Information Technology

July 13, 2006
IT in the pink of health

Runa Mukherjee

• Advances in technology can help cut costs and improve productivity;
• IT is the backbone of medical services, and enables earlier detection of disease;
• Healthcare IT is growing at an ever-quickening pace.
• Functions and procedures in a hospital are becoming more time-critical;
• IT will play key role in drug discovery, disaster planning, reducing medical errors, etc.
• IT innovations have made health care more affordable;
• Robotic surgery will be possible in remote areas as well;
• It is very important to better the existing medical equipment;
• Significance of IT-supported services in healthcare is obvious.

NEW DELHI -- There is a huge pressure on IT professionals within the healthcare organisations to keep up with IT demands. Advances in technology can significantly help streamline operations, cut costs, and improve productivity. In the long term, healthcare information technology professionals must also create real-time enterprise systems that are upgradeable and scalable enough to meet the demands of end-users, backed by rock-solid back-end infrastructure.

Providers and payers are responding to pressure from patients, grass root organisations and legislative bodies to improve the quality of care by evaluating and adopting new ideas, new technologies and new strategies. The adoption of innovative pharmaceutical, diagnostic, software and hardware products has altered how and where services are being delivered, and who is delivering them. Wireless networks combined with mobile devices effectively support the intensive data management and delivery requirements of healthcare facilities by bringing clinical information right to the patient - wherever and whenever it is needed the most.

Importance of IT in healthcare

The importance of IT in health services cannot be over-emphasised. IT is the bridge that allows all medical technology to communicate with each other and the platform that allows for creating greater efficiency and productivity in physician workflow. In many instances, IT today also enables earlier detection of disease. IT is the backbone of medical services. Without medical communication nothing is possible. All essential life care services are IT dependent.

Collaborative medicine is the keyword today. A leading heart research institute in India is today treating patients across the world, without the patients having to walk into the hospital for treatment, thanks to IT. All the medical records and reports are scanned and made available to the medical team within the hospital. Today many a lives are saved across the world because of IT in healthcare. Second or more opinions can be taken from doctor in the other part of the world, making the patient survive through the crucial hour.

“Healthcare IT is growing at an ever-quickening pace. The functions and procedures in a hospital or healthcare network are becoming more time-critical.  With increased government and organisational regulations and standards, time is beginning to play a crucial role in compliance, as well as quality of patient care.  Regulations such as HIPAA and FDA 21 CFR Part-II, require accurate time, authentication and increased security.  Organisations such as HL7 and IHE, have laid the groundwork for time requirements in their standards,” said Pradep Nair, vice president and head of Global Lifesciences Practise at HCL Technologies.

Time synchronisation allows networks, workstations, electronic health records (EHRs), cardiology equipment and other medical devices to display and provide legally traceable time, so that there is a true snapshot of timed procedures and events.

 “Whether it be generation of 3D models of 64 Slice CT scans, providing essential services via telemedicine to far-flung places, specialist opinions and referrals across the planet, or something as mundane but time-saving as electronic archiving and retrieving of digital X-Rays, IT plays a major role,” said Dr. Arjun Kalyanpur, CEO, Teleradiology Solutions.

Collaborative treatment a necessity

All areas of medicine will be benefiting from the use of IT. Diagnosis, interpretation, surgery and treatment, almost everything will include IT for better facilitation. It is a belief that technology will change the way a patient is being treated. Collaborative treatment has become a necessity today. A patient from a remote part of the world will be able to get benefits of the expertise of a specialist sitting in another part of the world, making collaborative efforts a success with the help of IT.

“The healthcare industry in India is just getting into IT, and that is why, fully-optimised, integrated systems are still a far way off,” said Nair.

Tomorrow’s IT will be an essential enabler, greatly enhancing business efficiency, profitability, and quality of care. Looking into the future, the healthcare industry will shift from its current role of IT consumer to become a major driver of innovation and advancement in technologies ranging from data storage to bio-nano-robotics.

