Sluggish Tech Adoption in Healthcare

Every year new technologies are developed and implemented across various healthcare facilities to transform healthcare delivery; and all of these share a common frustration: Slow and unsteady adoption of new technology. So what’s exactly stopping these healthcare facilities and the providers to adopt the innovations and the technologies being implemented? I’ve tried to compile the top barriers observed till date:

• No Real Solution - as Robert Pearl says, most of the tech entrepreneurs take a backward approach to invention. It always starts with technology and then addressing the issue. The ideal approach should always be “Goal Oriented’’; that is understanding the problem first and then defining the solution. 

• Cost – this has always been a major battle to win for successful adoption of technology. Implementing a new technology requires infrastructure change which definitely involves investing a huge amount of cost. But, the healthcare providers should understand that this cost is a one-time cost and an investment in the long run; as it definitely reduces the unwanted healthcare costs leading to more revenue and increased patient visits.

• Reluctance to Change – for any healthcare provider, entering data into an EHR is time consuming than keeping a paper record. The problem isn’t just the time it takes to type but also the structured format of the data entry, as it takes more time since the application does not allow providers to skip steps or leave out clinical details.

For example – a good friend of mine, whose mother was ill few days back had specific symptoms which pointed out towards a medical condition, but somehow getting checked for the condition was missed and it leaded to a complication. When visited a senior doctor for second opinion she was diagnosed with Diabetes. 

Wouldn’t it be nice if the EMR/EHR capturing all the complains can assist the doctors in prompting alerts based on previous researches done, highlighting that the patient might be having so and so medical conditions, and can recommend tests which are necessary to rule out the condition. This not just enhances the doctor’s practice, but also increases the trust factor a patient has on the doctor.

• Reluctance to share medical information with patients – healthcare providers have always assumed that they own the medical information of a patient as it is being maintained at the doctor’s office. But now with the patients being tech savvy and informed a lot has changed and demand their right to access to their own health records. The transparency of sharing information ensures patient satisfaction and increased participation in maintaining their treatment plans. 

Overcoming These Barriers

• Understanding the problem – this can be solved by including the end users; that is the doctors and the patients. Understanding their need by frequent interviews, questionnaires, focus group discussions etc. is the key to success. Keeping this in mind, we identified that the major issue with the vaccination coverage among infants & children is that most of the parents misplace and forget the due date of the pending vaccination which causes delay. 

On the growth front, parents are not aware on whether the growth of their child is in normal parameters or no. With iCHR mobile application, parents can now get timely vaccination, appointment notifications/SMS and also can view their child growth charts. Not just this with every sprint we are trying to be better with the frequent inputs of eminent physicians in the pediatric space. 

Entrepreneurs should have a long term vision, in terms of not just solving one problem but having a long term vision of how the technology or the desired solution will fit in improving the quality of patient care and evidence based efficiency of doctors. 

Keeping the complex enterprise solutions in mind, new tech solution should fit seamlessly into any existing application enhancing the interoperability and the information flow from one system to the other; which would be a great help in research and data analytics. 

• Smart & effective pricing strategy – entrepreneurs should define a convenient pricing structure for the healthcare providers, which does not overburden them with the cost factor and also solves the problem effectively. 

• Proper change management – healthcare providers need to come up with effective change management strategy. A push from top management in the healthcare facility is very necessary for the end users to adopt with the technology. Management should try incentivizing the physicians not just in monetary terms but in any other form convenient to the facility. 

Solutions must be developed in regional or local languages so that their adoption may be increased by the consumers. This could also aid in shedding away the initial reluctance towards technology and exploring the impact of various technologies. iCHR is currently available in English, Hindi and Gujarati language and has the capacity to go in any language. 

Healthcare organizations need to streamline their IT infrastructure, to be able to provide simple, quicker and more efficient healthcare service or delivery. After all, the healthcare solutions promote a new productivity model whereby the ultimate winner is the patient, who will have an instant equitable access to the best clinical expertise. Across history, it often has been the next generation that figures out how best to use new technology. Healthcare may be no different. 

Data – The Solution to Improved Child Healthcare in India

The healthcare industry historically has generated large amounts of data, which is driven by record keeping, compliance, regulatory requirements and patient care. As the healthcare today is more of patient-centric care, there is growing acceptance that data is the foundation to better and improved healthcare delivery.

