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
