ICT, eHealth & managing Healthcare
- the issues & challenges in
Indian Railway Medical Services.
ICT & eHEALTH: : NEW HORIZON
ICT & Healthcare: WHO perspective
• “The need for new ways to provide more efficient health care
services coupled with major advancements in information
and communications technology have resulted in the
increased use of ICT applications over the past decade”-
World Health Organisation.
• ICT has the potential to
help generate the human capital needed by the Healthcare.
revolutionize the way medicine is learned by health
provide support to HRD by facilitating training & CME.
Improve access, increasing effectiveness, lowering costs etc.
• Study by European Health Telematics Observatory (EHTO)
shows different uses of health telematics.
WHAT IS E-HEALTH?
E-health is the combined use in the health
sector of electronic communication and
information technology (digital data
transmitted, stored and retrieved
electronically) for clinical, education and
administrative purposes, both at the local
site and at a distance.
In case of emergency GP can
perform surgery with tele
monitored specialist assistance
In remote areas where
specialists are not available, a
GP can treat
Confirm diagnosis plan
As a communication tool
nature of aliments
When more than one
specialist is required to
treat a patient
For providing training to prevent
/ respond to typical disease
patterns in remote areas.
Relief efforts during
Through Video Conferencing
HEALTHCARE INDIA: AN OVERVIEW
• India spends 86,000 Cr in healthcare (5.2% GDP).
• Direct out of pocket spending (83%).
• 128 tertiary Medical College Hospitals.
• 5600 District Hospitals.
• 2400 Community Centers.
• 23000 Primary Centers.
• 132000 Sub Centers.
• Persistent adherence to Pareto’s Law (80:20)
• Good Public Private mix.
• Huge growth potential.
• Fastest growing service sector Industry.
INDIAN HEALTH SECTOR: FEW FACTS
• Limit of elasticity with
Paradigm shift in Healthcare scenario
Ambulatory & home care
Evidence based practice
Significant changes ahead..
• Extramural Hospitals.
• Customer: Market concept in healthcare.
• Key SURVIVAL factor 3– S
• Professionals need mindset change.
• Growing innovative approaches.
• Web based e-Health adaptability & TM.
Market concept in healthcare.
• Rise of sophisticated consumers.
• 24x7 society.
• Increasing awareness and expectation.
• Increasing public accountability.
• Increasing litigations under CPA.
• Managerialism and Cost containment.
• Changing boundaries between hospital
and home care.
• Beginning of the information age.
…empowered patients will be
demanding and impatient
CATALYSTS FOR GROWTH
• Public Private Participation
• Quality standards.
• Rating of Hospitals.
• Health Insurance.
• Medical tourism.
PUBLIC PRIVATE PARTICIPATION
• Growth can not be achieved by any one
sector & has to be a joint effort.
• Require large amount of interaction between
the various sectors.
• Sharing of resources in this service industry.
• Lot of professionalism is in askance.
QUALITY IN HEALTHCARE
• Hospital ratings will give credibility to the
public for usage.
• Accreditation of Health Care facilities.
• Protocols, Guidelines and SoP’s,
• Mandatory Quality Standards.
• Health Insurance biggest driver for Healthcare
• Could be laid down by the Government or by
the Industry or a combination of both.
• ICHA- National watchdog for enforcement.
• One of the biggest factors to open up.
• Make a lot of difference in bringing quality
health care ignoring the geography.
• Inequality & disparity can be taken care of.
• Acceptable to rural India.
• User friendly and cost effective.
• Indian Railways Medical Services has this
capability and the infrastructure.
• Potential to work as a National Interface.
Indian Railways: lifeline to the nation
63000 Route Kms. 6850 Block Stations.
44000 Coaches. 7700 Locomotives.
2.16 lakh Wagons 50 Workshop’s & PU’s.
Staff cost 52 Cr/day. Revenue Exp 99 Cr/day.