With the advent of rapid digitization in healthcare industry, it has become easy to analyze this large amount of data captured, recognize patterns from which conclusions and decisions can be drawn on the various aspects of healthcare, especially child health. By combining and effectively using big data, following potential benefits can be extracted:

• Analyzing disease patterns to improve child health surveillance;
• Improved and accurate development of more targeted vaccines, e.g., choosing the annual influenza strains;
• Identifying the side effects of any vaccination. Recently in some European countries: 1 in 10 girls given HPV vaccine suffered ‘adverse’ reaction (Source: http://ow.ly/BZ10300jU2e)
• Turning large amounts of data into actionable information that can be used to identify gaps and provide services in child nourishment and vaccinations.

Analyzing such kind of data can help in formulating various policies and measures that may help in better outcome for child health. For example – assessing the Fenton & WHO growth charts in a particular community or region can help in identifying patterns of any normal or abnormal growth in that community. Once identified, regulatory bodies can formulate measures to strength the child growth within that community or region.

Healthcare organizations can improve quality of care coordination and services, power accountability and personalized medicine across the ecosystem, create a competitive advantage for increased market share and reduce costs by having a data-centric focus. By enabling the sharing of quality data across multiple systems IT organizations can provide their users with new ways of achieving their desired outcomes. Lastly, proper data management within healthcare industry is the key to attain MDG related to child and maternal health and unleashing the potential of digital healthcare.

Significance of Vaccination for Pre-term Babies

Preterm babies are premature babies that are born before 37 completed weeks of gestation. There are sub-categories of preterm birth, based on gestational age:

• Extremely preterm (<28 weeks) 
• Very preterm (28 to <32 weeks) 
• Moderate to late preterm (32 to <37 weeks)

Source: Kevin Frayer / Associated Press

According to a WHO report, every year an estimated 15 million babies are born preterm (before 37 completed weeks of gestation), and this number is rising with every year. Preterm birth complications are the leading cause of death among children under 5 years of age, responsible for nearly 1 million deaths in 2013. There are various measures or guidelines illustrated by WHO on how to improve pre-term birth outcome; one of which is achieving full immunization against preventable childhood diseases. 

Points to keep in mind 

• All of these babies should be given routinely vaccinations. They should get all of the immunizations on the standard schedule as followed for term babies.
• Administering vaccinations are always safe whether given to term or pre-term and low birth weight babies. 

Why vaccination is so important? 

• Saves a Child’s Life – Timely vaccination ensures a child being protected from various diseases like Diphtheria, Hepatitis B, Measles, Meningitis, etc. Certain diseases like Polio, Smallpox have been eradicated with frequent and timely vaccination being administered.
• Protects not just your Child but the entire Community
• Saves Time and Money related to Healthcare Cost
• Protects Future Generations 

Keeping in mind, all of the above benefits it is very imperative that you as a Healthcare Provider, remind a parent to get their child timely vaccination. We understand that today with such heavy and hectic schedule it becomes difficult to remind each and every patient, but what if we say that technology is here for your rescue? 

What if you adopt a technology in such a way that it automatically reminds each and every parent of your practice in your name for timely vaccination of their child even in the cases of delayed vaccination? Sounds interesting, doesn’t it? If you want to know more on how can technology help you to be updated on your Child’s Health do contact us on ichr@oxyent.com or 011-40644232 for further queries and we’ll be more than happy to help!

Rotavirus vaccine - now a part of country's immunization programme

Introduction to Rotavirus

Rotavirus is a virus that causes gastroenteritis, an infection of the intestines and is one of the most common causes of diarrhea in children under the age of five. Studies have shown that nearly every child catches the infection before their fifth birthday. If infected, the baby may start to encounter the below symptoms in about 18 to 36 hours:

• Low grade fever
• Nausea and vomiting
• Mild to severe diarrhea, that usually lasts for three to seven days
• Abdominal cramps

Launch of Rotavirus Vaccine

The rotavirus vaccine has now been made a part of country’s universal immunization programme (UIP) for four states initially - Andhra Pradesh, Haryana, Himachal Pradesh and Odisha with expansion to entire country in phased manner. The World Health Organization (WHO) recommends the rotavirus vaccine as the only prevention and control measure for diarrhea. Most babies who get the vaccine won't get rotavirus diarrhea at all, and almost all of them will be protected from severe rotavirus diarrhea. 

On March 9th 2016, PM Narendra Modi launched India’s first indigenously developed Rotavirus vaccine “Rotavac”. With this launch, the vaccine is expected to bring down the infant deaths due to rotavirus diarrhea in India and across the globe. 

