Digitization in Healthcare for Better Accessibility

Annapurna Kuchibhatla, CTO, LV Prasad Eye Institute Headquartered in Hyderabad, LV Prasad Eye Institute is a comprehensive eye health facility providing world-class services in Patient Care, Vision Rehabilitation, Community Eye Health, Research, Education and many more.

‘Access to Healthcare’ can be understood as the possibility to identify healthcare needs, to seek, to reach & to use health care services and most importantly, to have the need for the service fulfilled. Accessibility can be explained in terms of Availability, Affordability, Approachability, Acceptability and Appropriateness. Digitization is the means to achieve these goals. To provide equitable care, the hospital needs to be digitized end-to-end, integrating different facilities and applications seamlessly.

Availability is whether the services are available, whether there is an adequate and continued presence of available services. Available health care resources should meet the needs of different patient categories at different geographical locations. Availability implies that health care services are available at all levels, such as Primary, Secondary and Tertiary, that are reachable in time. Providing Home Care facility is the latest trend. Analytics help in decision making to establish all the above appropriately.

Digitization leads to optimize the Doctor’s time so that they can treat more patients. Automatic Integration of diagnostic reports & Lab reports with EMR goes a long way in the accuracy, completeness and speed of diagnosis. MPLS and the cloud solutions empower the hospitals to be located based on the density, population and need for access, while keeping them connected. This along with EMR & HIS provides the patients with the freedom of getting the treatment in any branch of the hospital.

Call Centres, IVRS and web-based applications can be used in providing appointments. IP Phony and unified solutions can be used to integrate call centre and EPABX to attend patients’ calls effectively. Telemedicine helps to address the problem of scarcity of Doctors to some extent. Connectivity, EMR & HIS, SMS Applications, ERP, Analytics, and many more can help in scaling-up of the care. In providing Home care, digitization has a pivotal role to play.

As the healthcare providers have big data of patients & diseases, the disruptive technologies like Machine learning and deep learning can be used for predictive medicine. Artificial Intelligence exceeds the capacities of veteran Doctors in predicting Skin Cancers, Heart attacks and other fatal diseases. Big data & computing power together provide significant insight into family history,
genomics, genetic changes, life styles and so on, and as to how these can trigger cancers & their treatments.

"As the healthcare providers have big data of patients & diseases, the disruptive technologies like Machine learning and deep learning can be used for predictive medicine"

Affordability refers to the economic capacity for people to spend resources and time to use appropriate services. To improve affordability, the provider can adopt methods to improve efficiencies & reduce costs, there by creating affordable services to the needy.

Applying Six Sigma improves process efficiencies and reduces defects or complications. Implementing Lean practices and tracking surgical items surgery wise, mitigates pilferage, reducing the costs to the hospital and in turn to the patient. Barcode & RFID technologies can be used as required. Implementation of proper Billing, verification & validation mechanisms and compensatory controls in addition to the reports generated through EMR & ERP prevents frauds and money leakage. Surveillance cameras help in monitoring the key areas and in preventing & detecting the gaps, which leads to better operational, as well as financial control. Necessary Audit logs & Reports can be utilized for better monitoring & control.

Approachability relates to the fact that people who are in need of healthcare can actually identify that some form of suitable services exists. Websites & Social Media are the powerful tools for making the public know the services offered by a Healthcare Provider. Hence having an organized & optimized website is the Key to reach more population. The outreach activities can contribute to make the services more approachable for people from remote & undeveloped areas. Mobile Apps with cloud-based solutions facilitate the community workers upload necessary information. Based on the preliminary screening, the needy can be referred to the Primary, Secondary or Tertiary care.

The patients in these areas may not seek or access Health services with the fear of expenditure in terms of transportation, loss of daily wages and others. Telemedicine is a boon in this case. The patient details and diagnostic reports can be integrated to the EMR so that tracking the patient and providing further care to the patient is possible. Moreover, the data is fed to the analytics for proper decision-making and further to Machine Learning for patterns & predictive analysis and appropriate action.

Acceptability indicates the cultural, environmental and social factors determining the possibility for people to accept the aspects of the service such as the gender or social group of providers, the beliefs associated to systems of medicine and the perceived appropriateness for the persons to access and obtain care. Abuse & neglect of female population and downtrodden communities deprives them to seek care. Different groups may perceive appropriateness & quality differently. Hence, this aspect of Care is an important challenge. Education & awareness programs enlighten the population and address the acceptability issue. Analytics help in a big way in better planning of the services at Health care provider end, handling this challenge of acceptability. Machine Learning & IoT kind of facilities will be of greater help in planning the coaching and driving the people towards wellness.

Appropriateness denotes the alignment between services and the needs of patients, its timeliness, the technical and interpersonal quality of the services provided. Adequacy relates to the appropriateness (what services are provided) and quality (the way in which they are provided) of health services in integrated & consistent manner. Effectiveness of health services is the key. Wallpapers, HR Applications, online Story Board and so on create motivation and build culture. In addition to the metrics mandated by Accreditation Bodies like NABH, JCI and others, hospital-devised metrics take a long way in improving the systems as per goals. The data taken from source (from EMR, ERP and other Applications), provides insight into the areas for improvement. IP Cameras can be used for improving quality in care and to provide necessary improvement training. In one word, Digitization enables better accessibility in Healthcare.