1.51M Workforce. 7.23M IRMS beneficiary.
INDIAN RAILWAY MEDICAL SERVICES
TOTAL NO. OF ZONES 16
TOTALTOTAL NO. OF HOSPITALS 124
TOTAL NO. OF HEALTH UNITS 591
TOTAL NO. OF BEDS 13758
TOTAL NO. OF MEDICAL OFFICERS 2553
TOTAL NO. OF PARAMEDICAL STAFF 52088
BED OCCUPANCE RATIO 85%
AVERAGE LENGTH OF STAY
TOTAL OPD PATIENTS
TOTAL NO. OF ADMISSIONS 36797
MAJOR SURGERIES PERFORMED 32329
Mission Statement of IRMS
‘Total Patient Satisfaction Through
Humane Approach & Shared
Commitment of Every Single Doctor
To Provide Quality Healthcare
Using Modern & Cost Effective
Techniques & Technologies.’
COMPARATIVE HEALTH INDICES
INDIA SRI LANKA KERALA INDIAN
CBR/1000/year 26.1 17.3 18.2 9.82
CDR/1000/MYP 8.70 5.70 3.12 1.35
IMR/1000/year 68 15.4 14.0 13.76
MMR/lakh/year 407 59.6 87.0 27.0
CEO COCA COLA..
“…If you think that you can run an
organisation in the next 10 years as
you've run in the past 10 years:
You are simply out of your mind."
• Phasing out traditional ‘repetitive & periodic report’
• Transition to modern ‘Information on demand’
• To reap the benefit of
IT explosion worldwide.
↑ Safety standards.
Liberalised policy of GOI towards IT.
Indian Railways decided to establish in 1999
RAILNET - schematic
Proposed IRMS Network.
• Direct involvement from the Railway Board.
• Formation of National Core Committee.
• Utilisation of existing competence on PRS.
• Creation of new Zones, Divisions.
• Client- Server architecture.
• Nationwide networking using FOIS Railnet.
• Standardisation of Hardware & Software.
• Beginning of eHealth & Telemedicine.
Exploring the issues.
• IRMS will increasingly be concerned with chronic &
• Patients will be having same access to knowledge as
• Patients will become more equal partners.
Professionals to play the role of facilitators.
• IRMS needs to RECOAT itself now by
- Reducing resource myopia.
- Enhancing the competitive edge by professionalism.
- Creating consumer friendly atmosphere.
- Opening up the facilities to other users.
- Allowing market forces to operate.
- Taking advantage of the upcoming medical tourism.
The challenges ahead.
• Increasing aging population & lifestyle diseases.
• Rise in sophisticated consumerism approach.
• Increasing expectations in a 24x7 society.
• Growing public awareness about facilities.
• Increasing public and social accountability.
• Increasing emphasis on cost containment.
• Presence of big players in the arena.
• Emerging Health Insurance scenario.
• Good infrastructure.
• Trained and willing manpower.
• Good telecommunication systems in form
of its own and the leased lines.
• Support from the top management.
• Involvement of the sister concerns.
- Admin/S&T/Engg/Elect/Mech/Stores Deptt.
• Potential to work as a National interface.
• IRMS is an indirect activity Railway Deptt.
• Users and providers are the same.
• No competition whatsoever.
• No external market forces to improve.
• Persisting internal resource myopia.
• Top heavy organogram.
• Islands of excellence.
• Different platform at different places.
• Lack of involvement at the bottom.
• IRMS network would lead to better standards.
• ↑ Potential to make difference in quality care.
• Would prove cost effective in long run.
• Great potential for PPP’s & employments.
• IRMS has one of the best silent talents in Indian
• It has the capability & infrastructure to do it.
• Can be a leader in healthcare in next decade.
• IRMS has a long way to go .
Knowing is not enough;
we must apply.
Willing is not enough;
we must do.
CENTRAL HOSPITAL,S.E RAILWAY