Co-written with Phoebe Magdirila, and published in the September issue of ComputerWorld Philippines
Behind the health care provided to millions of patients in a hospital lies an efficient system in place that aids in faster communications and information dissemination. Today, Information Technology serves as nourishment to the health care industry — integrating voluminous pieces of information that circulates in the complex operations of health providers day by day.
E-health initiatives are now found in 68% of the ICST policies in the Asia and Pacific region, as stated by the United Nations Economics and Social Commission for Asia and the Pacific, Information Communication, and Space Technology (UNESCAP-ICST).
In the Philippines, local hospitals and clinics see IT systems as both a challenge and an opportunity. By improving the quality of healthcare and medical information accuracy, these systems allow the country’s healthcare providers to meet the increasing demands not only of the local market but also the international market.
Value for IT in Healthcare
Through the Strategic Framework laid down by the Aquino administration, the Department of Health (DOH) coordinates with different organizations and utilizes IT to solve the challenges of the geographic landscape of the country. “It is (thus) imperative that we focus on harnessing critical ICT technologies in making data and information available,” Health Secretary Enrique Ona said in his speech on his health initiatives in 2010. “Significant investments must be allocated for this.”
The DOH has started to use information and communication technology to improve health services. “The e-health strategic framework of the Philippines can be a good model for other countries to follow, especially as inroads on the use of text messaging to deliver healthcare to barrios have been proven effective,” says Mark Landry, health information technical officer, health information, evidence and research, World Health Organization, Western Pacific Regional Office.
Moreso, a recent Asian medical tourism analysis shows that the Philippines is one of the Asian countries with emerging prospects for medical tourism. Supporting this is a recent study by Deloitte Consulting Group which shows that 40% of the Americans will consider medical treatment abroad if it will cost half the price for the same quality. Foreigners now opt to cross borders to seek quality hospitalization services at a cheaper cost.
With this growing trend, the Philippine government expects to gain around US $3 billion through the medical tourism industry by 2015, with 200,000 foreign patients arriving annually.
To integrate data in the different departments of a hospital, Hospital Operations and Management Information System (HOMIS), a data management software is already being used in more than 40 public hospitals nationwide while some are using private systems under the public-private partnership (PPP) program of the government. “It would be best if we have health information systems,” shares Crispinita A. Valdez, Director of the DOH Information Management Services Division, told Computerworld Philippines in a telephone interview. “It helps if facilities that provide services to foreigners are computerized,” she adds.
Open Source in Telehealth
Local e-health initiatives of the University of the Philippines Manila – National Telehealth Center (UPM – NTHC) optimizes open source applications to provide e-medicine, e-records, and e-learning. “These are our four flagship programs,” says Melissa J. Pedreña, e-health nurse and training coordinator for telemedicine of NTHC. Using Frontline SMS and iPath, free downloadable applications queries through SMS and e-mail respectively come into their database and are forwarded to the designated medical specialist in the Philippine General Hospital (PGH).
According to NTHC’s recent statistics, 43% of the SMS telereferrals have been responded to by the domain experts within 15 minutes, while 48% of e-mail telereferrals were answered within 48 hours. While these systems help in providing medical solutions to patients and doctors, Pedreña believes that wider technology media will be even more effective. “Our path is [to provide] video conferencing, more than SMS and email,” she notes.
The records system in health centers is also slowly being integrated using the Community Health Information Tracking System (CHITS), a computerized data-gathering system that is networked to the reports of various regions. CHITS forms part of the Field Health Service Information System (FHSIS), which helps various department heads in the health sector in their decision-making. Currently, there are 49 health centers that utilize the system. And to further enhance the program, NTHC plans to integrate it in other platforms. “We also plan to integrate CHITS in mobile phones,” shares Noel A. Bañez, telehealth nurse and coordinator, CHITS, NTHC.
To provide solutions for private health institutions, NTHC also created a customizable system that can cater to the complex IT needs of hospitals. “Right now we are implementing the Open Medical Records System (MRS) for hospitals, which is also used in different countries like the US and may Africa nations,” Bañez explains.
“With telemedicine, I foresee that our health sector will be more integrated, wherein the transfer of data between one facility to another will not be a problem anymore – retrieval of information and quality of health care will not be a problem anymore,” Pedreña shares.
The explosion of the technological needs of hospitals and clinics has triggered a rapid expansion in the product and service offerings of IT firms. Hospital decision makers are now IT consumers who are clamoring for workable systems to create an efficient healthcare environment marked by accurate and more focused medical care.
