Right to Healthcare: September 2010

ANIL SWARUP

THE MONTHLY MAGAZINE ON HEALTHCARE ICTS, MEDICAL TECHNOLOGIES & APPLICATIONS

Director General, Labour Welfare Govt of India

RIGHT TO HEALTHCARE Evolution of health insurance and the government’s efforts for health services accessibility provide the requisite impetus for growth of the industry in India

STAKE A CLAIM

Pg. 20

eHEALTH INDIA 2010 Report Pg. 26

eINDIA Awards Pg. 36

Pg 8

VOLUME 5 / ISSUE 9 / SEPTEMBER 2010 INR 75 / USD 10 / ISSN 0973-8959 WWW.EHEALTHONLINE.ORG

this November

UPDATE YOURSELF magazine is pleased to announce the release of 2nd edition of its annual 'Healthcare Technology Resource Guide 2010-11', to be published in the month of November 2010. Being the 'only one-of-its-kind' for the Indian m a r ke t , t h i s a n n u a l d i re c t o r y i s a comprehensive compliation and showcase of latest products and solutions in Healthcare IT & Medical Technology space, helping healthcare deliverers to keep abreast about latest technologies, while facilitating their purchase decisions and planning.

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> www.ehealthonline.org > August 2010

EDITORIAL

VOLUME 5 | ISSUE 9 | SEPTEMBER 2010 WWW.EHEALTHONLINE.ORG

Fighting Fit! Health insurance is the most effective and conventional way by which people collectively pool their risk of incurring medical expenses. By estimating the overall risk of healthcare expenses, a routine finance structure in a form of monthly premium or annual tax is developed, ensuring that money is available to pay for the healthcare benefits specified in the insurance agreement. The benefit is administered by a central organisation such as a government agency, private business, or even a not-for-profit entity. Recently the US Healthcare reform bill secured by Obama administration has given all reasons for exhilaration to the American population in particular and the healthcare community in general, across the globe.

PRESIDENT: Dr. M P Narayanan EDITOR-IN-CHIEF: Dr. Ravi Gupta MANAGING EDITOR: Shubhendu Parth VP - STRATEGY: Pravin Prashant PRODUCT MANAGER: Dipanjan Banerjee (Mob: +91-9968251626) Email: dipanjan@elets.in EDITORIAL TEAM: Dr. Prachi Shirur, Dr. Rajeshree Dutta Kumar, Divya Chawla, Sheena Joseph, Yukti Pahwa, Sangita Ghosh De, Pratap Vikram Singh, Gayatri Maheshwary SALES & MARKETING TEAM: Arpan Dasgupta (Mobile: +91-9818644022), Bharat Kumar Jaiswal (+91-9971047550), Debabrata Ray, Fahimul Haque, Priya Saxena, Vishal Kumar (sales@elets.in) SUBSCRIPTION & CIRCULATION: Astha Mittra (Mobile: +91-9810077258, subscription@elets.in), Manoj Kumar, Gunjan Singh GRAPHIC DESIGN TEAM: Bishwajeet Kumar Singh, Om Prakash Thakur, Shyam Kishore WEB DEVELOPMENT TEAM: Zia Salahuddin, Amit Pal, Sandhya Giri, Anil Kumar IT TEAM: Mukesh Sharma, Devendra Singh EVENTS: Vicky Kalra EDITORIAL CORRESPONDENCE: eHEALTH, G-4 Sector 39, NOIDA 201301, India, tel: +91-120-2502180-85, fax: +91-120-2500060, email: info@ehealthonline.org eHEALTH does not neccesarily subscribe to the views expressed in this publication. All views expressed in the magazine are those of the contributors.

In India health insurance was introduced in 1912, when the first insurance act was passed and witnessed little change until 1972, when the insurance industry was nationalised and 107 insurance companies were brought under the umbrella of the General Insurance Corporation (GIC). Further, in 1999 the enactment of Insurance Regulatory Development Act (IRDA) took place, which allowed private and foreign entrepreneurs to enter the insurance market in the country. The recently launched Rashtriya Swasthya Bima Yojana (RSBY) has empowered the BPL population with the ability to avail quality healthcare services free of cost. Within a span of two and a half years, the scheme has provided healthcare cover to almost 70 million people living under the poverty line. The September issue of eHEALTH focusses on the health insurance sector in India with a thrust on claims processing management. It has a cover story on the in-depth analysis of the health insurance sector in India. Besides, the interview of Anil Swarup, Director General, Labour Welfare, Ministry of Labour and Employment, Government of India, the man behind RSBY, has been featured to take a watch at the government policy level. The article ‘Stake a claim’ is apt with the focus of the issue depicting that it is the time for ‘Integrating clinical logic into claim processing systems.’ We also find it our pleasure to present the collage of eINDIA 2010 held during 4-6 August in Hyderabad, which has a detailed event report along with the album of the award winers in different categories. Let’s take a look!

Themagazine is not responsible or accountable for any loss incurred, directly or indirectly as a result of the information provided. eHEALTH is published by Elets Technomedia Pvt. Ltd in technical collaboration with Centre for Science, Development and Media Studies (CSDMS) Owner, Publisher, Printer - Ravi Gupta, Printed at R P Printers, G-68, Sector-6, Noida, UP, INDIA and published from 710 Vasto Mahagun Manor, F-30, Sector - 50, Noida, UP, Editor: Dr. Ravi Gupta

Dr. Ravi Gupta Ravi.Gupta@ehealthonline.org September 2010 < www.ehealthonline.org <

IN FOCUS

ANIL SWARUP

Director General Labour Welfare Ministry of Labour and Employment Government of India

“RSBY DEMONSTRATES THE LARGEST USE OF IT APPLICATIONS IN RURAL AREAS” The Rashtriya Swasthya Bima Yojana (RSBY) has empowered the BPL population with the ability to avail quality healthcare services free of cost. Within a span of two and a half years, the scheme has provided healthcare cover to almost 70 million people living under the poverty line. In conversation with Divya Chawla from eHEALTH, Anil Swarup talks about the strengths of RSBY and the tremendous work being done under this scheme in India. 8

> www.ehealthonline.org > September 2010

WHAT IS THE BACKGROUND OF THE RASTHRIYA SWASTHYA BIMA YOJANA (RSBY) AND ITS MAJOR OBJECTIVES? Launched on 1st April, 2008 by the Ministry of Labour and Employment, Government of India, RSBY is the first ever paperless health insurance scheme, worldwide. The scheme aims to provide health insurance coverage for below poverty line (BPL) families and protect them from the financial liabilities because of costs incurred on health ailments that require hospitalisation. The scheme already has 5000 empanelled hospitals. The RSBY beneficiaries are entitled to hospitalisation coverage up to Rs. 30,000 for most of the diseases that require hospitalisation by paying a minimal registration fee of Rs. 30 per year for a family of five. The premium for the scheme is paid to the insurer by the Central and State Governments. The scheme covers 727 surgical packages and the government has fixed the costs for most of these interventions. All hospitals, while signing the contract have to agree to the pre-set costs. Another benefit of the scheme is that it has no age limit and it covers preexisting conditions from day one. Since the inception of the scheme, 17 million smart cards have already been rolled out covering a population of approximately 70 million. RSBY is also one of the fastest scaling schemes. Haryana was the first state to take up the scheme, followed by Delhi. The Government used the BPL data as the base data for selecting the potential beneficiaries of the scheme. However, now the Government is planning to extend the scheme to other categories of the population as well. HOW DID THE GENESIS OF THE SCHEME TAKE PLACE? The idea behind the conception of RSBY was to design a health insurance scheme based on a world class model that avoids the pitfalls of all health insurance schemes launched in the past.

Analysing all old schemes and taking lessons from their mistakes and learning from their good practices, and assessing health insurance schemes in similar settings around the world, RSBY was designed. The target population of the scheme was looked at, very closely, before implementing it. As the target population comprised of illiterate BPL families, the Government decided that the scheme should be cashless and paperless. Further, most of these people are migrants and hence the scheme had to be designed in such a way, whereby it can be available all over the country. WHAT IS THE BASIS OF SELECTING AN INSURANCE COMPANY/VENDOR FOR PROVIDING HEALTH INSURANCE IN A PARTICULAR DISTRICT OR AREA? The insurance vendors for RSBY are selected on the basis of a competitive public bidding process held by the respective state governments. The Government of India requires various elements to be included in the technical bids. Technically qualified bids further go through a financial evaluation process, where the insurer with the lowest bid is selected for providing health insurance

in a state of a particular district. The financial bid is the amount payable by the Government for the annual premium per insured household. The insurer must further agree to provide the benefit package prescribed by the Government through a cashless facility by issuing smart cards to all beneficiaries. The individual contracts are decided as per various districts or states and the insurer has to agree to set up an office in that region. Only one insurer can operate in a single district at any given time, while more than one insurer can participate in a particular state. As of now, the scheme has 11 insurance vendorsâ&#x20AC;&#x201D;4 public sector and 7 private sector. WHAT IS THE FINANCIAL STRUCTURE OF THE SCHEME? As RSBY is a Government sponsored scheme for the BPL population of India, majority of its funding, almost 75 percent is done by the Central Government, while the respective state governments invest the remaining 25 percent. However, in case of Jammu and Kashmir and the North-Eastern states, the contribution of the Central Government amounts to 90 percent, while the respective state governments pay the remaining 10 percent. The premium amount that the Government pays to

September 2010 < www.ehealthonline.org <

IN FOCUS the insurance company, ranges between Rs. 450 and Rs. 650, for a family of five. HOW HAS THE IMPLEMENTATION OF IT HELPED IN DEVELOPING AND FACILITATING VARIOUS PROCESSES OF THE SCHEME? India is the only country where IT applications are being used at a high level to empower the rural population. As of now, the RSBY scheme demonstrates the largest use of IT applications in rural areas. The scheme employs IT at a massive level, because the Government before launching the scheme, realised that the previous such health insurance schemes failed because of lack of IT applications. Moreover, implementation of IT ensures the scheme to be fool proof. A major challenge faced while implementing the scheme was that most of the target population of this scheme comprised of migrants. IT applications were recognised as the only viable solution to overcome this challenge. The scheme provides a smart card to the beneficiary, which can be used anywhere in the country and hence is beneficial for the migrant population. Further, use of the biometric enabled smart card makes the scheme cashless and paperless as the beneficiary just needs to present it at the hospital and avail all facilities without paying any money. The smart card also solves all problems related to security of the data. The RSBY smart card tracks every single penny spent, electronically and also ensures that the money is issued to the right person. To ensure that the card reaches the right person, all smart cards are printed and delivered on the spot. Currently, there are 11 sets of software that make this scheme possible. Three of these are security software, developed internally, by the National Informatics Centre (NIC). Two are data management software, one of which has been provided by the World Bank. Further, various insurance companies have developed their own software. We are now working towards

India is the only country where IT applications are being used at a high level to empower the rural population. The RSBY scheme employs IT at a massive level, because the Government before launching the scheme, realised that the previous such health insurance schemes failed because of lack of IT applications. developing a platform that can facilitate real-time data collection. WHAT ARE THE MAJOR USPs, BENEFITS AND ADVANTAGES OF THE SCHEME? The biggest USP of the RSBY scheme is the empowerment it provides to the beneficiary. By being a RSBY smart card holder, the beneficiary has the freedom to choose from the empanelled private as well public hospitals to avail the best possible treatment for his family. The scheme has done well, because it has business sense for all stakeholders involved. The model of the scheme is conducive both for expansion of the scheme as well as long term sustainability. The insurance company is motivated to insure the maximum number of BPL families because he is paid a premium for each insured household. As, the hospital is paid per treated beneficiary, it is also motivated to provide treatment to the RSBY beneficiaries. The money earned by the public hospitals can be used by them for their own purposes. Several NGOs are now actively participating in the scheme, because they have the incentive of being paid for the services they render in reaching out to the RSBY beneficiaries. The governmentâ&#x20AC;&#x2122;s incentive is its ability to provide health insurance to a large portion of the BPL population by paying a certain sum of premium per year per family. The scheme is also running smoothly because of the IT implementation. All

> www.ehealthonline.org > September 2010

families are provided with biometric enables smart cards that have their fingerprints and photographs. Further, all hospitals empanelled under RSBY are IT enabled and connected to a server at the district level, which ensures smooth data flow. The use of biometric enabled smart cards has also made the scheme fool proof. It is ensured that the card reached the correct beneficiary as there remains an accountability for issuance of the smart cards. RSBY is also evolving a robust monitoring and evaluation system that can track all transactions happening across the country and and provide periodic analytic reports. Data analysis will further help in improvements of the scheme. Another key feature of the scheme is its portability, as the smart card can be used by the beneficiary all over the country. The beneficiary only needs to be carrying the smart card and provide his/ her finger prints for verification. Although, RSBY provides insurance cover for a family of five, yet the USP of the scheme is that if a child is born in the family, he/she is automatically insured, in spite of being the sixth member of the family. The scheme also includes maternal complications, because of which there has been a rise in the number of institutional deliveries as the beneficiaries do not have to pay for them. Further, the government is also planning to include preventive care in the list of diseases covered under the scheme.