According to HCL Technologies, the various areas of healthcare where IT will play key roles in are:

• Drug discovery
• Medical devices
• Disease monitoring and surveillance
• Emergency preparedness and disaster planning
• Remote (Field) data collection
• Improving clinical efficiency, patient care, and accuracy
• Reducing medical errors by providing legible, accurate and timely information
• Provide simultaneous online decision support and guides with ready access to reference information
• Improving administrative efficiency and reducing costs
• Provide patient care data for retrospective analysis
• Enhance the ability to comply with regulations

“Things would only become faster and better by the use of IT. For example, UMTS or Universal Mobile Telecommunications Systems, with 3G mobile phones would be available in India by the year-end. These would tremendously increase the speed of transfer of, for instance, CT images of an accident victim being transmitted to the radiologist and neurosurgeon via MMS technology,” said Dr. Kalyanpur.

Dr K.K. Aggarwal, president, Federation of NCR doctors and National Heartcare Foundation of India, explained: “Distant learning, medical communication, 3D Live Colour Doppler echocardiography for detection of cardiac cases are being used by us. It is three dimensional, live, ultrasound of the heart using a probe on the chest of a patient and within seven minutes, everything in the heart, anatomy or physiology, can be evaluated.”

“IT innovations such as computer-based patient records, hospital information systems, computer-based decision support tools, telemedicine and newer means of distributing health information to consumers have facilitated improved quality, and accessibility of health care. It has also made health care more affordable,” said Ranabir Saha, IT manager, Apollo Gleneagles Hospital.

Facilitating healthcare with IT

One of the major companies in this respect, Team Computers, has played a significant role. Ponnanna Uthappa B, head, enterprise solutions and marketing, said: “The common punch line with hospitals is ‘Hi-tech super specialty’ and this highlights the fact that technology is playing a major role in medical science today. Though Team Computers does not provide a direct medical-oriented support to hospitals, we indirectly help the smooth functioning of the hospitals through our reliable and easily accessible networks and data base support systems.”

A Wockhardt innovation, which has received wide recognition and appreciation, is the Virtual Visit. "It involves a patient who has undergone a critical surgery, walking around and telling his relatives all over the world how he is feeling. Seeing is surely believing", said Dr.Habil Khorakiwala, chairman, Wockhardt Group.

A bypass surgery is a traumatic experience for the entire family and sons and daughters often rush in from distant cities and continents to be with the ailing father. Imagine the father telling his children in distant America that he is fine after the surgery and the children actually seeing him on a computer screen, talking and walking around!

The year 2004-05 witnessed Life Sciences and Healthcare practise at HCL focussing on the R&D business segment primarily in the areas of drug discovery and development of genomics projects as well as bioinformatics solution development. The Life sciences team at HCL has further strengthened its domain knowledge by induction of team of domain analysts in CRO, healthcare informatics and medical devices arena.

Robotic surgery: A reality in the future

Robotic surgery will be possible in remote areas as well. Robotic surgeries will allow for delivery of specialist surgical care at a remote location. This can bring additional expertise to the operating room to benefit the patient.

“Remember, surgery is carpentry plus intelligence. Carpentry can be done by anyone but intelligence can be exchanged only through IT,” emphasised Dr. Aggarwal.

The first demonstration of trans-Atlantic telesurgery was reported in 2001 when surgeons in New York operated on a 68-year-old woman in Strasbourg, France and used remote-controlled robots to resect (took out) her gall bladder by laparoscopy.

In today's operating rooms, you'll find two or three surgeons, an anesthesiologist and several nurses, all needed for even the simplest of surgeries. Most surgeries require nearly a dozen people in the room. As with all automation, surgical robots will eventually eliminate the need for some of those personnel. Taking a glimpse into the future, surgery may require only one surgeon, an anesthesiologist and one or two nurses. In this nearly empty operating room, the doctor will sit at a computer console, either in or outside the operating room, using the surgical robot to accomplish what it once took a crowd of people to perform.

Having fewer personnel in the operating room and allowing doctors the ability to operate on a patient long-distance could lower the cost of health care. In addition to cost efficiency, robotic surgery has several other advantages over conventional surgery, including enhanced precision and reduced trauma to the patient, who would experience less pain and less bleeding, which would mean a faster recovery.