“Local healthcare service providers understand that they need to transform themselves into patient-centered, information- rich organizations,” says Doug Del Prete, healthcare subject matter expert, Global Business Services, IBM Philippines.
As part of its smarter planet ideology, IBM also envisions smarter health care, wherein health systems are targeted to be interconnected through advanced analytics. “Healthcare does not have boundaries and information should not be siloed,” he says.
IBM developed its vast healthcare solutions portfolio using advanced business analytics software tapped from recently acquired Cognos and powered by Big Blue storage and servers. “These technologies can directly support key business priorities, provide insights about performance, behaviors, and outcomes, and help deliver care and services more efficiently,” adds Del Prete.
IBM sees all these translating to interconnectivity — making data available to health professionals across various institutions and transforming them into clinical decision intelligence as these could improve patient outcomes and help lower costs of health care.
IBM continues to invest around $6 billion USD in R&D annually to develop and enhance its products and solutions portfolio. “IBM also plans to set at least 100 of its own experts — versed in practices such as cloud computing, services research, and analytics — onto various medical technology projects,” Del Prete says.
More Than Data
Another IT solutions company, HP, also sees growth of images as medical data as a crucial part of improving health care operations.The US forecasts for diagnostic imaging procedures to cross the $1 billion mark by 2012.
“The need for online medical image archiving and storage has skyrocketed in the last few years, with IT staffers and technicians trying to cope with more data, more patients and more work,” says Robin Purohit, vice president and general manager, Information Management, Software, HP. To aid this growth, HP optimizes health care IT through its HP Medical Archiving Solutions (MAS). To address the growing medical imaging data, the company has created a scalable solution that is applicable to small as well as to large scale hospitals and clinics.
With the integration of HP StorageWorks disk storage and Proliant Servers with storage grid software, fast and reliable access to medical images will be available. With security and privacy features in place, designated departments across different sites may access crucial image of any size real-time without compromising the privacy of data.
“By bringing MAS to the ‘masses’ – small and large customers alike – we have dramatically increased the number of organizations that can benefit from having easy access to the right patient information at the right time. HP is empowering more healthcare providers to improve overall patient care,” Purohit notes.
In other cases where there are fewer resources, it’s really about making the most out of what is already in place.
Famed for its power to reduce costs and transform application delivery, cloud computing has always become particularly FUD-laced [fear, uncertainty, and doubt] when discussed on the table. Cloud computing still gives a scratchy picture for many organizations especially in the healthcare sector given its sensitivity to sharing of patient information.
However, the winds seem to be changing in favor of the cloud. “Cloud computing is rapidly developing as an alternative way to deliver computing power to the enterprise. At the same time, the service demands on enterprise healthcare institutions are also growing. More patients need access to healthcare and costs needed to be constrained,” says Dr. NT Cheung, CMIO, Hong Kong Hospital Authority (HKHA) in a speech at a recent Healthcare Innovation IT Summit.
Hospitals and clinics with smaller pockets do not have to invest a ton of money for cloud-based solutions.
According to Exist, a cloud-based app model relieves the capital expense, as well as some of the operational expenses including software and hardware maintenance. Less mission-critical apps such as email and back-office tools are ripe for cloud-enabling, whether public or private. However, some healthcare applications will likely always reside in private clouds either for privacy or security reasons.
“There’s a dearth of talent in IT in the Philippines; more so of health IT practitioners. It would be wise for the industry to prepare for this labor shortage. If you can’t hire, and you can’t build the team, you can either outsource or refer to cloud solutions,” says Exist.
Exist Global, a software engineering company with expertise in building enterprise healthcare solutions underscores that managing a hospital IT team can be very demanding, given the complexities in the healthcare market.
Creating the application is only half the battle. IT teams need to manage delivery, infrastructure, as well as disaster recovery. “Cloud computing can help to free up IT staff to attend to more critical tasks, increasing operations efficiency,” shares Mike Lim, Exist CTO. “Cloud computing harnesses combined infrastructure components, scales for the economy, and allays resource issues. It has a disruptive potential to create powerful new value propositions,” adds Mike. Beyond cost, the appeal of a cloud model in the healthcare setting — with its massive data requirements and complex system configurations — may well be the speed of delivery.
Speaking about disaster recovery, Exist notes that cloud platforms that have data failover mechanisms will get you up and running in a couple of hours, whereas you wouldn’t have known where to start from if otherwise.
Exist is on its way to developing a cloud platform that would accelerate the use of technology for hospitals and healthcare institutions.