ICT, eHealth & IRMS - ICMCC

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ICT, eHealth & IRMS - ICMCC

ICT, eHealth & managing Healthcare

- the issues & challenges in

Indian Railway Medical Services.

Dr.Santanu Sanyal

Indian Railways


ICT & eHEALTH: : NEW HORIZON

GEOGRAPHY IS

NOW HISTORY.


ICT & Healthcare: WHO perspective

3

• “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

professionals.

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.

4-Sep-06


EHTO Study:


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.

5

4-Sep-06


TELEMEDICINE

Telemedicine Telemonitored

Applications

Procedures/Surgery

In case of emergency GP can

perform surgery with tele

monitored specialist assistance

Remote Consultation

In remote areas where

specialists are not available, a

GP can treat

Second Opinion

Confirm diagnosis plan

treatment

Healthcare

Knowledge Base

As a communication tool

understanding the

nature of aliments

Complex

Interpretations

When more than one

specialist is required to

treat a patient

6

Disease Management

For providing training to prevent

/ respond to typical disease

patterns in remote areas.

Disaster Management

Relief efforts during

natural calamities

Continuous

Medical Education

Through Video Conferencing

4-Sep-06


HEALTHCARE INDIA: AN OVERVIEW

8

• 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.

4-Sep-06


INDIAN HEALTH SECTOR: FEW FACTS

• Limit of elasticity with


Paradigm shift in Healthcare scenario

From

Acute illness

Communicable

Inpatient care

Experience based

To

Chronic illness

Lifestyle diseases

Ambulatory & home care

Evidence based practice

Curative oriented

Preventive approach

10

Reactive

Proactive approach

4-Sep-06


Upside down..

11

4-Sep-06


Significant changes ahead..

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• Extramural Hospitals.

• Consumerism.

• Customer: Market concept in healthcare.

• Key SURVIVAL factor 3– S

Service

Speed

Satisfaction

• Professionals need mindset change.

• Growing innovative approaches.

• Web based e-Health adaptability & TM.

4-Sep-06


Market concept in healthcare.

13

• 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.

4-Sep-06


The catch..

…empowered patients will be

demanding and impatient

patients.

14

4-Sep-06


CATALYSTS FOR GROWTH

• Public Private Participation

• Quality standards.

• Rating of Hospitals.

• Health Insurance.

• Telemedicine.

• Medical tourism.

15

4-Sep-06


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.

16

4-Sep-06


QUALITY IN HEALTHCARE

17

• 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.

4-Sep-06


TELEMEDICINE

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• 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.

4-Sep-06


INDIAN RAILWAYS

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4-Sep-06


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.

20

1.51M Workforce. 7.23M IRMS beneficiary.

4-Sep-06


INDIAN RAILWAY MEDICAL SERVICES

21

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

8 DAYS

TOTAL OPD PATIENTS

31 Million

TOTAL NO. OF ADMISSIONS 36797

MAJOR SURGERIES PERFORMED 32329

BUDGET (2004-2005)

660 Crores

BENEFICIARY POPULATION

7.23 Million

4-Sep-06


Mission Statement of IRMS

‘Total Patient Satisfaction Through

Humane Approach & Shared

Commitment of Every Single Doctor

& Paramedic

To Provide Quality Healthcare

Using Modern & Cost Effective

Techniques & Technologies.’

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4-Sep-06


COMPARATIVE HEALTH INDICES

HEALTH

INDICES

INDIA SRI LANKA KERALA INDIAN

RAILWAY

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

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4-Sep-06


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."

24

4-Sep-06


RAILNET- background.

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• Phasing out traditional ‘repetitive & periodic report’

model

• Transition to modern ‘Information on demand’

model.

• To reap the benefit of

IT explosion worldwide.

↑ Safety standards.

↑ Speed.

Liberalised policy of GOI towards IT.

Indian Railways decided to establish in 1999

‘RAILNET’

4-Sep-06


RAILNET - schematic

26

4-Sep-06


Upcoming horizon…

Platform

27

4-Sep-06


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.

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• Beginning of eHealth & Telemedicine.

4-Sep-06


Exploring the issues.

29

IRMS will increasingly be concerned with chronic &

ageing diseases.

• Patients will be having same access to knowledge as

professionals.

• 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.

4-Sep-06


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.

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• Emerging Health Insurance scenario.

4-Sep-06


The advantages..

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• 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.

- RAILTEL/CRIS/RITES/IRCOT.

• Potential to work as a National interface.

4-Sep-06


Disadvantages.

32

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.

4-Sep-06


Conclusion.

IRMS network would lead to better standards.

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• ↑ 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

Healthcare scenario.

• It has the capability & infrastructure to do it.

• Can be a leader in healthcare in next decade.

IRMS has a long way to go .

4-Sep-06


Knowing is not enough;

we must apply.

Willing is not enough;

we must do.

34

Goethe

4-Sep-06


CENTRAL HOSPITAL,S.E RAILWAY

KOLKATA, INDIA.

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4-Sep-06


THANK YOU

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sanishita@vsnl.net

4-Sep-06

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