COVER STORY

INSURING A HEALTHY FUTURE

Health insurance is indispensable for mobilising resources, providing risk protection and achieving improved health outcomes

By Divya Chawla

ealthcare financing in India is unique with considerably low share of public financing in total healthcare financing amounting to only about one percent of the GDP, whereas the average share of public financing in other low and middle-income countries is about 2.8 percent. Moreover, a significant portion of the public spending goes into tertiary care, whose beneficiaries are mostly non-poor. There is a need to prioritise public funding for preventive and promotive healthcare, which can benefit the poor. Another striking feature is that the total statesâ&#x20AC;&#x2122; spending accounts for almost three-fourth of the total public spending on healthcare, which is more regressive than central governmentâ&#x20AC;&#x2122;s spending. The World Health Organisation has stated that greater than 80 percent of the total expenditure on health in India is private and most of it is made out-of-pocket directly to private-forprofit healthcare sector. Studies suggest that the rich in India only spend a marginal fraction more than the poor population on healthcare. Owing to the lack of resources, the poor tend to avoid getting care and on an average, the poorest Indian is 2.6 times more likely to forgo medical treatment, when needed. Further, at least 24 percent of people hospitalised in India fall below the poverty line because of the increased out-of-pocket expenditure towards hospitalisation. As per

> www.ehealthonline.org > September 2010

an analysis, more than 40 percent of people hospitalised, especially those in the bottom four-income quintiles, borrow money or sell assets to pay for the hospitalisation cost. In such a scenario coupled with shrinking public health budgets, increasing healthcare costs and growing demand for health services, health insurance has emerged as the only viable option to save the massive out-of-pocket expenses on healthcare in India and make healthcare affordable and accessible for all. Health insurance was introduced in India in 1912, when the first insurance act was passed and witnessed little change until 1972, when the insurance industry

was nationalised and 107 insurance companies were brought under the umbrella of the General Insurance Corporation (GIC). Further, in 1999 the enactment of Insurance Regulatory Development Act (IRDA) took place, which allowed private and foreign entrepreneurs to enter the insurance market in the country. The bill also facilitated establishment of an authority to protect interest of the insurance holders by regulating, promoting and ensuring orderly growth of the insurance industry. According to the bill, foreign promoters are expected to hold paid up capital of up to 26 percent in an Indian company and requires them to have a capital of INR 100 crore along with a business plan to begin operations. Health Insurance Market

Since 1999, health insurance has been a minor portion of the health ecosystem as currently only about 3 – 5 percent of Indians have their health insured. Further, the market size of commercial health insurance is as low as 1 percent of the total health spending in the country. According to the Annual Report 200809 of IRDA, the premium collected for health insurance in India increased from INR 4894 crore in 2007-08 to INR 6088 crore in 2008-08. In percentage terms, of the total premium collected in the non-life insurance segment, the increase was of about 2.5 percent. IRDA estimated that the overall growth of the health segment has been greater than the general average industry growth. Insurance for All

A plethora of health insurance schemes currently exist in the country. On a broader scale, these schemes may be segmented as Voluntary Health Insurance Scheme or Private-for-Profit Scheme; Employer-based Schemes; Insurance Offered by NGOs/Community-based Health Insurance Schemes and Mandatory Health Insurance Schemes or Government-run Schemes.

Share of Non-life Insurance Sectors in India (2008-09) Voluntary health insurance schemes: Voluntary health insurance schemes in India are offered by public as well as private sector companies. In the public sector, the GIC, as well as its subsidiary companies— National Insurance Corporation, New private sector employers provide health India Assurance Company, Oriental insurance to their employees. EmployerInsurance Company and United based health insurance schemes in India, Insurance Company; and the Life cover only about 30 – 40 million people. Insurance Corporation (LIC) of India Out of these, it is estimated that almost offer voluntary insurance schemes. 20 million people are covered under reimbursement of health expenditures Employer-based schemes: Employer- types schemes. based health insurance schemes are offered both by the public as well as Community-based schemes: The private employers. These schemes are emergence of community health usually offered through employerinsurance in the recent years has aimed managed facilities, such as lump sum at improving access to healthcare among payments, reimbursement of employees’ the poor and protecting them from health expenditure, fixed medical indebtedness resulting due to medical allowance along with the annual income, expenditure. According to the WHO monthly or annual allowance irrespective Report 2000, prepayment schemes are of the actual expenses, or covering all the most effective way to protect people employees under a group health insurance from the unexpected expenditures on policy. Public sector employers such as healthcare and initiatives need to be taken Railways and Armed Forces and several in this direction in order to cover the poor

IRDA’s Initiatives in the Health Insurance Space IRDA has been constantly working towards boosting the confidence of policy holders in the health insurance system. In this regard, it has issued two landmark circulars to general insurance companies on—renewability of health insurance policies and health insurance for senior citizens. The renewability of health insurance policy circular, issued on March 31st 2009, protects nonlife insurers from declining renewals, unless certain specified reasons and certainly not on the grounds of an insured having made a claim on his policy in the previous year. Also, the circular promotes transparency and advises the disclosure of renewal terms, thereby enhancing fair treatment of policyholders. The circular on health insurance for senior citizens states that health insurance products filed on or after July 1st 2009, must allow entry up to 65 years of age and also to give proper information about the product on the website. The circular suggests clear disclosure of premium amounts to senior citizens and not deny them coverage on baseless grounds. A change of TPA during renewal is also allowed. Through this circular the industry has been encourages the industry to share data on fraudulent entities.

September 2010 < www.ehealthonline.org <

COVER STORY population under such schemes. The not-for-profit nature of the communitybased health insurance schemes makes it one of the viable options for providing healthcare to the poor. Out of about 22 community-based health insurance schemes, initiated in India by various NGOs, almost 10 are active right now. According to Devadasan et al. 2004, community-based health insurance in India is of three types—type I, type II and type III, depending upon the insurer. In type I (HMO design), the hospital provides healthcare, as well as runs health insurance programmes. The type II (insurer design) schemes are run by voluntary organisations, while purchasing care from independent providers. In type III (intermediate design) schemes, the voluntary organisations purchase care from providers and insurance from insurance companies.

Public Sector’s Voluntary Health Insurance Scheme Life Insurance Corporation of India

General Insurance Corporation

•

Ashadeep Plan II

•

Personal Accident Policy

•

Jeevan Asha Plan II

•

Jan Arogya Policy

•

Raj Rajeshwari Policy

•

Mediclaim Policy

•

Overseas Mediclaim Policy

•

Cancer Insurance Policy

•

Bhavishya Arogya Policy

•

Dreaded Disease Policy

Mandatory

Government-run

Schemes: Mandatory, government-run

health insurance schemes or social health insurance schemes have not yet reached a maturity stage in India. Challenges such as large rural and informal sector, lack of cohesion and solidarity and poor institutional capacity restrict the growth and emergence of social health insurance schemes in India. In these schemes, the premiums are usually based on the

person’s income rather than the health risk. These schemes are largely restricted to the employed population in the urban areas. The existing mandatory health insurance schemes in India include Employees’ State Insurance Scheme (ESIS) and Central Government Health Scheme (CGHS).

Success Stories Rashtriya

Swasthya

Bima

Yojana

(RSBY): The Government of India

Health Insurance – A necessity and not a tax saving instrument

KARAN CHOPRA Head – Retail Business HDFC ERGO General Health Insurance Company Limited

India is a developing country with over 26% of the population still living below the poverty line. Almost 35% of the population is illiterate. The living conditions in semi urban and rural India, makes the population living there vulnerable to various diseases. Nearly one million Indians die every year due to inadequate healthcare facilities and 700 million people have no access to specialist care and almost 75-80% of medical specialists live in metros and urban cities. Most of the people in India refrain themselves from better medical facilities offered by private players due to the exorbitant expenses. Some avoid medication in totality due to expenses.

There is very little awareness about medical insurance in India. The awareness is restricted to urban regions. Insurance is limited to only 10% of the total population. Health insurance coverage among urban, middle- and upper-class Indians, however, is significantly higher and stands at approximately 50%. It is important to understand that health insurance is the means to increase the accessibility to quality healthcare especially to private healthcare providers wherein high cost remains a barrier. Health insurance is fast becoming a necessity considering the effects on health of an individual due to rising pollution levels, change of lifestyle and limited sanitation awareness. It is important that one understands the medical insurance and insures his family against the possible medical expense in the future.

> www.ehealthonline.org > September 2010

decided to launch a health insurance scheme, for the poor, based on a worldclass model, that has no pitfalls. The result was the inception of RSBY, a Government funded health insurance scheme for the below poverty line (BPL) population of the country. Launched on 1st April 2008, the scheme requires provides a hospitalisation cover of Rs. 30,000 to a BPL family of five on payment of just Rs. 30 as registration fees by the family. The insurance premium is paid by the Government and ranges somewhere between Rs. 450 and Rs. 650. Being a government funded scheme, the Central Government provides 75 percent of the total funding, while the remaining 25 percent is provided by the respective state governments. Moreover, the scheme has more than 5000 empanelled hospitals, which before empanellment agree to a pre-set cost structure for almost 727 surgical ailments that the beneficiaries are eligible for. Ever since its inception, almost 17 million smart cards have been rolled out under the scheme covering a BPL population of approximately 70

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COVER STORY

Some Community Health Insurance Schemes in India

Scheme

Location

Target Population

Premium Collected

Benefit Package

ACCORD

Gudalur, Nilgiris, Tamil Nadu

Tribals living in Gudalur and members of the AMS union

Rs. 25 per person per year

Hospitalisation cover up to Rs. 1500 per person per year

BAIF

Uruli Kanchan, Pune, Maharashtra

Women (between 18 and 58 years) of the microsavings scheme in 22 villages

Rs. 105 per person per year

Hospitalisation cover up to Rs. 5000 per person per year

BUCCS

Buldhana Maharashtra

Members of the Buldhana Urban Cooperative and Credit Society

DHAN Foundation

Kadamalai Taluk, Theni District, Tamil Nadu

Women members of microfinance scheme and living in Mayiladumparai block

Rs. 100 per person peryear

Karuna Trust

Nasirpur Block, Mysore District, Karnataka

BPL families in T Narsipur block

Rs. 30 per person per year; Fully subsidised for SC/ST

Hospitalisation cover up to Rs. 2500 per person per year. Includes ambulance services and loss of wages

MGIMS Hospital

Wardha, Maharashtra

Small farmers and landless labourers living in 40 villages around Kasturba Hospital

populationRs. 48 per family of four (in cash or kind)

Hospitalisation cover up to Rs. 1500 per person per year

Raigarh Ambikapur Health Association

Raigarh, Chhattisgarh

Poor people living in the catchment area of the 92 rural health centres and hostel students

Rs. 20 per person

Primary and secondary healthcare

SEWA

Ahmedabad, Gujarat

SEWA Union women members (urban and rural) and their husbands living in 11 districts of Gujarat

Rs. 22.50 per person; Rs 45 for a couple

Hospitalisation cover up to Rs. 2000 per person

SHADE

Kolencherry, Kerala

Members of the SHGs operating in Ernakulum district

The Universal Health Insurance Scheme (Rs. 548 for a family of five)

Hospitalisation cover for a family up to Rs. 30,000 per family per year

Studentâ&#x20AC;&#x2122;s Health Home

Kolkata, West Bengal

Full-time student in West Bengal state, from Class V to university level

Rs. 4 per student per year

Primary and secondary healthcare

Voluntary Health Services

Chennai, Tamil Nadu

Rs. 250 per family of 5

Hospital cover

Yeshasvini

Bangalore, Karnataka

Total population of the catchment area of 14 mini-health centres Members of the District Farmersâ&#x20AC;&#x2122; Cooperative Societies and their families

Rs. 120 per person

Cover for all surgeries up to Rs. 100,000

> www.ehealthonline.org > September 2010

Hospitalisation cover up to Rs. 5000 per person per year Hospitalisation cover of up to Rs. 10,000 per person per year

Key Features of ESIS and CGHS Indicators

ESIS

CGHS

Beneficiaries

Factory sector employees and dependants with income less than Rs. 7500 per month

Employees and dependants of Central Government; certain autonomous and semi-government organisations; Members of Parliament; judges; freedom fighters; journalists

Benefits

Medical and other health-related services provided through ESIS facilities and partnerships

Medical care through public facilities; restricted private care

Premiums

4.75 percent of employeesâ&#x20AC;&#x2122; wages; 1.75 percent of their wages by employees; 12.5 percent of total expenses by the state governments

Provider Payments

Salaries for physicians; hospitals have global budget financed by ESIC through state governments

Administrative Costs

About 21 percent of revenue expenditure. Wages of corporation employees and cash benefits, revenue recovery and implementation in new areas.

