IT cos call for better investments in hospital informatics

Soumya Viswanathan - Mumbai

There is good news for IT companies. The US-based Gartner Inc’s survey on IT spending for the future predicts that healthcare would be one of the fastest growing industries of 2003-2004. "The sector is growing now following historical underinvestment in key industry solutions," the report says. It projects the business spending as 69.4 billion dollars in 2001 and 102.7 in 2006, which makes CAGR (%) from 2001-2006 as 8.15, which is more than IT spending in manufacturing, education, communications, financial services etc.

The unparalleled growth predicted for this vertical in a way proves that healthcare is still in its nascent stage with ample opportunity for growth. It also shows that the lack of initiative in IT is not a problem confined to Indian healthcare industry. It is a case worldwide.

In India, CRISIL’s experience in grading hospitals corroborates this -- hospitals they graded failed to get a higher grade for HIS component, which is one of the important hospital support service as per CRISIL grading.

The report further says that despite compelling drivers to IT spending, the industry’s constrained ability to invest capital and its difficulty in embracing IT systems will obstruct new IT initiatives. Indian healthcare industry too has not come to terms with accepting IT systems, particularly, in investing capital for a fully integrated HIS, say experts.

Hospitals generally go in for smaller vendors who fit in their shoestring budget but end up wasting whatever spent when they realise that the system neither meets their requirement nor gives desired results. Take for instance the status of bed availability in a hospital. "The status of beds at the reception and the actual status varies in most of the HIS available," Ranjana Maitra, practice head, healthcare vertical, Wipro Infotech explains. "With our HIS product the data is continuously updated since there are 7-8 different bed status levels and hence the system at any point of time reflects the exact status of the beds and there is no mismatch," she adds.

Maitra complains that willingness prevails when it comes to spending Rs 2 cr on a CT scan but not IT. Agrees S Govind, executive director and COO, Medicom, "Hospitals in India perceive IT budgeting as a low priority area when compared to equipment budgeting." Agrees Satish Kini, CEO, CCST. "Selling a product to a hospital is as difficult as it was seven years back. There has been no change in accepting IT."

The IT in India is also underdeveloped because hospitals’ requirements are generally assessed by the CIOs or the IT managers who have no knowledge of hospital informatics says a senior official from TCS. "The decision making team should comprise hospital administrator, an IT person with knowledge of hospital informatics and experience of having worked in hospital and specialists from medical background," he adds. Secondly, as Maitra says, choosing a HIS product starts with evaluation of product. But only corporates and big govt hospitals go for it, she laments. Wockhardt for instance, spent Rs 50-60 lakh on evaluation alone. "Evaluation entails choosing the right product based on hospital’s requirements, followed by a thorough site visit of the implementations done," says Maitra. According to Saji Salam, consultant, healthcare and life sciences practice, Cognizant Technologies, decision making is pathetically slow and professional decision making is limited to a few corporate hospitals.

There are also hospitals with HIS system but nil implementation and end user training. Result is that these have scrapped their system and gone back to paper. Some others like Max Healthcare have switched over to other vendors. Max invested a huge sum on a product from an Australia-based company but has now switched over to Wipro’s HIS. Informed sources say that support and implementation were not upto the mark and the product was also not suitable for Indian healthcare processes.

TCS and Wipro officials say that cases where hospitals approach them due to dissatisfied systems are becoming very common. Says Maitra, "Hospitals have to be educated that they must not look at the price alone because anyone get some engineers together, do some amount of coding and call it a HIS."

But IT industry can look forward to more educated and demanding payer market with insurance sector being regulated. "The market in India is maturing and with the insurance sector opening up in India, I feel the importance of having an information management system in a hospital would become vital," says Govind.

Gartner’s report puts forth some more drivers of IT. Worldwide, leading drivers of IT investment will include the uncompromising need for patient safety, rising cost of delivering and managing healthcare, the need for integrated cost containment strategies, rapidly changing patient demographics and patient demands, the push for process standardisation and automation and regulatory requirements like HIPAA in the US, it says.