Challenges in Adopting It for Small Hospitals & Chains of Small Hospitals

Vijaybhasker Srinivas, Head – Process Control, Lifespring Hospitals Small hospitals are hospitals that have less than 30 beds. In India, 85 percent of private sector establishments have less than 25 beds. Hence, these establishments constitute a vast majority in the healthcare space. For IT to make deep impact on the healthcare, IT service providers have to take into account the realities and constraints faced by these establishments in using IT.

Typically, these hospitals offer services that require one or two specialists only. Hence, they do not have much problem of coordination between various specialities. While we can manage these hospitals without IT, requirements of clients generally bring IT in for providing computerized bills. As the business grows, the requirement of cash control comes in and kick-starts the use of IT for billing and related tasks. Billing also helps in easy payments to the consultants engaged. Some hospitals also use IT to track employee attendance and generate payrolls. Few send thank you SMSs or provide information of new specialities or specialists available at the hospital.
In most cases, the hospitals tie-up with other service providers for costly radiology equipment. Where procured, the equipment may only be DICOM ready but not DICOM enabled. Hence, these hospitals do not need the multitude of modules that are offered by several players. However, when only a few modules are selected, the resultant reports do not satisfy their needs.

For example, the doctors attending to and visiting the in-patient in the operation theatre and the ward cannot be paid without their names being entered somewhere in the OT module or the IP module. Thus, we have a lot of dichotomy between what is needed and what is provided – taking the segment of hospitals away from the IT.

These hospitals do not have a separate IT depart¬ment. They generally have only one com¬puter, which is used to handle all processes – would require single screens to capture all processes. Many persons, who use this lone computer, may not even know the different key strokes on the keyboard (Ctrl+C/Ctrl+V or even ask function key combinations). Starting an application like TeamViewer is a nightmare. As a general rule, these hospitals are stingy in their IT budgets and would not spend on getting license for their OS; and worse, may not have good antivirus protec-tion and backup plans. Internet speeds & uptime may be harder to predict than the Indian monsoon. Many may not have UPS backup for their computers – thus making the computers crash several times due to power shut¬downs. The hospitals have to use IT within these con-straints. Most solutions built for larger hospitals do not take these constraints into consideration.

EMR is not a possibility as doctors don’t have time or training to enter the data into the computer. Nor can their subordinates do this given the vast skill & knowledge gaps between the doctors and their subordinates (and coupled with the bad handwriting of the doctors). Use of ICD codes and NABH accreditation are not on agenda of these hospitals.