Status of Finances

More than 80 percent of the ESIS income-double the expenditure on benefits

million people. This just reflects on the tremendous success of the scheme and quickly its expanding to all corners of the country. Various countries such as Pakistan, Bangladesh and several Africa countries are now adopting this scheme based on its success in India. Rajiv Aarogyasri Health Insurance Scheme: Launched on 1st April 2007

in the state of Andhra Pradesh, the Rajiv Aarogyasri Health Insurance Scheme, demonstrates a unique public private partnership model for offering a health insurance scheme that is tailor made to the health needs of the poor patients. The scheme provides end-to-end cashless services for identified diseases through a network of service providers both in the government as well as the private sector. The scheme is designed, in particular, to address benefit in primary care through screening and outpatient consultations in health camps or network hospitals. The scheme initially covered 163 identified diseases in 6 systems and gradually extended to 330 diseases in 13

Varies from Rs. 15 to Rs. 150 per month based on salary of the employee; funded mainly by the Central Government fund Salaries for doctors; treatment in private hospitals reimbursed on case basis Direct administrative costs; RRT 5 percent of the total expenditure; part of salaries can also be charged to administrative costs About 15 percent of the CGHS income-half of the salary expenditures

systems under Aarogyasri-I. The coverage extended to 942 procedures in 31 systems and an additional 612 procedures through Aarogyasri-II. The scheme has been a huge success in the state of Andhra Pradesh, so much so that it is being considered to make it a centrally-assisted scheme. The Government is able to provide insurance coverage of up to Rs 2 lakhs per year on a family floater basis for 2.03 crore families at a cost of only Rs. 400 per family per year. Further the huge disease and patient load ise substantially managed with the implementation model. Every day, at least 8000 patients are screened in health camps and PHCâ&#x20AC;&#x2122;s, around 4000 patients get registered in network hospitals, around 2500 patients are treated as outpatients and 1500 patients get inpatient treatment. The scheme is also bringing in quality medical infrastructure and expertise to the state. Several new hospitals have come up at the district and sub district levels. Presently on any given day a minimum of 13000 beds are occupied by Aarogyasri beneficiaries across the state. Hence the

scheme has stabilised over a period of two years and is financially viable and administratively feasible. Chief Minister Kalaignar Insurance Scheme for Life Saving Treatments:

The Government of Tamil Nadu launched the Chief Minister Kalaignar Insurance Scheme for Life Saving treatments on 23rd July, 2009 for providing quality and free healthcare for the economically weaker sections and the downtrodden. The scheme has carefully designed the eligibility and benefit criteria to benefit the most needy and deserving. It covers more than 600 surgical procedures that have been identified by senior medical/ surgical consultants. The scheme is another example of the successful use of IT applications to deliver efficient services. Use of biometric cards makes the scheme completely cashless and a web-based claims management system has ut the state-wise management of the scheme under a single umbrella, facilitating centralised administration and uniform claim processing across the

September 2010 < www.ehealthonline.org <

COVER STORY Health Insurance – A necessity and not a tax saving instrument banking industry. For those considering adopting technology solutions, the decisions range from automating the claims processing and adjudication systems, predictive analytics, membership, billing and customer service processes. Key Success Factor

P RAMMOHAN MD & Co-Founder Healthsprints Network Pvt. Ltd.

Payers throughout the world share the same primary concern – how to survive and stay competitive while healthcare costs are on the rise. In the past few years, many companies approached this challenge by trying to roll out premium rate increases to their customers. This strategy is being met with resistance from employers and retail consumers. With a growing backlog of claims and continually rising costs for administrative processes and medical care, the market is ripe for IT solutions that reduce a company’s operating costs. But the healthcare insurance industry lags behind and has been slow in adopting technology improvements as compared to peers like territory, without any delay. Beneficiaries of this scheme include families of the 27 welfare boards as well as families earning less than Rs.72,000/- per annum. With the currently fixed eligibility criteria,

Industry analysts believe the level of automation in a payer’s business processes is now becoming the key success or failure factor within the sector. In addition to outdated paper processes, studies show that many payers are affected by a high inefficiency factor in the automated systems they currently use. Often, they achieve less than 50 percent of the possible efficiency in their back-office systems simply because they are unaware of benchmarks and what they should be able to accomplish. Buyers, therefore, must understand not only what technology solutions to adopt, but also how to mitigate risks in those business solutions as existing technology evolves or new technology emerges. Technical Functionality

The Internet is the vital link more than 1.3 crore families will get to benefit from this philanthropic project. This project has offered a win-win situation for everyone concerned including the Government, insurance

Status of deployment of the RSBY scheme in the following states (until May 2010)

State

Districts Covered

Enrollments (in Millions)

Haryana

0.85

Rajasthan

0.12

Maharasthra

0.3

4.76

Bihar

0.17

Total

More than 96

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to increasing functionality and interconnectedness in sharing data and information. Hospitals and physicians need quick response to verify health benefits coverage of their patients and status of transactions. In addition, Internet functionality of a business process and its related data facilitates a payer’s ability to increase customer satisfaction by providing Web access to health care providers to submit pre approvals and claims electronically. Initiatives by government of India like legalising digital signatures for use in e-commerce bring in credibility and accountability in enabling web transactions for health insurance. Conclusion

Healthsprint Networks Private Limited has deployed data exchange platforms for various Health Insurance & Micro Health Insurance schemes across the country covering more than 50 million population and the insurance carriers have seen significant improvement in process efficiency, decreased transaction cost, improvement in CRM and claims ratio management by enforcing package rates through the platform. company, healthcare providers and the general public. A massive figure of 117,013 patients benefited from the scheme (as on 31st May, 2010), which is a clear proof to the success of the project. With the health insurance density still low in India, there is considerable scope for growth and proliferation of this industry. Moreover, the plethora of schemes being offered just add on to the possibilities for growth. Essentially, health insurance can be an important means to mobilise resources, provide risk protection and achieve improved health outcomes. There is now a need to increase awareness and bring in flexible schemes that can cover the entire population under health insurance.

SPOTLIGHT

STAKE A CLAIM

‘INTEGRATING CLINICAL LOGIC INTO CLAIM PROCESSING SYSTEMS,’ healthcare demands for processing guidelines

ost existing health insurance claims systems focus on data and workflow management. The primary goal is to achieve process efficiency. The workflow management module is meant for better work distribution and routing or in-built escalation. It integrates simple rules engine to configure products and automate various validation checks on policy, claimant, benefits and provider. The ability to efficiently link policy benefits, enrollment and underwriting information, previous claims, prior authorisation and any subsequent enhancements to the current claim, is deemed as mandatory. This article explores how clinical logic can be integrated into claims systems so that the knowledge and experience of doctors who process claims is built into the system. The need for standards in claims processing

Indian health insurance companies or TPAs (Third Party Administrators) generally hire medical professionals ranging from pharmacy graduates to alternative systems doctors to MBBS doctors for process claims. These results also vary for how a similar claim is processed within a single TPA and also from one TPA to another. The significant variation of care across providers further complicates the problem. Due to all

these factors, it is felt that claim processing is discretionary or arbitrary. This leads to provider-customer disputes. In other countries, a common solution to these problems are usually found as some set of protocols or guidelines are already adopted by the industry. Without widely accepted and evidence based guidelines, which detail what is ‘medically appropriate or justified’ or what is ‘reasonable and customary’ for a particular medical or surgical intervention, conflict is inevitable. The two main initiatives in the last few years in developing standard treatment guidelines or clinical protocols by WHO/ AFMC STGs (2008) and FICCI STGs released in 2009 have limitations in terms of conditions covered and have been written with minimum standards of care or from the public health system infrastructure perspective. They do not truly fulfill the needs of the insurance industry as the content is not specifically designed for pre-authorisation and claims adjudication. The health insurers and TPAs require guidelines that help to define the medical complexity of a particular case, providing appropriateness and reasonability checks for diagnostics, treatment, associated consumables and indicative length of stay. In some countries such guidelines are developed by independent organisations and are regularly updated. These are viewed as benchmarks and thus become a widely accepted

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basis for prior authorisation and claims resolution. It is commonly accepted that to be effective a guideline should only focus on the clinical aspect. They do not provide the cost of investigations or surgical charges or consumables that may be required. The cost is determined by provider and insurer negotiations, which include factors such as patient volumes, speed of payment etc. Thus both the parties rely on the guidelines to determine clinical appropriateness and rely on agreed tariffs or package rates to take care of the cost issues.

content. We are yet to officially launch the treatment protocols and pathways. We are also in the process of creating a distribution and support network.” The claim processing guideline was launched in 2009 under the brand name of ‘ClaimsRef’ and they cover 200 common in-patient interventions that aims to enhance productivity and optimise cost savings by: • Improving efficiency, uniformity and accuracy in claims processing • Promoting standard practices across different TPA / insurer

Medical professionals use their training and experiences to verify a healthcare claim and to determine if the procedure, diagnostics, consumables being billed are warranted and if the costs are reasonable. Claim processing guidelines

Milliman recognised that India needed similar systems to bring about some form of standardisation and two years ago they set out to create a complete suite of solutions specifically for India. Thus the solutions developed for India represents the practice patterns, infrastructure, equipment physician training, culture and costs prevalent here. The claim processing guidelines were part of a larger ongoing initiative by Milliman in India which included the development of various tools and products. Richard Kipp, Managing Director, Milliman India, explained, “Our efforts in this direction started two years ago with discussions about treatment protocols with industry stakeholders. It was very clear that standardisation based on Indian evidence and practices is required in India. We are building a complete suite of solutions with evidence based treatment protocols, pathways and hospital order sets being the center piece. We have two derivate products from this process, claim and underwriting guidelines. These products use the same evidence based medical

sites and personnel Ensuring early identification of ‘incomplete claims’ and ‘inaccurate charges’ • Supporting information based negotiation with providers Milliman has conducted formal external review of these guidelines with practicing experts to ensure they are comprehensive and accurate. It has been found that almost all common causes of admission are covered by the 200 conditions in ClaimsRef. Further, the design of ClaimsRef helps with two critical steps, the prior authorisation and final claim settlement. In health insurance, the preauthorisation is an important step. When a hospital sends an admission note to a TPA for preauthorisation, the authorisation personnel refer to ClaimsRef for that particular intervention and match the details on the authorisation note to validate appropriateness for admission and to determine the severity of condition. Severity determination is rather important as it defines the likely investigations and length of stay and •

consumables that may be used during the hospitalisation. Once severity is determined the ClaimsRef indicates the likely length of stay. Claims processors can then look up the rates for the specific facility type and location in the TPAs database and estimate the likely cost of procedure / hospitalisation episode. If a TPA has pre-negotiated package rates, then they can just use those. When settling a claim, the Milliman guidelines enable a claim processor to accurately determine the severity of a patient’s condition and identify if the length of stay, investigations, consumables and treatment are in proportion to the condition. They also list special checks to identify patterns of inappropriate billing or industry accepted non chargeable items. In addition to standardising and accelerating claim processing, the ClaimsRef also reduces errors and omissions, thus enabling a TPA or an insurance company to process more claims with existing manpower. ClaimsRef guidelines also have additional details which can be useful for a claims team. Possible clinical reasoning for additional investigations and longer hospitalisation are also available. This enables a claim processor to rule out common reasons for variance before calling the hospital and therefore, the claim settlement process is driven by clinical logic. Integration of claim processing guidelines into a claims management platform

ClaimsRef is not a software or an IT application however Milliman also provides the claim processing guidelines in a rules format they can be easily integrated into a claims system. This significantly automates the ‘clinical checking’ of a claim. This makes the use of the guidelines an inherent part of the claims workflow and increases their effectiveness. The integration is relatively simple as data sets, master tables and rules are provided to the IT team, with instructions for integration.

September2010 < www.ehealthonline.org <

SPOTLIGHT

The knowledge and experience of doctors who process claims should be built into the system.