Robotics also decrease the fatigue that doctors experience during surgeries that can last several hours. While surgical robots offer some advantages over the human hand, we are still a long way from the day when autonomous robots will operate on people without human interaction. But, with advances in computer power and artificial intelligence, it could be that in this century a robot will be designed that can locate abnormalities in the human body, analyse them and operate to correct those abnormalities without any human guidance.

Other potential applications of tele-surgery include:

• Training new surgeons
• Assisting and training surgeons in developing countries
• Treating injured soldiers on or near the battlefield
• Performing surgical procedures in space
• Collaborating and mentoring during surgery by surgeons around the globe.

Enhancing the existing medical equipment

It is very important to better the existing medical equipment as most of the government hospitals and hospitals in the remote areas will not avail the latest technology in healthcare services immediately. Thus, up-gradation is important. More digitisation, online repair, expanded life span, online up-gradations, new inventions, new discoveries, new applications etc must be carried out in hospitals and health centers across the country.

“IT applications help in redesigning existing medical equipment by adding functionalities which aid the patient, by helping medical device OEM’s, comply with regulations like RoHS, etc. and making sure they are more user-friendly,” explained Nair.

“IT applications are being used specifically in the fields of image processing, higher resolution display of medical images and rapid generation of 3D images of vital organs and blood vessels. For example, today a person with suspected heart disease no longer needs to undergo a diagnostic coronary angiogram, a high-resolution 64 slice CT scanner, with a powerful and high-speed workstation can obtain the same diagnostic information non-evasively, without any of the risks of angiography,” said Dr. Kalyanpur.

Early diagnosis of fatal diseases

Though nothing much has been done toward the curbing of such diseases, early diagnosis will be possible. Access to standard and latest protocol will also further the progress in this field.

“Hundreds of thousands of chronic disease patients have undergone physical, laboratory, and radiological studies. These include the disease history, physical signs, blood counts, biopsies, genetic/molecular analysis, x-rays, CTs, MRIs, and other evaluations. Unfortunately, much of this information is currently kept in separate database repositories; often using different IT platforms that are not able to directly exchange information. The result of this segregation is that researchers are unable to effectively study data “as a whole”, which slows down the pace at which new therapies could be developed. This complex problem requires complex solutions,” asserted Nair.

There are comprehensive approaches that begin with detailed mapping of the current workflow and processes that occur in research centers, evaluating each department as an individual entity as well as a part of the whole. Simultaneously, the needs and wants of researchers are assessed to insure that end user preferences are taken into account. These process maps and assessments are combined and analysed to identify areas eligible for improvement. These improvements may be streamlining methods, updating technologies, or both. These systems implements solutions that will collect, standardise, validate, and help analyse research data with more efficiency and accuracy than can be accomplished with legacy systems. Data can be better correlated to reveal hidden relationships that will help accelerate research and treatment by aggregating the information and applying unique analysis tools.

“Medical research in diseases such as cancer will definitely get a major boost from IT vis-à-vis quicker drug formulations, faster and efficient processing of drug trial data,” said Dr. Kalyanpur.

The utilisation of IT in healthcare system globally has been gaining greater importance with IT proving to be an indispensable ally in the management of diseases and saving lives. The medical industry has widened its horizons and diversified into various specialities, all of which together constitute the massive health care industry of today. The advent of IT has changed every existing industry beyond recognition at an accelerated pace and its impact is seen in the health care industry. The advantages the healthcare sector derives from information technology include better customer management, integration of supply chain and raising the bar on operational efficiency.

The way ahead

Pharmaceutical and biotech companies’ core competencies will lie in innovation and drug discovery. At each stage the pool of data keeps increasing and it has become critical to capture and analyse data at each stage. In drug research, global competitiveness is critical for success. A drug isn’t worthwhile unless it’s superior to what’s available. In every stage of drug discovery and development, it has become essential to use IT.

Thus, the significance of IT-supported services in today’s healthcare is obvious. Indian companies and others have to further facilitate this field for the betterment of medicine as well as for wider and greener pastures for our IT sector to graze on.