1. HIMSS ASIAPAC12 CONFERENCE
17-19 SEPTEMBER 2012
MARINA BAY SANDS, SINGAPORE

2. STATE OF HEALTHCARE IT IN
INDIA
AMIT MISHRA
EXECUTIVE MEMBER, HIMSS INDIA
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3. India Healthcare Landscape
• Public Healthcare Infrastructure
• Public Health Programs
• Private Healthcare Infrastructure
• Demand Supply Gap
• Complexity and Challenges
• Growth Perspective
• Healthcare IT Spending in India
• The Way forward
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4. Healthcare Infrastructure
Public Health
Private Healthcare
Programs – GOI
Not For Profit Org /
Public Healthcare
Other Healthcare Org
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5. States of India Number of Hospitals
Mizoram,Nagaland,Pondicherry,Himachal,Manipur,Meghalya,Goa >10
Orissa,Chandigarh,Haryana,Bihar 11-50
Assam,Punjab,MP,Karnataka,UP 51-100
Rajasthan,Gujarat,Kerala 101-200
Andhra Pradesh , Tamilnadu,West Bengal, Delhi, Maharashtra < 200
Source: Research Paper of Ramesh Bhatt and Nishant Jain, IIMA
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6. Spending on Health
a
Health expenditure ratios
Private Out-of-pocket
Total expenditure General government
expenditure on expenditure as %
Member on health as % of expenditure on health
health as % of total of private
State gross domestic as % of total
expenditure on expenditure on
product expenditure on health
health health
2000 2008 2000 2008 2000 2008 2000 2008
USA 13.4 15.2 43.2 47.8 56.8 52.2 25.5 24.4
Germany 10.3 10.5 79.8 74.6 20.2 22.0 54.8 53.9
UK 7.0 8.7 79.3 82.6 20.7 17.4 64.6 63.7
Sri Lanka 3.7 4.1 48.3 43.7 51.7 56.3 83.3 86.7
India 4.6 4.2 27.5 32.4 72.5 67.6 92.2 74.4
Source: WHO
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7. The density of doctors per 10,000
populations in India is 6 as compared to
the world average of 11.5, while the India is a signatory to the Millennium
density of nursing staff in India is 13 per Development Goals (MDGs).
10,000 as compared to the world average
of 28.4.
The Urban and Rural Divide: Although
World Health Organization report that
about 70% of India’s population lives in
India needs to add 80,000 hospital beds
the rural areas, it accounts for only a
each year for the next five years to meet
meager 15% share of the cumulative
the demands of the population.
healthcare resources
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8. Complexity and Challenges
Inadequate accessibility to affordable quality services
Low Government funding & lack of efficient execution of schemes & initiatives
Shortfall in Health care infrastructure and Workforce
Dependency on Paper Records
Costs Continue to spiral
Rational Use of Drugs
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9. Growth Perspective
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10. “Information systems at any McDonalds's are more advanced,
and more useful, than those in your doctor’s office.”
Fast Company – April 2006

11. Healthcare IT Spending in India
Source :SHS
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12. HIMSS India Study Highlights
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13. The Healthcare IT …User Experience
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14. Reasons of dissatisfaction
• HIS is not user friendly as all systems are not fully integrated
• Limited user interface and lack of customization
• Outdated technology, unsatisfied with vendors, limited
support
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21. Barrier for Health IT adoption
Lack of sufficient funds
Lack of human resources
Lack of strategic plan for computerization
Return on Investment of computerization cannot be quantified
Lack of clinical guidance
Unsuccessful implementation of computerization projects
Providers cannot meet requirement for products and services
Lack of legal and policy support
Lack of support from hospital administrators
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22. Slow Adoption …
Cost is an issue
System is not ready and doctors and staffs are not willing to use HIS
Lack of supporting infrastructure
Hospital expansion
Lack of IT literacy among Medical & Para-medical professionals
Lack of Govt. determination to introduce HIS in hospitals
Government policies
Phase- wise implementation of HMIS in Govt. District Hospitals
Training issues, lack of capacity building program for clinical staff
Resistance of staffs
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23. Suggestions….
• “Should be user friendly and staffs should be provided need
based training”
• “Hospital should go for Computerized HIS as early as
possible”
• “Sensitization of Doctors and staff to use the technology by
using various medical professional association such as IMA,
FOGSI etc”
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24. The Way Forward…
 NEED OF HEALTHCARE IT STANDARDS
 NATIONAL STANDARDS FOR INTEROPERABILITY
 NEED OF A PUBLIC HEALTHCARE INFORMATION SYSTEM
 TASK FORCE FOR HEALTHCARE INFO SYSTEM
IT TRAINING - HEALTHCARE PROFESSIONALS AT MED-schools
 THE EARLIER THE BETTER
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26. May be a UNIVERSAL ADAPTER
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27. Standards and Interoperability
• Standards provide a common language and set of expectations
that enable interoperability between systems and/or devices.
• “Interoperability” describes the extent to which systems and
devices can exchange data, and interpret that shared data. For
two systems to be interoperable, they must be able to
exchange data and subsequently present that data such that it
can be understood by a user.
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28. Importance of Standards and
Interoperability
• Standards bring technological, economic and societal benefits.
• Healthcare dependency on information
• Benefits in figures
• GBP 2.5 billion - annual contribution standards make to the UK
economy
• 80% - percentage of world trade impacted by International
Standards
• AUD 100 million - benefits to Australian economy from
sampling standards in the mining industry
• 84% reduction in transportation time due to standardization of
container transport : source ISO
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29. India’s Imperatives for Standards
• Effective Management of limited Usable Healthcare Resources
• Population > Data > Information
• Languages and Dialects
• Cost – having many different competing ways of doing the
same thing can be costly. Examples of this are the large
number of different mobile phone power sockets; or where
every computer supplier developed a list of allergies from
scratch.
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30. • Safety – for example specifying the minimum safety
requirements for a baby car seat; or the safest way to present
an allergy alert on a computer screen.
• Health Insurance
• Medical Tourism
• Measurement of health status, performance monitoring, and
the achievement of national performance targets.
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31. NEED OF A PUBLIC HEALTHCARE
INFORMATION SYSTEM
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33. TASK FORCE FOR HEALTHCARE INFO
SYSTEM
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34. IT TRAINING - HEALTHCARE
PROFESSIONALS
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35. THE EARLIER THE BETTER
• Need of Healthcare IT Standards Specifically designed for
developing Country like India where the HIT is still in nascent
stage.
• Eliminate waste and duplication while ensuring that patient
information is available at the point of care, eliminating
unnecessary tests, enabling more informed decisions and
improving the quality of care.
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36. Better…
• Telecom Industry India
– Telecom Centers of Excellence
– Development Organization of Standards for Telecom in India
– Telecom Sector Skill Council
• World’s Reputed Clinical Staff
• World’s Recognized IT resources
Aneesh Chopra: ‘There’s never been a better
time to be an innovator’
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37. THANK YOU
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