The rules identify key variations based on the data entered into a claims management platform. The data input is compared against the clinical logic and rules, if any variation is identified then an alert is generated. The key variations that the clinical logic is able to identify include, but are not limited to: • • • • •

ICD CPT mismatch Length of stay mismatch Duration of ICU mismatch Excessive physician visit flag Unwarranted specialist visit flag

•

Unwarranted assistant surgeon fee flag

•

Procedure not indicated for the age group / gender

• • • • • • •

Excessive investigations flag Unwarranted investigation flag Excessive consumables flag Unwarranted consumables flag Excessive drug use flag Unwarranted drug use flag Drug charged above marked price flag

•

Non chargeable consumable flag

The generation of these alerts ensures that these variations are noted by the claims processor. For example, upon receipt of the hospital claims at discharge, a very junior claim processor enters data from the hospital invoice into their claims management system. The system runs the Claimsref clinical logic rules and compares the data entered with the expected investigations, length of stay and consumables etc for that specified procedure. If the hospital has excessive units of a particular billed item, those entries are flagged as variation for a senior claim processor (usually a doctor) to consider. The flags alert the claims doctor to review the clinical reasoning for these variations in discharge summary or to seek details from the provider. With additional integration, the claims IT system can retrieve the cost of expected services from the negotiated rates database. If the invoice costs are within the expected cost range, it automatically clears the invoice for payment. If any variance is noted it flags them. This ensures that complete and appropriate claims get processed immediately allowing the doctors, who

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are an expensive resource, to focus on the ‘incomplete or potentially inappropriate claims.’ However, the generation of these rules based alerts is dependent on accurate and the additional data entry will have some implications on productivity. An effective way to manage productivity implications is to recognise, where the maximum value claim processing guidelines. The clinical logic rules can be activated or inactivated for different scenarios. These options may be desired for different claims type, claims value, products, staff experience, provider etc. For example, the customisation provides:  option to inactivate data entry and rules for reimbursement claims  option to activate detailed data entry and rules for claims that are higher than a specified amount  option to activate detailed data entry and rules for all conditions for junior claims processor or specific complexity conditions for an experienced claims processor  option to activate additional data entry for specific billing components • critical hi78 cost investigations • critical high cost consumables • critical high cost pharmacy items • industry accepted exclusions that are not payable A robust claims IT system would provide the claims manager at the insurer or TPA the facility to create such rules and then activate or deactivate them based on business needs at a specific time.

Conclusion Indian health insurance industry is at a critical stage of development. While it is growing rapidly, the associated processes of underwriting and claims processing are yet to be standardised. Specific set of guidelines can be integrated into claims systems to ensure standardised information based claims adjudication and enhanced cost savings. The next generation of claims systems will incorporate more intelligence to ensure quality and standardisation in claim processing.

EVENT REPORT

The sixth edition of Indiaâ&#x20AC;&#x2122;s largest ICT expo and conference, was held from 4-6 August 2010 at Hyderabad International Convention Centre (HICC). The event was hosted by the Government of Andhra Pradesh and organised by Elets Technomedia and CSDMS, along with the Department of IT (GoI), Ministry of Panchayati Raj (GoI), Ministry of Labour & Employment (GoI), UIDAI, Directorate General of Employment & Training, NeGP, and IGNOU. The three-day event was attended by over 5,000 stakeholders from across the development and government sector, including elected members of state Assemblies and the Parliament, senior level bureaucrats, policy makers, academia, NGOs and industry associations.

J Satyanarayana,Special Chief Secretary, Dept of HFW, Govt of AP

Vijaylaxmi Joshi, Principal Secretary & Commissioner, Health, Govt of Gujarat

Dr Ashok Kumar, DDG & Director, Central Bureau of Health Intelligence, MoHFW, Govt of India

Dr S Vijaya Kumar, Special Secretary, Dept of Health & Family Welfare, Govt of Tamil Nadu

Babu A, CEO, Aarogyasri Health Care Trust, Govt of Andhra Pradesh

Sangita Reddy, Executive Director, Apollo Hospitals

The chief guest Dr K Rosaiah, Chief Minister of Andhra Pradesh, lighting the lamp at the inauguration of eINDIA2010. Standing L-R: K Ratna Prabha, PS, IT , GoAP; Dr Asraf Abdel Wahab, Deputy Minister, Ministry of Administrative Development, Egypt; Lt. Gen. (Retd) Bhopinder Singh, Lt Governor, Andaman & Nicobar; R Chandrashekhar, Secretary, DIT, GoI; Komathireddy Venkat Reddy, Minister, IT & Communications, GoAP

D Sridhar Babu, Minister, Higher Education, Andhra Pradesh and J Krishna Rao, Minister for Food, Civil Supplies, Legal Metrology & Consumer Affairs, Andhra Pradesh talking to the exhibitors

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D Sridhar Babu, Minister, Higher Education, AP & Dr M P Narayanan, President, CSDMS & J Krishna Rao, Minister Nadendla Manohar, Dy Speaker, AP Legislative Assembly for Food, Civil Supplies, Legal Metrology & Consumer Affairs, AP

A Raja, Union Minister for Communications and Information Technology, Government of India

Agatha Sangma, Minister of State for Rural Development, Government of India Agatha Sangma, Minister of State for Rural Development, Government of India along with Dr M P Narayanan, President, CSDMS (centre) and Dr Ravi Gupta, Editorin-Chief, Elets Technomedia (left) launching the special issue of eGov magazine.

nibh ero cor si. Guerciduipis dolobore ent

Odissi dance performance by members of Smitalay

eINDIA Award winners along with Dr M P Narayanan, President, Centre for Science, Development and Media Studies (CSDMS) and Dr Ravi Gupta, Editor-in-Chief, Elets Technomedia

September 2010 < www.ehealthonline.org <

EVENT REPORT

An exclusive coverage of the eHEALTH INDIA 2010

e-Xcellence in Healthcare The three day event from 4-6 August, 2010 was aimed at providing a unique platform for knowledge sharing and discussing emerging issues in depth in the areas of IT and technology in the healthcare services sector. Sangita Ghosh De of eHealth reports.

he 6th eINDIA 2010, the threeday international conference and exhibition, was held at Hyderabad International Convention Centre, Hyderabad during 4-6 August 2010. eINDIA aimed at providing a unique platform for knowledge sharing in different domains of ICT for development and facilitates multistakeholder partnerships and networking among government, industry, academia and civil society organisations. This year eINDIA was even more focussed with six thematic tracks namely eGov, eHealth, digitalLEARNING, Telecentre, eAgriculture and Municipal IT. Conceived and produced by Centre for Science, Development and Media Studies (CSDMS) and Elets Technomedia, eINDIA 2010 was co-organised by Department of Information Technology, Ministry of Communications & IT, Government of India, Unique Identification Authority of India, Directorate General of Employment & Training (DGET), Ministry of Labour & Employment, Government of India and National eGovernance Plan (NeGP). Department of IT & Communication, Government of Andhra Pradesh was the ‘Host State Partner’ for this event, while Sri Lanka was the official ‘Country Partner’. eHealth India 2010, being one of the

ICT has brought in revolution, across all departments in the government including healthcare, eHealth INDIA 2010 disussed it in depth.

eHealth India 2010, being one of the six thematic tracks of eINDIA 2010, hosted policy makers, academicians, researchers, technology vendors as participants and delegates from across India as well as overseas. six thematic tracks, hosted policy makers, academicians, researchers, technology vendors as participants and delegates from across India as well as overseas. The three-day long conference threw light in the areas of IT and technology in the health sector, while providing a successful platform for sharing knowledge and discussing emerging issues in depth.

Day One Public healthcare – vision to transform The first session of day one of eHealth

> www.ehealthonline.org > September 2010

track started with the vision address delivered by J Satyanarayana, Special Chief Secretary, Department of Health and Family Welfare, Government of Andhra Pradesh on ‘Transforming public healthcare through technology.’ According to him, transformation is a radical and fundamental change and therefore, transformation in public healthcare also needs to go through the path of radical changes pertinent to the necessity of the rules and tools of the sector. The target areas of the sector are very sensitive and large in numbers,

EVENT REPORT

SRI J SATYANARAYANA Department of Health and Family Welfare, Govt of AP

SANGITA REDDY Apollo Hospitals

DR KARANVIR SINGH Sir Ganga Ram Hospital

MILES AYLING Department of Health, United Kingdom

DR ASHOK KUMAR Central Bureau of Health Intelligence, MoHFW, Govt of India

DR AJIT K NAGPAL Healthcare Advisory Council J&K State

DR B K RANA NABH, Quality Council of India

where focus needs to be on specific needful areas in achieving success. It is now proved that technology in primary healthcare is different from technology in secondary or tertiary care. Therefore it is more wise to concentrate on Public Private Partnership (PPP) mode, opined Shri Satyanarayana. With the availability of proper opportunity of management in human resource, healthcare is a suitable area for IT development provided with optimal infrastructure. Besides, in the sector with IT, medical technology has also going through a meaningful phase of development. All these developments result into a proper management of delivery of services in manpower, funding, logistics, and procurement as well with requirement of trained manpower. In this scenario, Aarogyasri is one of the successful paperless projects, he mentioned. The vision address was followed by the first keynote address delivered by Sangita Reddy, Executive Director, Apollo Hospitals on ‘Envisioning hospital of the future – putting technology at the heart of care’. In her address Reddy makes an excellent presentation that was focussed on Hospital Information System (HIS). According to her, appropriate application of technology in every step of healthcare needs innovation and proper flow of information enabling it more acceptable, sustainable, affordable, patient centric and efficient. Following to her presentation, Dr Karanvir Singh, Head-Medical Informatics, Sir Ganga Ram Hospital, Delhi delivered the second keynote address with focus on ‘Implementing an electronic medical record system’ in hospital. “We have been having Hospital Information System (HIS) in Gangaram hospital since 2005. Our experience says that a proper HIS includes an effective usage of Enterprise Resource Planning (ERP) solutions and a successful Electronic Medical Record (EMR) system. Now implementation of a proper and smooth running EMR is really critical and an expert’s job as it involves entering crucial data correctly and timely,” says Dr Singh. If a hospital needs to run uninterruptedly and effectively with the support of HIS, EMR has to be executed accurately, he voiced. The first session of day I ended with a special address by Miles Ayling, Director of Service Design, Commissioning and System Management Directorate, Department of Health, United Kingdom. He spoke about the innovations and implementation of HIS and technology in National Health Service (NHS) started in 1948 in United Kingdom and the new organisation, a part of NHS

> www.ehealthonline.org > September 2010

called NHS Global that is aimed at partnering with healthcare systems overseas. NHS is publicly funded, third largest organisation in the world, a three tier system and its services are free with a annual budget of USD165 billion. According to him, while reaping the opportunities in improving the healthcare system currently, one has to face the challenges as well. NHS has a record of 1 million patients contact every 30 seconds that really shows its vastness and the nature of complexity that it has. It is a highly dense network of thousands of hospitals, community centres and general practitioners, where only technology has helped in delivering seamless services to its patients facing a lot of challenges though. To overcome the challenges funding had increased three to four times more for the past few decades and clearly focused on increasing quality, innovation and productivity continuously which could be the part of learning curve for anybody. Reform, Transform, Perform: Charting blueprint of the future healthcare Session two of day one started with the discussion on ‘Reform, Transform, Perform – charting blueprint of the future of healthcare in India’ moderated by Dr Ashok Kumar, DDG & Director, Central Bureau of Health Intelligence, Ministry of Health & Family Welfare (MoHFW), Government of India. ICT has brought in revolution, across all departments in the government including healthcare, commented Dr Kumar, while moderating the session. “In India ICT in healthcare still needs more attention as the service needs to percolate at the bottom of the society, therefore spurring demand more into primary healthcare and subsequently moving upwards to secondary and tertiary healthcare systems. The country needs the most effective and successful healthcare system but with a major transformation to meet the challenges,” he added. According Dr Ajit K Nagpal, Chairman Healthcare Advisory Council, Feedback Ventures & Convener Task Force on Health Sector Reforms, J&K State, the transformation highly demand the PPP mode. “We need strong public policies to foster the PPP mode for quality but affordable and of course accessible healthcare in our country. As reformation and transformation has many challenges in itself, implementation of ICT in healthcare needs more attention of the experts and policy makers to make it scalable and available,” he observed. In the session, Dr B K Rana, Dy Director, NABH, Quality Council of India was of the opinion that for

DR MAHESH REDDY Nova Medical Centres

DR V BALASUBRAMANYAM

St John’s Medical College, Bangalore

In strengthening future health systems in India, innovation in policy, processes and technology is vital.

a hassle free delivery of services the system needs a successful and productive coordination, where data needs to be protected at the most. Therein, Dr Mahesh Reddy, Executive Director, Nova Medical Centres Pvt Ltd commented that to provide medical facilities at par across the country, provision of health insurance should be made mandatory and for the matter government should facilitate the process of decentralisation of its accessibility at the earliest. Dr V Balasubramanyam, Domain ConsultantMedical E-learning & Professor, Department of Anatomy, St. John’s Medical College, Bangalore said, “As per my understanding and experience, we need to understand technology and try to apply it meaningfully so that the patient is comfortable. Let’s not follow implementing technology blindly.” Following to his remarks, Dr P S Ramkumar, Adjunct Professor - Information Sciences, Manipal University commented that there are gaps in the process of implementing ICT in healthcare which has resulted enough wastages of resources. The best thing can be done is bridging the gap and benefit from the best of the product. The session ended with the observation from Dr Ramchandra Lele, Director-Nuclear Medicine, Jaslok Hospital and Research Centre, Mumbai, which said that India’s priority is delivering its best for the primary healthcare whatsoever the situation is.

