirements:/
a) User friendly and training for front office staff to double
up as data entry professionals
b) Low cost of adoption and scalability
c) Extensibility to add more modules
*C. Multispeciality Hospital:* 2 or more specialists working
together, sharing resources, typically 20 - 40 beds. No time
available for any one. Full fledged hospital with inpatients,
ICUs, Operation theatres. Need a high end system which can be
deployed across the hospital which enables data sharing in
realtime, has operation theatre module, scheduling,
pharmacy, billing, insurance, radiology and possibly
tele-radiology and clinical research modules.
/Key requirements:/
a) 24/7 IT support and training of dedicated data entry personnel
b) Low cost of adoption and scalability of system
c) Extensibility to add more modules
*D. Tertiary Care Hospital:* I dont need to dwell on this,
these guys typically have a large IT team which basically
tells the management how to create more jobs for the IT teams!
Very few players in this segment, concentrated in metro cities.
*E. Network of Hospitals: *Hospitals run by corporates or
missionary organisations or by non-profit groups. This is
where there a large impact to make a difference, in addition
to *A and B* above.
These networks usually have highly efficient hospitals, which
provide excellent care, have extremely dedicated teams and are
extremely progressive. However, funding is a constant worry,
but groups manage to do an excellent job within resources
available. Network hospitals range from stand alone
polyclinics to large tertiary care hospitals, and the main
requirement is efficient sharing of clinical, laboratory and
radiological information along with billing and insurance. In
addition to the HIS for the hospital network, what is needed
is a management console (what i like to call the hospital
resourse planning software, HRP) which can help in monitoring
all the different aspects of the hospitals, and not limited to
clinical care. I would include resource planning, salary,
stock and inventory, pharmacy, scheduling, appointment
management, health education, outreach, tendering, reporting etc.
So, now that we have broken down the segments, this is what we
are doing about it. We are looking at open source solutions
suitable for each segment and customise it for individual
hospitals. We have identified a few IT service providers, and
depending on the skill sets available and the expertise, we
work with them to customise the software. We realise that
there is a large talented IT pool, but what is happening is
that the IT companies are handing out solutions that they can
build as opposed to building solutions that the hospitals
need. At Vaatsalya, our goal has been to leverage both our
clinical and IT experiences to design affordable, and scalable
systems which are doctor friendly.
We will be announcing some of the findings and tie-ups with IT
service providers on our website soon. Please feel free to
contact me if you need specific information and help.
Good Luck,
Ashwin
-- Dr Susheel Oommen John MD
The Leprosy Mission Trust India
16 Pandit Pant Marg
New Delhi 110 001
--
Dr Susheel Oommen John MD
The Leprosy Mission Trust India
16 Pandit Pant Marg
New Delhi 110 001
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