As every hospital’s immunization schedule differs in India, iCHR has the capability to adapt any immunization schedule according to the hospital’s requirement. If your hospital has captured rotavirus vaccine as a mandate vaccine, and is still not a part of your hospital information system (HIS); integrate iCHR in your hospital premises for better management of child health records. Contact us to know more on ichr@oxyent.com or 011-40644232.

How will Implementing an Automated Child Health Record benefit my Hospital?

The Healthcare Industry has evolved rapidly in the past few years; adopting state-of-art infrastructure, robotics, information systems, IoT devices, etc. With such advancements, the next step for hospitals is to focus on adopting technology for each specialized departments like Maternity, Pediatrics, Cardiology, etc. and sharing the captured data with their patients so as to maintain a healthy doctor-patient relationship, providing credibility and retaining the patients for long-term. 

In Pediatrics today, the child health records in the hospitals are handed over to the parents as paper based records which are not formally maintained. Parents in most of the cases either misplace these records or do not carry them each time when visiting the doctor for administering the vaccination to the child. Hospitals do not maintain OPD record for vaccination and hence there is no way of recovering the vaccination history, leading to confusion and panic.

What can a Hospital do to minimize this?

Every hospital can adapt to a system that keeps track of a child’s vaccination schedule, which helps parents to get timely reminders and notifications of vaccinations, digitally plot growth charts including both Fenton & WHO chart so that it is easy for doctors to educate parents about their child’s growth and give instructions as and when needed.

With this in mind, we introduce everyone to iCHR - India’s 1st Hospital linked Integrated Child Health Record – a revolutionary concept of automated vaccination record and growth monitoring, for your precious child. iCHR is up and running currently in Fortis La Femme, Jaypee Hospital, Paras Hospital, Bhagat Chandra Hospital & Alchemist Hospital. Our goal with iCHR is to attain the sustainable development goals and reduce the child mortality rate. It helps in keeping track of all the vaccinations according to the schedule recommended by the Indian Association of Pediatrics. The application offers the following benefits:

Benefits for Doctors

• Cloud based patient management system.
• Maintaining the visit history of patients which saves record keeping and maintenance cost.
• Paperless and secured vaccination record available anytime, anywhere in the world. 
• Brand documentation of vaccine.
• Digital plotting of growth parameters on WHO and Fenton Charts.

Benefits for Parents

• Paperless and secured Vaccination Record available anytime, anywhere on your mobile phone.
• Interactive growth chart on parent’s mobile phone to track growth of preterm and term babies.
• Easy to understand.
• Each hospital visit details on tap of a button.
• Automatic vaccination due date calculator.
• Timely vaccination reminders and notifications for the parents.

Lastly through iCHR we are helping a hospital to enhance the retainer-ship with their patient through timely vaccination reminders, notifications for promotional and announcements by the hospital, which helps in engaging the patient not just within the hospital premises, but also outside the hospital. If this sounds interesting and you are still not on board, contact us to know more on ichr@oxyent.com or 011-40644232 for further queries and we’ll be more than happy to help!

Malnutrition in India and how iCHR is helping

Birth of a child is perhaps one of life’s most treasured moments for every parent. Protecting the child’s health and ensuring proper nutrition and growth are the only important goal for any parent. In July 2015, the Government of India, released malnutrition figures from the Rapid Survey on Children (RSoC) data that was collected in 2013-14. According to this report:

• 29.4% of children (aged less than three years) fall in underweight category (low in weight for their age),
• 15% were wasted (low weight for their height)
• 38.7% were stunted (low in height for age)

Introduction to Malnutrition

The Dorland Medical Dictionary defines Malnutrition or Malnourishment as a condition that results from unbalanced diet causing various health problems. This unbalanced diet results from eating a diet in which nutrients are either not enough or are too much. Simply put, malnutrition can be categorized as under-nutrition (Underweight) and over-nutrition (Obesity). Malnutrition is caused by various conditions or circumstances like:

• Poor Diet
• Food Shortages
• Food Prices and Irregular Food Distribution
• Lack of Breastfeeding
• Lack of monitoring vital parameters of child such as: age, height, weight and head circumference

Malnourishment at an early age leads to reduced physical and mental development of the child. Hence, the first two years of a child’s life are critical and is termed as “Window of Opportunity”. There are various parameters to identify malnutrition in a child, the most crucial being monitoring the vital parameters up to 12 years of age:

• Head circumference
• Height
• Weight

How iCHR is helping?

iCHR is the India’s 1st Hospital linked Integrated Child Health Record – a revolutionary concept of automated vaccination record and growth monitoring, for your precious child. Our goal with iCHR is to attain the sustainable development goals and reduce the child mortality rate. It helps in keeping track of all the vital parameters up to 12 years of age responsible for monitoring the growth of a child such as:

• Head circumference
• Height 
• Weight
• BMI 

The parameters are plotted on WHO based charts, which help the child’s pediatrician to analyze any risk of malnutrition, and the statistics can also be used by ICDS for future studies. 