Day Two Day two started with the keynote address

delivered by U K Ananthapadmanabhan, President, Kovai Medical Centre & Hospital, Coimbatore on ‘Harnessing technology for hospital mordernisation – new paradigm in care management.’ The major observation in his presentation was pointed towards the transformation of technology that is changing the scenario completely. “I felt exciting when networking through computers started that changed the work process flow in the hospitals. A lot has been changed in the past few years. As I foresee now, following to the early stage of development, there should be a team of vendors who would develop customised software for specific needs,” Ananthapadmanabhan quoted, while delivering his lecture. IT in modern healthcare: Best practices and solutions The keynote address was followed by a round of experts discussion on “IT in modern healthcare organisations – best practices & solutions,” chaired by U K Ananthapadmanabhan. In the discussion, Amod Kumar, Director, Maternal & Newborn Health Project, Intra Health International Inc. informed that in Uttar Pradesh in the next five years with National Rural Health Mission (NHRM), the monitoring system in healthcare services is going to see an overall change. Therefore, in the scenario the process of hospital modernisation is utmost important and for that the PPP mode is the best policy. Also Rashtriya Swasthya Bima Yojna (RSBY) should be implemented on an urgent basis to improve the healthcare scenario at the earliest.

DR P S RAMKUMAR Manipal University

DR RAMCHANDRA LELE Jaslok Hospital, Mumbai

U K ANANTHAPADMANABHAN

Kovai Medical Centre & Hospital

AMOD KUMAR Intra Health International

SANJAY SINGH Sir Ganga Ram Hospital

September 2010 < www.ehealthonline.org <

EVENT REPORT

ANIRUDDHA NENE 21st Century Health Management Solution

DR THANGA PRABHU Wipro GE Healthcare

INDERJITH DAVALUR Aosta Software

OM MANCHANDA Dr Lal Path Labs

ALAM SINGH Milliman India

Sanjay Singh, Head of Department of Information Technology, Sir Ganga Ram Hospital stated in his presentation on ‘Wired Network Security - Best Practices’ that in the modern hospital environment where information is running and being stored in bits and bytes, the underlying wired network infrastructure becomes the ‘nervous system’ of daily operations and must be secured to insure day to day normal operations. While implementing technology, if the wired network in today’s hospital environment is compromised and becomes inaccessible, every aspect of hospital operations is at risk and patient lives may be at jeopardy. Further to that, in a presentation, Aniruddha Nene, Principal Consultant & Director, 21st Century Health Management Solution focussed on ‘IT in modern healthcare organisations – best practices & solutions,’ where he depicted that the solution has to work on patients sensitivity. With the entry of ICT, the work flows system and services in healthcare system has changed a lot. But the challenges remained in the uncertainty, delays and errors and in information gap. To meet the need, the challenges have to be met individually. Clinical excellence and business efficiency in healthcare through IT Session two started with the keynote presentation by Dr Thanga Prabhu, Clinical Director-HCIT, Wipro GE Healthcare. Dr Thanga Prabhu pointed towards the challenges in clinical care, where medical domain knowledge has been doubled over the past eight years. Besides, unnecessary overloading of digital data, and variations in clinical practices have complicated the process. Only a proper implementation of IT can become the core tool in solving these problems. Following to the keynote address, there was a panel discussion on ‘Achieving clinical excellence and business efficiency in healthcare organisations

–possibilities through IT,’ moderated by Dr Karanvir Singh. In his presentation Inderjith Davalur, CEO, Aosta Software analysed that the quality of being exceptionally good of its kind deliberates to fineness, superbness, and of course superiority. In the areas for clinical excellence in healthcare, a special feature or quality that confers superiority comprises beauty, distinction, merit, perfection, and virtue. In a measure of productivity that compares output to inputs, efficiency in healthcare is measured with the number of minutes required to process a patient admission. Further to the presentation, Om Manchanda, CEO, Dr Lal Path Labs in his presentation on ‘Achieving Clinical Excellence and Business Efficiency’ stated that ICT provides efficiency and scalability in business and healthcare being very much consumer driven fall in the same path. Going deeper into the discussion, Alam Singh, Assistant Managing Director, Milliman India delivered his presentation on ‘Clinical Protocols and Pathways: integrating into HIMS’ stating that it is very important to integrate logic, knowledge and intelligence for an efficient IT management system to gain the most of the productivity. The session ended with a presentation by Dr Uma Nambiar, CEO, S L Raheja Hospital, Mumbai on ‘Clinical excellence & business efficiency in HCO possibilities through IT,’ where she mentioned that challenges in clinical excellence need to organise the data and categorise them for fruitful usage, India has to go a long way to achieve the system, though. Strengthening through innovations in policy, processes and technology Session three of day two started with the keynote presentation by Satya Gottumukkala, Vice President, Healthcare and Life Sciences, Religare Technologies. “As healthcare is booming in the country, we need

People Speak DR UMA NAMBIAR S L Raheja Hospital, Mumbai

“Thanks. eINDIA & eHealth 2010 at Hyderabad was very well organised and useful event of national importance. Hearty congratulations to the organisers as well as all those who sponsored and participated in it with their valuable contributions.” Dr Ashok Kumar, DDG & Director, Central Bureau of Health Intelligence, MoHFW, Government of India “On the onset let me appreciate and congratulate you for hosting such a grand event. It

SATYA GOTUMUKALLA Religare Technologies

was indeed a successful event with clear vision and purpose.” Sanjay Singh, Head - IT, Sir Ganga Ram Hospital, New Delhi

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People Speak “Once again you managed to organise the conference perfectly without any flaws. There were enough serious players present to have a good interaction with persons from different parts of the industry. Many speakers had presentations in the form of wishlists, posing as challenges, as tasks to work on. But we would like people to share their

VIJAYALAXMI JOSHI Govt of Gujarat

experiences about how they had overcome problems as lessons.” Dr Karanvir Singh, Head-Medical Informatics, Sir Ganga Ram Hospital, Delhi “It is really a great experience to become the part of ehealth india 2010 seminar for the first time. Hope next year also, this programme will be successful like this year.” Sandip Basu Thakur, AMRI Hospitals, Kolkata

DR S VIJAYAKUMAR Govt of Tamil Nadu

“I would like to express my deep appreciation for the opportunity to share my thoughts & ideas as an expert panel speaker at eHealth India 2010 at Hyderabad. I must congratulate the whole team for an excellently organised conference and the quality of discussions that took place. It was indeed a wonderful privilege to be a participant and panelist at such august gathering.” Dr Mahesh Reddy, Executive Director, Nova Medical Centres

to pull in maximum resources and for that IT can be leveraged the most. Currently cloud computing is in to perform on top of that,” pointed out Gottumukkala in his presentation. Following to his presentation started a panel discussion on ‘Health systems strengthening innovations in policy, processes and technology’ moderated by Vijaylaxmi Joshi, Principal Secretary (Health) & Commissioner Health, Government of Gujarat. “In the morning session I was listening to a presentation on ERP, I think to match up to the current pace of IT revolution and to look into the future further, healthcare services need to bank on ERP at the most,” she commented. According to Dr S Vijaya Kumar, Special Secretary, Department of Health & Family Welfare, Government of Tamil Nadu, as far as the initiatives at the government level are concerned, one of the most important steps of Tamil Nadu healthcare services is that its decision to go for a successful PPP mode. Dr Iyyanki Murali Krishna, Adjunct Professor, Asian Institute of Technology, Thailand defined a case study in his presentation on ‘Studying diseases patterns, hotspots and diffusion in Chiang Mai province, Thailand.’ The main objective of this study is to apply the spatial epidemiology approaches for studying diseases patterns, hotspots and diffusion in Chiang Mai province, Thailand, he pointed out. “In India it is very hard to retrieve data of healthcare status of the country in the government

sector. Had it possible, it could have done wonder,” commented Bhudeb Chakravarti, General Manager, National Institute of Smart Government, while delivering his lecture in the session. Following to his comments, Anju Sharma, MD, NRHM, Gujarat assured while saying that in the changing scenario, the government is now able to serve the most updated version of services to the patients. “We have started e-mamta in Gujarat to build a database of the mother and child to track the service by the name of the patients,” she added. But in all the cases, whatever required should be met at the earliest because healthcare is for the people of the country, it is a public issue and therefore, not meant for profit, Dr Balaji Utla, CEO, Health Management & Research Institute, Hyderabad mentioned in his lecture. CIO Conclave-mainstreaming IT in Indian hospitals “We need to change our objectives in the healthcare sector. The role of the hospitals should be modified in changing their visions. The patients should be treated as customers as well and need to be served anywhere at anytime whenever they are required treated as emergency services,” commented Susheela Venkataraman, Managing Director, Internet Business Solutions Group, Cisco in her presentation in session four of day two. The keynote presentation was followed by a panel discussion on ‘Hospital CIO Conclave-

DR IYYANKI MURALI KRISHNA Asian Institute of Technology

BHUDEB CHAKRAVARTI National Institute of Smart Government

ANJU SHARMA NRHM, Gujarat

DR BALAJI UTLA Health Management & Research Institute

SUSHEELA VENKATARAMAN Internet Business Solutions Group, Cisco

September 2010 < www.ehealthonline.org <

EVENT REPORT

INDRAJIT BHATTACHARYA IIHMR, NewDelhi

DR SRINIVAS K IYENGAR, Care Hospitals

Mainstreaming IT in Indian hospitals is the need of the hour, in healthcare sevices sector in the country, opined experts. DR NEENA PAHUJA Max Healthcare

TIM ELLIS Department of Health, United Kingdom

SANDIP BASU THAKUR AMRI, Kolkata

DR N K THOKCHOM Global Hospitals Hyderabad

DR SANJEEV SOOD Indian Air Force

mainstreaming IT in Indian hospitals’ moderated by Indrajit Bhattacharya, Professor-Health Informatics, International Institute of Health Management Research (IIHMR), New Delhi. “Data mining is important and therefore, the software to manage data needs to be customised accordingly,” commented Dr Karanvir Singh at Sir Ganga Ram Hospital, Delhi in the session. According to Dr Srinivas K Iyengar, Vice President, Care Hospitals the keyword is ‘change management ‘ and the challenge is to implement HIS individually in hospitals in that changing scenario. While sharing her experiences of the IT implementation in Max Healthcare, Dr Neena Pahuja, CIO, Max Healthcare Group shared, “Max was one of the early service providers to go for a central database. We have chosen WorldVistA as it is the open source database. But for the successful usage of the software we go for a lot of data cleaning.” But it has always been a challenge to track data, voiced Tim Ellis, Whole System LTC Demonstrator Programme Manager, Innovation & Service Improvement Division, Department of Health, United Kingdom. “We ran the software on 6,000 people at a stretch that also gave us the profile of the patients along with their lifestyle,” he clarified. The problem lies elsewhere, mentioned Sandip Basu Thakur, Associate VP (IT), AMRI, Kolkata. “In healthcare there is no dearth of information but the challenge is feeding that data into the system correctly on time. It would be the best if the doctors take the responsibility,” he stressed upon.

> www.ehealthonline.org > September 2010

Whereas Dr N K Thokchom, Group VP (IT, Telemedicine & Strategic Initiatives) informed that IT in global hospitals are now evaluated and reviewed as per its performance and how flexible it is to accommodate new technology. The session was concluded with the comments of Group Capt (Dr) Sanjeev Sood, Indian Air Force Station, Jodhpur who said, “There are examples of projects which are successful and which are not. But that largely depends on the doctors who needs to overcome their protocols and limitations to learn

People Speak “eINDIA has been growing strength after strength in the past few years. I come year and can share my experiences, also I am in a mood to meet my old pals.” U K Ananthapadmanabhan, President, Kovai Medical Centre & Hospital, Coimbatore “I was satisfied with the overall experience and organisation & management of the event. But I also felt for more targeted attendance in the healthcare segment especially in areas dealing with the developmental aspects.” Susheela Venkataraman, Managing Director, Internet Business Solutions Group, Cisco

and implement the language of technology. We also need to concentrate on patients safety and security.”

