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June - 2016 - issue > CEO Insight
Bhavdeep Singh
CEO-Fortis Healthcare
Tuesday, May 31, 2016
Technology, will the change and transformation ever stop! What feels like a perpetual wheel of activity that started in the early 80's just keeps moving faster and faster with no end in sight. As we are all aware, this has been among the most noticeable of disrupters in the delivery of healthcare and its impact is being increasingly felt by all of us every day.

Healthcare delivery in India is driven by the need to expand healthcare coverage, improve its quality and availability, at price points that are acceptable. The notion of who pays for healthcare-the individual or the State/Insurance have also dictated how rapidly healthcare infrastructure has proliferated. Setting up of brick and mortar healthcare delivery infrastructure remains a costly initiative. And as you continue to expand beyond the large metros, there is an obvious constraint of trained doctors, paramedics and nurses. For these reasons alone, we continue to face challenges as we try to address the ever growing problem of disease.

The genesis of today's network hospitals lies in standalone medical practice and smaller privately run clinics, each with their unique identity and mode of operation. Corporatization of healthcare is a more recent phenomenon that has led to aggregation and the growth of network hospitals. However, as we move forward, the idea of scalability is fast becoming the mantra This requires underlying consistency and commonality in processes to bring in rigor, while generating efficiencies that can then be scoped to manage large geographically distributed healthcare facilities.

We are therefore witnessing the deployment of integrated Enterprise Resource Planning (ERP) software to provide a unified view of a complex network operation. In the case of Fortis we have already integrated our financial, HR and supply chain backbones and are now leveraging these for chain wide efficiencies.

Fortis has also been a front runner in managing hospital operations and was among the earliest to introduce the Fortis Operating System. FOS, as it is referred to, is now being upgraded and an integrated state of the art Hospital Information System is under implementation with the intent to dramatically improve the patient facing processes and guest experience. Many of the front end applications are being internet/mobile enabled so patients can remotely make their own advance appointments and also confirm and pay for the consult via the internet. This will dramatically reduce wait time for a patient at the hospital. Our hospitals are also gearing up for an e-prescription service to replace the legendary doctor scrawl on hand written prescriptions. Patient histories, diagnostic reports, discharge summaries and other vital information regarding an existing patient will all be digitally stored so they can be accessed remotely by the patient as well as by any of the Fortis hospitals (with informed patient consent). Once this all comes together, it will be a useful tool in emergency situations where speed is of the essence.

Directionally technology application on the one hand is starting to bring in efficiencies that can reduce the cost of delivering care while improving patient convenience. On the other hand it is also improving predictability in medical outcomes. The deployment of the next generation Da Vinci Robotics system at our Fortis Memorial institute is a step in this direction. Precise surgical operations can be carried out without damage to collateral tissue, thus minimizing recovery time. Moreover, precise doses of radioisotopes can now be administered to targeted cancerous tissues under direct surveillance without the patient having to move to two different machines. The emphasis too is on catching the disease early, even before it is visible to the human eye, so treatment can begin in advance. Such Cancer therapy is available at our hospitals and progressing rapidly. Being concerned with human life, speed and accuracy of delivery in a zero error environment is necessary. The robustness and fail safe nature of all equipment and technology is therefore a high priority in healthcare delivery and the evolution in this space has been remarkable.

Digital Convergence for Smart Healthcare Solutions
Because of the enormity of disease and the lack of concomitant infrastructure which cannot be overcome in a "steady state environment," disruptive thinking is necessary in solving the healthcare dilemma.

Smart IT solutions are proving to be a key differentiator, a source of going forward and a key enabler. Initially they focused more on improving efficiencies and productivity. However, they are now also focusing on improving access and reaching out to millions of patients looking for quality treatment and care.

The emergence of e-consults and e-ICU's such as 'Critinext', run by Fortis are examples where critical care can be extended to patients in smaller hospitals and establishments that are located in far flung and remote areas. These areas typically do not have access to local super speciality expertise. Critical patients at such remote hospitals can be wired up and connected real time through an internet connection to a monitored central hub manned by experts. Their vital parameters are tracked closely and appropriate interventions recommended real time so they can be nursed back to health. In this manner, several hundred critical care beds can be monitored at the same time by a central expert team of doctors. This is a great way, of exponentially expanding access to high quality healthcare and alleviating the problem.

Additionally, many of the health problems we see today are a result of sedentary and poor lifestyle choices which can be corrected given notice and attention. This has led to the conclusion that equal effort must be made to reduce the problem by keeping our population healthy and well, as opposed to treating illness.

Business models are now in evidence around the world where individuals are charged a fee for 24X7 surveillance of their vital medical parameters in-order to keep them healthy. An early preventive intervention with appropriate counselling is made by the provider should these be suggestive as being deranged.

As technology helps to collect data of a particular patient over a period of time, it gives more personalized and appropriate care. It also helps to come up with demographic and clinical analysis. The potential of digital health technologies to therefore alter the healthcare landscape is tremendous.

Looking at the challenges from another prism, that of providing complete and collaborative healthcare. We need systems that integrate and share vital clinical data with payers, providers, plan participants and organizations that consider themselves accountable for providing collaborative care. Companies that can provide such platform based services and who have the relevant domain expertise will be able to deliver greater business impact ranging from accelerated speed to market to enhanced innovativeness, stronger customer loyalty and top-line growth.

This move to enhance clinical, financial and administrative outcomes will create several new opportunities to provide speedy and good quality healthcare at a cost efficient point. We should continue to innovate on ways to leverage new technologies to do so.

And so, with all of that said, the IT transformation story in healthcare continues...
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