Case Study

Fortis Le Femme, being the major implementer of iCHR application gave insight on patients whose growth improved immensely with the utilization of the growth charts, namely:

• Fenton Growth Chart for Preterm Babies
• WHO Growth Chart for Term Babies

The chart below depicts the Weight versus Age vital parameters for a preterm baby on the Fenton Growth Chart which illustrates that growth of the baby at 46 weeks falls under 3 centile which is a bit on the lower side. With proper instructions and guidelines of the pediatrician, the growth of the child can be improved. 

Fenton Chart – Weight versus Age

The chart below depicts the Weight versus Age vital parameters for a term baby on the WHO Growth Chart illustrating that growth of the baby from 2 months to 15 months of age falls below 3 centile which is on the lower side. 

WHO Growth Chart – Weight versus Age

In both the above cases, with timely intervention and proper instructions of the pediatrician improved the growth of the child and helped the parents to come out of fear of retarded growth for their child.

We at iCHR are profound & proficient in providing the platform at your doorstep starting from installation, training the end users, support and maintenance of the application. We make sure that you do not fall in traps & make the best of decisions for the hospital and the patients. If this sounds interesting and you are still not on board, contact us to know more on ichr@oxyent.com or 011-40644232 for further queries and we’ll be more than happy to help! 

Current Vaccination Scenario in India

In India, an estimated 26 millions of children are born every year. As per WHO in 2015, 5.9 million children under age five and 696,000 neonatal deaths were recorded. Achieving full immunization against preventable childhood diseases is the right of every child, and to provide this right to every child, the Government of India launched the Universal Immunization Program (UIP) in 1985, one of the largest health programs of its kind in the world. According to a report, it is observed that though the program is being operational for over 30 years, only 65% children in the first year of their life have been able to achieve full immunization and the increase in coverage has stagnated in the past 5 years to an average of 1% every year. It has also been observed that every year in India, 5 lakh children die due to vaccine-preventable diseases. Another 89 lakh children remain at risk, because they are either unimmunized or partially immunized against vaccine-preventable diseases. (Source: Mission Indradhanush)

Various reasons have been identified on why the coverage has been slow such as:

• Lack of awareness on the need of immunization
• The vaccination and growth records handed over to the parents are paper based records which are not formally maintained. Parents in most of the cases either misplace these records or do not carry each time visiting the doctor for administering the vaccination to the child.
• Often the parents miss the vaccination schedule of their child due to the busy and hectic lifestyle, because of which the child suffers.
• Hospitals do not maintain OPD record for vaccination and hence there is no way of recovering the vaccination history.

What can be done to solve this issue?

Technology is joining hands with Healthcare rapidly, from HIS to EMRs/EHRs; the need of the hour is to now develop applications which will focus on specialized departments such as Maternity, Pediatric Department, etc. 

With this thought, would like to introduce iCHR - India’s 1st Hospital linked Integrated Child Health Record – a revolutionary concept of automated vaccination record and growth monitoring, for your precious child. Our goal with iCHR is to attain the sustainable development goals and reduce the child mortality rate. It helps in keeping track of all the vaccinations according to the schedule recommended by the IAP. The application offers the following benefits:

Benefits for Doctors

• Cloud based patient management system.
• Maintaining the visit history of child which saves record keeping and maintenance cost.
• Paperless and secured vaccination record available anytime, anywhere in the world.
• Brand documentation of vaccine.
• Digital plotting of growth parameters on WHO and Fenton Charts.

Benefits for Parents

• Paperless and secured Vaccination Record available anytime, anywhere on your mobile phone.
• Interactive growth chart on parent’s mobile phone to track growth of preterm and term babies.
• Easy to understand.
• Each hospital visit details on tap of a button.
• Automatic vaccination due date calculator.
• Timely vaccination reminders and notifications for the parents.

We at iCHR are profound & proficient in providing the platform at your doorstep starting from installation, training the end users, support and maintenance of the application. We make sure that you do not fall in traps & make the best of decisions for the hospital and the parents. If this sounds interesting and you are still not on board, contact us to know more on ichr@oxyent.com or 011-40644232 for further queries and we’ll be more than happy to help.