Day Three Day three started with the keynote address on ‘Healthcare for the poor –serving bottom-ofthe-pyramid population through efficient use of technology and service innovation’ by Babu Ahmed, CEO, Aarogyasri Health Care Trust, Government of Andhra Pradesh. In his presentation, Babu shared his experiences of Aarogyasri as a case study saying, “The challenges we faced is a bit difficult because we deal with the bottom of the pyramid – primary healthcare in India. The volume and background of healthcare is critical in the country especially when it talks about the access of it. It is even more challenging in catastrophic condition in rural government health centres where bringing in experts is really tough leading to a situation where 30-40% of the posts are vacant. Reforming health insurance through technology The keynote address was followed by a panel discussion on ‘Reforming health insurance through technology’ chaired by Alam Singh, Assistant Managing Director, Milliman India. “We connect the consumer (the patients) and the service providers for cashless service in hospitals and other healthcare centres,” P Rammohan, Managing Director & Co-Founder, HealthSprint Networks informed in his presentation on ‘Health insurance data exchange to analytics - way forward.’ While sharing her experiences, Anjana Agrawal, CIO, Max Bupa mentioned that technology is very important for Max Bupa to access to the new market of healthcare which is growing leaps and bounds.

“We leverage on the maximum usage of Internet for networking especially to reach out to the places where health schemes are not sponsored,” said Sanjay Dutta, Head, Health Vertical, ICICI Lombard. Third Party Administrator (TPA) being licensed by the Insurance Regulatory and Development Authority (IRDA) has now become a connecting bridge between the insurance companies and the customers and technology has open diversified ways to serve the best, Malti Jaswal, CEO, E-meditek TPA Services Ltd was quoted while saying. “We are a membership based, costless, not for profit organisation and highly technology based insurance company,” informed Steven Yeo, VP & Executive Director, HIMSS AsiaPac following to Jaswal’s comments.The organisation is further involving in the medical banking sector to leverage maximum on cash to provide best of the service, he added further. Technology: Bringing accessibility and affordability for masses Session two of day three was started with the presentation of Venkat Changavalli, CEO, GVKEMRI on ‘Leveraging Technology for Emergency Management & Healthcare Delivery’ as keynote presentation. His presentation was focused on innovative pro-poor PPP (Public Private not for Profit Partnership) service delivery model to improve quality and access to healthcare services across India. Part two of session two was focussed on the discussion on ‘Technology enabled remote healthcare – bringing accessibility and affordability for masses’ chaired by Dr B S Bedi, Advisor-Health Informatics, C-DAC, Government of India. From

BABU AHMED Aarogyasri Health Care Trust

ANJANA AGRAWAL MAX Bupa

SANJAY DUTTA ICICI Lombard

MALTI JASWAL E-meditek TPA Services

STEVEN YEO HIMSS AsiaPac

people Speak “I would like to convey my sincere thanks to the organisers for their excellent arrangements and successful conduct of the conference; all the resource personnel for the useful discussions and deliberations we had ;and exhibitors for introducing us to their

VENKAT CHANGAVALLI GVK-EMRI

innovative products and services. Overall,the conference offered a great opportunity for learning as well as networking with some old and new colleagues, friends and industry stakeholders.” Gp Capt (Dr) Sanjeev Sood, Air Force Station, Jodhpur “This is a great global forum for networking and exchanging thoughts on evolving eHealth and medical informatics topics. Need more robust sessions and good participation from industry, academics, NGOs and government eHealth initiatives.” Dr Thanga Prabhu, Clinical Director-HCIT, Wipro GE Healthcare

DR B S BEDI C-DAC, Govt of india

September 2010 < www.ehealthonline.org <

EVENT REPORT

DR PAVAN KUMAR Nanavati Hospital, Mumbai

M C KARTHA C-DAC, Trivandrum

DR A K AZAD MOHFW, Govt of Bangladesh

DR K GANAPATHY Apollo Telemedicine Network Foundation

DR RUCHI DASS Lifetime Wellness Rx International

NITIN MATHUR HealthPA.com

B GIRISH BABU CARE Foundation

ANITA SHET pinkwhalehealthcare.com

very beginning of technology era in India, the government started to look into the possibilities of how much the social sector can get the benefit of it and health was no exception in that. The session portrayed a varied picture accumulating the facts from the speakers that was extremely rich with the experiences shared by them. “It is very alarming to know that a major portion of doctors and medical practitioners are still unaware of the activity and success of telemedicine in India. Nanavati Hospital has taken the risk of introducing tele-medicine as one of the early service providers in the sector and now we can say that we are much successful inspite of hurdles and obstacles that came across our ways,” shared Dr Pavan Kumar, Consultant Cardiac Surgeon & Head-Telemedicine Master Centre, Nanavati Hospital, Mumbai. While Dr Sanjeev Sood delivered his presentation on ‘Transforming healthcare through technology-from innovation to execution’ that gave a productive scenario of the changing paradigm of the sector, M C Kartha, Project Manager, C-DAC, Trivandrum shared his experiences about usage of technology at its best in a project on ‘Cancer detection and cervical cancer treatment using Mobile Tele-medicine Unit’ in Kerala. He was followed by his co-panelist Professor Dr A K Azad Director, MIS, MOHFW, Government of Bangladesh who put forth the success story on ‘Remote Health Care - Initiatives of Ministry of Health of Bangladesh’. The project was an e-Health initiative under MOHFW, connected to ‘Digital Bangladesh Vision’ of the current government pertaining to a top development agenda in Bangladesh. Online and mobile healthcare: Exploring services and business models The third or the last session of day three started with the keynote presentation on ‘mHealth – the reinvention of health care’ by Dr K Ganapathy, President, Apollo Telemedicine Network Foundation. Dr Ganapathy delivered his lecture on his research on ‘mHealth: A potential tool for healthcare delivery in India,’ that spoke the prolific future of mobile health in depth in healthcare service sector. His lecture was also the part of the panel discussion on ‘Online and mobile healthcare – exploring technologies, services and business models’ chaired by Dr Ruchi Dass, Vice President,

> www.ehealthonline.org > September 2010

IT involvement and operations in healthcare services industry is still in a developing stage in India. Dependence and expertise related to IT and technology will gain its own share of pace as par the growing momentum of time. Lifetime Wellness Rx International. “eHealth and mHealth are going to be the future of the growing health sector in India. But it is also true that technology has to be backwardly compatible otherwise the development would have a silo-base problem and will be soon dead or non-vital,” said Das, while delivering her introductory lecture about the session. According to Nitin Mathur, CEO, HealthPA.com, with the invent of technology, healthcare can now provide a multiple options of service providers, where the service is just a phone call away and therefore, the sector has become a bit complicated than the past few years. “We have started working on a project in 50 villages of Maharastra where mobile health devices have been regarded as the major tool to serve the rural population base. We have trained the doctors and other para medical staffs to gain maximum from the project,” stated B Girish Babu, Chief-Care Rural Health Mission, Care Foundation. Smart card is one of the major tool in mobile devices in healthcare and it is slowly making its place, commented Vijaya Verma, Founder & CEO, Yos Technologies. “We are using these smart cards to record and preserve data of the newborns for future data base maintaining a individual calender in providing services on time. The cards can also be used in emergency care where critical health information can be delivered taking the help of these cards,” she informed. “We still consider the IT involvement and operations in healthcare is in a developing stage in India. Dependence and expertise related to IT and technology will gain its own share of pace as par the growing momentum of time,” assured Anita Shet, CEO, pinkwhalehealthcare.com, while replying to a queries in the session.

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eINDIA AWARDS 2010

“...I believe that apart from showcasing and presenting ICT for development projects and initiating discussions around them, it is equally important to recognise the successful endeavours in this field. eINDIA Awards would encourage others to follow in the footsteps of their visionary counterparts.” Ms Agatha Sangma, Minister of State for Rural Development, Government of India at the inauguration of eINDIA2010 Awards ceremony The eINDIA Awards is the premier accolade to innovative endeavors made in assimilating technology in developmental concerns. The initiative aims at identifying and felicitating unique and innovative initiatives in the ICT for development space, as also the projects that can be easily replicated in a sustainable manner. While eINDIA Awards had a formal twotier Jury process, it also had a parallel online mechanism for the Citizen’s Choice Award in all 26 sub-categories under eGovernance, Education, Healthcare, Agriculture, Municipal IT and Telecentre. The online voting process allowed citizens to vote and recognise projects that have impacted their lives the most. As part of the formal evaluation process a panel of 25 distinguished international Jury members had to first assess the nominations on certain pre-defined criterion, with each project being evaluated by a minimum of three Jury members. The average weighted score was then used to select the Top 5 from each category. The list was then used by the In Person Jury, which met in Delhi on July 22, 2010 to decide on the winners in each of the segment.

THE AWARD JURY • Ashish Sanyal Sr Director, DIT, Government of India • Shakila T Shamsu Joint Adviser, Planning Commission • Rajen Varada Resource Person, UN Solution Exchange

Secretary General, B’desh

Joint Director, CIET, NCERT

Telecentre Network

• P Vigneswara Ilavarasan Assistant Professor, IIT-Delhi

• Michael Riggs FAO, Italy • Hardik Bhatt CIO, City of Chicago • Dr R Sreedher Director, CEMCA

• Dr Ashok Kumar DDG & Director, CBHI, Government of India

• Anir Chowdhury Policy Advisor to PMO, UNDP, Bangladesh

• Dr Basheer Ahmad Shadrach Executive Director, Telecentre. org Foundation

• Dr S S Jena Chairman, NIOS

• Dr V Balaji Global Leader, ICRISAT • Dr Gopi N. Ghosh Assistant Representative & Resource Person, FAO • Dr. B S Bedi Adviser-Health Informatics, C-DAC • Dr Ananya Raihan

> www.ehealthonline.org > September 2010

• Sri B S Raghupathy Joint Director, DET, Bangalore • Brig (Dr) R S Grewal Vice Chancellor, Chitkara University • Sourav Banerjee Senior Education Specialist, USAID • Prof Arun Nigavekar Former Chairman, UGC • Prof Vasudha Kamat

• Rufina Fernandes Chief Executive, NASSCOM Foundation • Michael Gurstein Sr Journalist, The Journal of Community Informatics Centre for Community Informatics Research, Canada • Lekha Kumar Commissioner, Income Tax, Government of India • Dr R Siva Kumar CEO, NSDI & Head-NRDMS, Government of India • Dr Akhilesh Gupta Adviser, DST, Government of India • Sunil Kapoor Zonal Director, Fortis Healthcare Limited • Ndaula Sulah ED, Ugabytes, Uganda

eINDIA2010

Leadership Award Lt Gen (Retd) Bhopinder Singh, Lt Governor of Andaman and Nicobar Islands Lt Gen Bhopinder Singh was accorded the prestigious eINDIA2010 Leadership Award for bringing ICT to remote and difficult terrains like Andaman and Nicobar Islands and connecting distant communities through effective use of IT. While sharing his views, he said that the Andaman and Nicobar Islands require IT in myriad ways. There are several challenges which have to be addressed in these areas, and for that eGovernance is of crucial importance. â&#x20AC;&#x153;eINDIA has been a great learning experience in terms of getting exposure into the field of IT, and I will take back this learning for furthering the ICT cause in Andaman and Nicobar Islandsâ&#x20AC;?, he added.

September 2010 < www.ehealthonline.org <

GOVERNMENT POLICY

HEALTH Services Management System IMPLEMENTING AGENCY Department of Medical Health & Family Welfare, Rajasthan OBJECTIVES  Ensure better health for women  Minimise maternal mortality, neo natal mortality and trace areas with decreasing sex ratio at birth  Monitor health care institutions

JURY AWARD

OUTCOME  Contributed in saving the vision of rural citizens in terms of avoiding needless blindness  Enhanced the capacity of prevalent eye care system of Tripura by structurally integrating primary, secondary and tertiary care

CITIZEN CHOICE #1

he Pregnancy, Child Tracking & Health Services Management System is a web-based online system developed by National Informatics Centre (NIC) Rajasthan for Medical, Health & Dept of Medical Health & Family Welfare, Family Welfare Department, Govt of Rajasthan being awarded for ‘Health Services Management System’ in eHEALTH Government of Rajasthan, for INDIA 2010. improving its services right upto the grass root level (health sub-centre). The system is extremely useful in ensuring better health for women, minimising maternal mortality, neo natal mortality and in tracing areas with decreasing sex ratio at birth. It is also useful in monitoring functioning of all health institutions across the state numbering more than 13, 000.

OUTCOME  Improved health services  Better health surveillance  Reduction in maternal mortality  Reduction in child mortality  Improved child health because of better monitoring of vaccination programme

TRIPURA Vision Centre Project

he tele-ophthalmology project is initiated for the ophthalmology department, Department of Health and Family Welfare, Government of Tripura. It is aimed at offering primary and preventive Department of Health and Family Welfare, eye care services to rural citizens Govt of Tripura receiving Jury Award from Smt K Ratna Prabha, Principal Secretary-IT, of Tripura by adopting advances Govt of Andhra Pradesh. in medical sciences, bio-medical engineering and its convergence with Information and Communication Technology. Poised with the challenges of inadequate medical facilities and limited eye care specialists in the rural areas, this initiative has overcome all geographical, economic, social barriers earlier faced by the rural citizens and helped them in obtaining quality eye care services from Vision Centres located at their doorsteps. The Vision Centre is a comprehensive model for providing eye care in a decentralised manner located at the 35 block offices of the state.

> www.ehealthonline.org > September 2010

IMPLEMENTING AGENCY ILFS ETS for Government of Tripura OBJECTIVES  To take preventive and primary eye care services to remote locations  Measuring the quality and effectiveness of the service offered at various eye care centres

CIVIL SOCIETY

CITIZEN CHOICE #1

OUTCOME  Compilation of over 219,852 pregnant and nursing women data till May 2010  Timely referrals of high risk women and children  Better coordination among mother and child healthcare functionaries

MIS for Safe Motherhood and Child Survival

he Safe Motherhood and Child Survival (SMCS) project is the core project of Deepak Foundation undertaken since 2004 in partnership with the Deepak Foundation has been awarded the Department of Health and Citizen Choice award for the project ‘MIS for Family Welfare, GovernSafe Motherhood and Child Survival.’ ment of Gujarat, with the broad objective of reducing the maternal and infant mortality rate in the District. The project goals are in line with the Millennium Development Goals (1990-2015), National Population Policy (2000), National Rural Health Mission (2005-2012) and the Gujarat Population Policy (2002) goals. The project aims to reduce maternal mortality ratio to less than 100 per 100,000 live births and reduce infant mortality rate to less than 30 per 1000 live births.

IMPLEMENTING AGENCY Deepak Foundation OBJECTIVES  Monitor health service delivery to pregnant and nursing women and their newborns  Monitor activities of grassroots health functionaries related to maternal and child health  Share health indicators with all stakeholders

HEALTH Risk Assessment Index of India IMPLEMENTING AGENCY MakeMe Healthy & Disease Management Association of India OBJECTIVES  To conduct holistic health risk assessment with the use of technology  Focus on preventive healthcareglance

ake Me Healthy is a pioneering and unique venture in India in the field of Lifestyle Health & Chronic Disease Management and is taking Preventive MakeMe Healthy & Disease Management Association of India being awarded for Healthcare to the doorsteps of ‘Health Risk Assessment Index of India’ by the people using Tele-Health Smt K Ratna Prabha. Technologies. Make Me Healthy conducts lifestyle health risk assessments for the individuals in the comfort of their home or office, in just 15 minutes. All that an individual needs to do is make a call or send an SMS to book an appointment. The assessment comprises of collection of family and personal health history, information about social habits and biometric screening comprising of: random blood sugar and HbA1C, ECG, spirometry (PFT), total cholesterol, triglycerides, blood pressure, pulse oximetry and body composition.

September 2010 < www.ehealthonline.org <

JURY AWARD

CITIZEN CHOICE #3

OUTCOME  Two thousand assessments conducted in the pilot phase  Selected by DMAI as its exclusive partner to conduct their Health Risk Assessment Index survey for the next two years

ICT ENABLED DIAGNOSTIC SERVICE PROVIDER

eMEDLABS IPM IMPLEMENTING AGENCY Institute of Preventive Medicine OBJECTIVES  Provide laboratory services in diagnosis of diseases through pathology, microbiology and biochemistry  Provide facilities in diagnostic units in all medical laboratory tests  Meet the problems of the target group for the various services

JURY

MENTION

CITIZEN CHOICE #2

OUTCOME  Customers can be followed up regularly for feedback  The initiative has received an overwhelming response from the customers

JURY AWARD

he Institute of Preventive Medicine, Public Health Laboratories and Food (Health) Administration is a multi-faceted department with multifarious activities and functions in the process of achievThe representatives of Institute of Preventive Medicine receiving award from the ing preventive health care. The dignatories for project ‘eMedLabs IPM.’ project was started to solve the problems by harnessing the state-of-the-art ICT where the quality of the investigations and the reports used to be poor and complaints used to occur everyday from the citizens visiting the public health labs, the long queuing time to get the vaccination done for the international travellers, recurring complaints and problems on several issues related to infectious diseases, to ensure timely reporting of the investigation.

CITIZEN CHOICE #1

OUTCOME  In diagnostics nearly 2 lakh tests, every year since 2007, with an average of 600 tests per day

FROM Customer Satisfaction to Customer Delight

et up effectively last year (2009-10) on 1st April, 2009, the Programme/Project idea was conceived two years back and was implemented fully (phase one) in 2009-10 last year. The idea was to ‘From Customer Satisfaction to Customer Delight,’ representatives of Dr Lal PathLabs provide a ‘One Call Does It All’ receiving award from Smt K Ratna Prabha. kind of a model wherein all home collection customer enquiries, queries, etc can be received and personalised attention given for execution of actual service at customers’ home and workplace in a hygienic, fast and safe manner. This facility was initialised at Janak Puri where a state of the art communication and knowledge hub was set-up – first of it’s kind in the country in diagnostics domain for customer delight. This hub was an amalgamation of latest technology, communication know-how, innovative systems and superior integration of the diagnostic labs across Delhi/NCR and a team of best customer service professionals adapt with medical knowledge at the same time.

> www.ehealthonline.org > September 2010

IMPLEMENTING AGENCY Dr Lal PathLabs OBJECTIVES  Provide customer delight, one stop shop for all queries  Serve the target group of people who cannot visit the lab personally

HEALTH INSURANCE

JURY AWARD

CITIZEN CHOICE #1

OUTCOME  The BPL population receives treatment for most types of serious illness without facing a catastrophic financial burden

RAJIV Aarogyasri Community Health Insurance Scheme

he scheme is an innovative and non-conventional health insurance scheme in PPP mode and many following features, making it a unique. Aarogyasri is a non-conventional health insurance scheme that runs as an independent Babu A, CEO, Aarogyasri Health Care Trust, trust with Hon’ble Chief Minister as Govt of Andhra Pradesh (extreme left) receiving award from Shri S R Rao, Chairman to oversee the implemen- Additional Secretary, DIT, Govt of India. tation and act as the regulator of the scheme. Through this scheme, the Government is able to provide insurance coverage of up to Rs 2 lakhs per year on a family floater basis for 2.03 crore families at a cost of only Rs 400/- per family per year. This could be achieved by the Government without cutting in to other provisions in the budget for healthcare. Further the huge disease and patient load could be substantially managed with the implementation model.

IMPLEMENTING AGENCY Aarogyasri Health Care Trust OBJECTIVES  Improve access of BPL families to quality medical care for treatment of identified diseases  Assist BPL families for their catastrophic health needs without compromising the importance of existing healthcare delivery system of the government

CHIEF Minister Kalaignar Insurance Scheme IMPLEMENTING AGENCY Tamil Nadu Health Systems Society OBJECTIVES  Provide quality and free healthcare for the economically weaker sections and the downtrodden

JURY AWARD

n its quest towards a healthy society, the Tamil Nadu Government has launched the Chief Minister Kalaignar Insurance scheme for life saving treatments on July 23rd, 2009 for providing quality and free Dr S Vijaya Kumar, Special Secretary, Dept of Health & Family Welfare, Govt of healthcare for the economically Tamil Nadu (extreme left) receiving award weaker sections and the down- for ‘Chief Minister Kalaignar Insurance trodden. The eligibility criteria Scheme.’ are carefully determined so as to benefit the needy and the deserving lot. This has been possible by roping in selected private hospitals apart from the Government medical colleges and District hospitals in the state. More than 600 surgical procedures and treatments identified by senior medical/surgical consultants are covered under the project. For efficient administration and management of this scheme, advanced IT elements have been used.

September 2010 < www.ehealthonline.org <

CITIZEN CHOICE #2

OUTCOME  Launched across the entire state in one shot  Improvement in the mortality rate and the good number of beneficiaries from the less populated and remote district

PRIVATE SECTOR

USB Powered 3Lead ECG monitor IMPLEMENTING AGENCY Infotech OBJECTIVES  Offer low cost and effective cardiac diagnostics  Enable portability to improve reach to remotest parts in the country

JURY AWARD

CITIZEN CHOICE #2

OUTCOME  Easy access to information about consultants, their availability, fees, facilities available in different hospitals

CITIZEN CHOICE #1

nfotech’s medical team has conceived, designed and developed world’s first USB powered three lead compact ECG monitor to offer a low cost and effective cardiac diagnostics. The system works with the power supplied by the ‘USB Powered 3Lead ECG monitor’ has USB port. The USB-based ECG been awarded the best Private Sector Initiative Citizen Choice Award. monitoring system resembles a pen-drive. The main features of this system are three- lead ECG Monitoring and Heart Rate Measurement. Plug-in this module into one of the PC’s USB ports and run the application software on the PC to monitor the ECG of an individual. The other end of this device is provided by the ECG leads which needs to be attached to the patient for whom ECG is to be monitored. The ECG data can also be transmitted to an expert in the cardiology room using ZigBee in case of emergency.

OUTCOME  Miniaturisation, portability and better clinical workflow solutions Low power consumption

HELLODoctor24X7

ello Doctor24x7 was conceived to provide round-the-clock medical and healthcare information to the public over phone as a primary medium coupled with HelloDoctor24x7 Healthcare receiving the SMS, email and fax as the sec- Jury Award for the best Private Sector Initiative of the year. ondary medium. Based on the premise of streamlining healthcare information over mobile phones, a group of medicos and technocrats sat down to implement an ICT enabled infrastructure where these services can be rendered to the public. Originally the brainchild of two medicos, the programme has been operational in Orissa with its service delivery centers based in Bhubaneswar. HelloDoctor24x7 DataCentre keeps accurate and up-to-date healthcare information and uses a range of software tools, both developed in-house and open sourced, to streamline the overall process while providing the information at the least possible time.

> www.ehealthonline.org > September 2010

IMPLEMENTING AGENCY HelloDoctor24x7 Healthcare OBJECTIVES  Streamline healthcare information  Enable people to access healthcare services seamlessly anytime, anywhere

ICT ENABLED HOSPITAL

CITIZEN CHOICE #1

OUTCOME  Faster registration of patients  Updation of patients’ medical records  Better coordination in advise for investigation of various pathological tests  Improvement in medicine distribution mechanism

COMPUTERISATION of Wellness Centres

he CGHS in India provides a comprehensive health care for central government employees and their family members, pensioners and their dependant family members, Members of Parliament, ex-MPs, Central Governement Health Scheme (CGHS) has been awarded the Citizen and judges of the Supreme Court Choice Award for ‘Computerisation of Wellof India. The Linux and web-based ness Centres.’ computerisation program rolled out under the scheme has helped connect all CGHS Wellness centres through Internet and central server. The data of beneficiary is accessible from anywhere in India using the beneficiary ID. Earlier each family used to have one family CGHS card number. Now each member of CGHS has a unique ID number, which enables data tracking, medical records including medicines consumed.

IMPLEMENTING AGENCY Central Governement Health Scheme (CGHS) OBJECTIVES  Make CGHS services more patient friendly  Introduce innovative services like  Beneficiaries could be permitted to draw medicines from any where  Credit facility to beneficiaries for treatment taken under emergency in another city

BACKBONE HIS IMPLEMENTING AGENCY Kovai Medical Center and Hospital OBJECTIVES  Working towards a paperless system  Initiating and maximising the usage of SMS  Bring those transactions directly into the financial system and generate GRNs

JURY AWARD

ovai Medical Center and Hospital (KMCH) is a 500-bed Multidisciplinary Super specialty hospital located in Coimbatore. KMCH has successfully U K Ananthapadmanabhan (second from left) and Inderjith Davalur, (extreme right) achieved several important receiving the award for ‘BackBone HIS’ milestones while implement- implemeted by Kovai Medical Center and Hospital. ing BackBone HIS. KMCH launched a full scale project of introducing a comprehensive HIS roll-out that covered all of its operations. In addition, it decided early that every one of its centres will be automated with a robust HIS. The hospital is equipped with state-of-the art medical equipments and is located on an 20 acres site with 11 operation theatres. KMCH also has specialised clinics like asthma clinic, diabetic clinic, slim clinic, Pain clinic, de-addiction clinic, painless labour clinic, andrology clinic, diet clinic etc and one of the best Emergency-Trauma Care Center network in the region.

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OUTCOME  Improves patient experience and reduces administrative work  Text Messaging in communicating vital information  Information kiosk that provides information on several important issues

APPLICATIONS

THINKING ‘iBOX’ THE ARTICLE GIVES AN ACCOUNT OF ANIRUDDHA NENE’S DISCUSSION WITH A CTO OF A HOSPITAL IN GUWAHATI, ANIRUDDHA NENE Principal Consultant – Imaging & Director 21st Century Health Management Solutions Pvt Ltd

recently visited a new hospital in Guwahati to understand the ground issues. While doing this personal ‘recce’, the office bearing the designation of CTO, caught my eye. Nowadays, thanks to lot of noise made on how badly healthcare providers need ICT solutions, I felt the drive to just go and have an informal discussion with him, in a bid to learn something new or find some solutions. I introduced myself and the interaction began with a heartfelt discussion on how Indian Healthcare industry is primitive as compared to western counterparts. The CTO had a good experience of software and in fact had worked on a large project implementation of HIS overseas. We started discussing on the need of clinical records in hospitals. The CTO reacted immediately, saying that there was an urgent need of PACS for the hospital and suggested to propose the solution the next day itself. He almost expected that I

WHICH RESULTED IN THE BIRTH OF iBOX, A COMPONENT OF ADVANCE IMAGING SYSTEMS TO ADDRESS THE NEED OF COMPREHENSIVE DIGITAL RECORD FOR DIAGNOSTICS.

always carry ‘fit-to-size’ proposal in my briefcase! Well this reaction was not different and I have witnessed most of these cases over the past two years. Still discussing and undecided, on this one (hoping to get a new input) I asked him as to what was his utmost priority or concern that PACS will solve? As it turned out, it was to access all the previous diagnostic imaging records. But when asked about how long he plans to store them on-line, the answer was ambiguous – “Not sure”, he said. This time I had another question ready – “Do you have elimination of films in your road map?” He replied, “Well, we have to give films because many of the referring physicians want films and we can’t say no. I know that in the West filmless environment is the main driver to implement PACS. That’s why you know we want something like MiniPACS”. Frankly speaking, I do not know who

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coined this word ‘Mini PACS’. Hopefully s/he meant that a product with restricted feature functionality, but in Indian context it can be redefined as ‘something cheap but having the four letters P A C S’ when I am not so sure what I want! Anyways, I tried to look surprised and reacted “When the doctors are not sure about the utility, Radiologists look at it only from the perspective of storing interesting cases. Management is questioning every rupee spent on this from ROI perspective, what makes you feel that this is an urgent need?” His answer this time was, for a change, quite interesting. “You know, the hospital that is coming up on the other side of the town is already having it and we want to take some step in this direction anyway. We are sure that’s the road ahead. It’s just a matter of time and as a new hospital we do not want to lag behind.” I admired his frankness, though. It is easy to discuss meaningfully when the ‘other side’ is

open to admit that they need help. I was perseverant. “Who is your target? Is it the referring physicians and consultants, insurance companies, patients, corporate customers…” Prompt answer - “Patients first. Our mission statement talks about it very clearly. Patient First”. That’s where I got somewhat ‘aggressive’ and asked him looking straight into his eyes, “Which PACS or Mini-PACS was ‘patient centric’ that looked upon the patient as the direct beneficiary who would feel and appreciate the impact of PACS?” After a pause, came the answer, “If patients gain confidence that their data is safe with us, they will naturally feel good about it.” I disagreed and said, “We (Indians) are different. We take ownership of our health records and this is irrespective of the hospital taking the onus. So, if we really need to be patient centric we should think what will reduce their anxiety.” If he needed to reach out to the patient, it is best if we could capture all the diagnostics data in the form of images in digital media like CD or DVD. An anticipated reaction from the CTO, “Giving data in a CD is nothing new. We already plan to give DICOM CD for our CT scan examinations and Angiographies”. Even though, I was anticipating this, I was still happy that at least the focus was now moving closer to the patient centric approach. I said, “What if you can give all images and reports for all diagnostics to the patient in ONE CD. This CD can have information about the tests that you would like to share with them as a part of counseling. This will have information about precautions and preparation for the tests. The best part can be that it will give three different user interfaces: One for patient and second for Consulting Doctor. Each interface providing the tools and means for the data to be presented in a manner each user needs. For example, a consultant may need an embedded DICOM viewer but patient may not. Patient may need information

Foolproof method of tracking every scan on every machine that is performed but is not communicated to iBox. Plugs revenue leakage effectively.

on tests and preparations but Consultants may not. Look at it from process angle, imagine having a Mini PACS that provides a terminal near central dispatch desk that will compile information of all tests and reports on a single click. No need to burn multiple CDs at each modality that adds unnecessary task to the technician. Patients would definitely appreciate such comprehensive digital records in one media and I am sure a time will come when referring physicians will start appreciating too. Third interface “Management iBox” can open Pandora’s box for the management to get statistics for the Department Manager of the diagnostic. But that remains in the Mini PACS and obviously does not go to the patients! ” I learnt something and iBox was born!

The site 21chms iBox workflow is simple and it hooks onto the 21chms AIS Mini PACS. Since patients preserve iBox reduces the storage requirement substantially to begin with. iBox is being implemented in Ayursundra ‘One Stop Medical Centre’ in Guwahati and to be rolled out in the tertiary care unit of the same group to be launched soon. Dr Abhijit Hazarika, Chief Executive Officer, Ayursundra, is confident that this is the best practice for our country and prefers to be the trend setter than a follower.

iBox 21st Century Health Management Solutions has introduced iBox as a component of Advance Imaging Systems to address the need of comprehensive digital record for diagnostics. It is a radically different approach for geographies like India where the responsibility of patient records still lies with the patient and it is willingly accepted by the patients. iBox offers consolidation of all images and reports in a single media. ‘My iBox’ is utility for the patient to view the data, and ‘Doctor’s iBox’ is a utility for the clinicians to refer to the images and reports more meaningfully”.

September 2010 < www.ehealthonline.org <

NEWS REVIEW

Forensic lab with latest technology to come up near Pune The Union ministry of home affairâ&#x20AC;&#x2122;s (MHA) directorate of forensic science (DFS) has set the ball rolling for the establishment of a hi-tech Central Forensic Science Laboratory (CFSL) on a 25-acre campus at Wadgaon Maval, about 25 kms from Pune, along the Pune-Mumbai highway, media reports. Apart from the forensic lab, the campus would house the Government Examiner of Questioned Documents (GEQD) unit, which plays a pivotal role in the unravelling of high-profile white collar crimes like hawala transactions and fake stamp papers besides in identification of handwritings on secret documents etc. The existing GEQDs have played a key role in the scrutiny of the fake stamp papers in the multi-crore rupee Abdul Kareem Telgi scam.

The Central Forensic Science Laboratory and Government Examiner of Questioned Documents near Pune will be a major boost to investigation of criminal cases referred from Maharashtra and neighbouring states as well as cases referred by the central agencies, informed Shri R M Tripathi, Senior Scientific Officer, Directorate of Forensic Science. Under the 11th Five Year Plan, the Union ministry of home affairâ&#x20AC;&#x2122;s has made a provision of INR 200 crore for the directorate of forensic science to implement as many as 26 projects aimed at modernisation of forensic science applications across the country. According to sources consolidated funds worth INR42.60 crore have been set aside for the Central Forensic Science Laboratory and Government Examiner

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of Questioned Documents near Pune and similar facilities in Bhopal and Guwahati, informed sources.

Best-of-the-Best in Healthcare and Life Sciences Industry to be Recognized

“The roots of all goodness lie in the soil of appreciation for goodness” ..Dalai Lama Medical Devices

Healthcare Delivery

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Others • Diagnostic Services Provider Company • Wellness Services Provider Company • Healthcare Retail Company

For more information please visit www.frost.com/hcawards2010 Writing Instrument Partner:

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NEWS REVIEW | PRODUCT NEWS

Transasia brings UF 1000i, automated urine particle analyser Transasia Bio-Medicals Ltd in association with Sysmex has launched the UF 1000i, a fully automated urine particle analyser to help medium and large sized laboratories to optimise urine microscopy with faster turn around times, standardised reporting, effective workflow management and resource utilisation. UF-1000i is Sysmexâ&#x20AC;&#x2122;s latest urine fluorescence flow cytometer. Based on Fluorescence Flow cytometry technology using polymethine dye for specifically staining nucleic acids, sensitive particle analysis i.e bacteria detection at clinically relevant levels can be achieved. By identifying over 65,000 particles, analytical performance in respect to sensitivity, accuracy and precision can be further enhanced. UF-1000i also measures RBC, WBC, bacteria, epithelial cells, casts, crystals, yeasts and spermatozoa, updates urinary conductivity besides RBC morphology information and an intelligent rule-based UTI flag. With two separate analytical channels, UF-1000i offers selective analysis of either bacteria alone or the full range of parameters, and permits bacteria counting. UF-1000i automatically monitors the urine conductivity proven to correlate well with urinary osmolality and creatinine. UF-1000i delivers a sampleâ&#x20AC;&#x2122;s results within minutes. It determines infection or inflammation, while even very sensitive bacteria detection is possible with UF-1000i. Bacteria concentrations down to clinically relevant levels between 103 and 104 / mL can be determined by the instrument.

Sysmex XT 4000i, haematology analyser with two special software launched Transasia has launched the Sysmex XT 4000i, a fully automated fluorescence flow cytometry based, high-end six part differential haematology analyser, also incorporated with two special software for enumerating Ret-He and IG. The analyser also reports body fluid, reticulocyte count and IRF (immature reticulocyte fraction) for evaluating bone marrow erythropoietic activity. XT 4000i has fully automated fluorescence flow cytometry based six-part differential hematology analyser, where up to 100 samples per hour can be done. The multichannel analysis allows comprehensive information processing system and data storage, semiconductor laser has lower power consumption, higher stability, and longer life thus cutting down on maintenance cost, fully automated reticulocytes analysis with florescence flow cytometry, no pre-treatment and faster reporting time of just 60 seconds, platelet count switching algorithm between impedance and optical methods for reliable and accurate platelet counts. The Sysmex XT4000i, approved by the US FDA, has the latest reportable parameters like IG counts, new diagnostic parameters like IRF for erythropoietic functions and Ret-He for determining functional iron deficiency and differentiating anaemias. The dedicated body fluid mode allows for rapid and standardised automated evaluation of various body fluids directly from the sample tube, and provides differentials for mononuclear and polymorphonuclear leukocytes to aid interpretations. The analyser provides extremely reliable counts even at low concentrations.With the Sysmex XT 4000i , Transasia is looking to enable the diagnostic laboratories and hospital labs to provide advanced clinically relevant information to optimise patient care.

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The First Symposium on Healthcare IT Standards from HL7 India October 28 â&#x20AC;&#x201C; 30, 2010, Bengaluru HL7 India is an independent, non-profitdistributing, membership based organization that encourages the adoption of standards for healthcare ICT within India. The objective of HL7 India is to support the development, promotion, implementation of HL7 standards and specifications in a way that addresses the concerns of healthcare organizations, health professionals and healthcare software suppliers in India. HL7 India is the accredited International Affiliate of Health Level Seven International for India. Technology Media Partner:

HL7 India is happy to inform you that an international symposium for spreading awareness of HL7 Standards will be held, under the aegis of HL7 India, twice every year in various places in India. This premier event will bring together key professionals spread across varied domains like Healthcare Information Technology professionals, Service engineers and Healthcare delivery personnel. The details are available at : http://hl7india.org/Education.html Contact: Education@HL7India.org

Registration Fees: Rs. 15,000/= per head (Ordinary) Rs. 14,000/= per head (HL7 India members)

Probable Speakers: Gora Datta

Mark Shafarman Chris Lynton-Moll Supten Sarbadhikari

NEWS REVIEW

Common treatment protocol for the countrymen The health ministry has planned to standardise common set of protocols for treatment across the country. For this the ministry has set up an expert panel to draft a set of norms for unified treatment standards expected to be implemented in next three to four months and in hospitals and healthcare service centres in one-two years. This move comes after the controversy on some of the health insurance firms declared of withdrawing the cashless payment facility for treatment at hundreds of hospitals, alleging that they were over-charging customers who had health insurance policies and leading to huge losses for the insurers. The move towards standardisation follows the recent passage of the Clinical Establishment Act, which calls for common standards to be maintained by healthcare facilities. Currently, there are no standard methods of treating ailments or providing standard infrastructure facilities during hospitalisation. In the process the ministry is in talks with various state authorities for implementing common standards of treatment at hospitals across the nation. The Act will seek to provide uniformity in healthcare delivery, said Dinesh Trivedi, minister of state for health and family welfare. It will start with a review of the existing system of clinical establishments, which include hospitals, nursing homes, maternity homes. It would include regulation of professional services and accreditation of healthcare infrastructure to ensure universal access to equitable, affordable and quality healthcare thatâ&#x20AC;&#x2122;s responsive and accountable to patients. In the US, accreditation of health services is an established practice and financial resources are allotted to health institutions on the basis of accreditation provided with a standardise star rating.

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