Over the last few years, have been fortunate enough to be working with the HealthCare sector in India.

In the due course of time, I have been interacting with IT Departments of various Hospitals (Very Large and Large and to some extent at the Primary Health level too). What I have been trying to understand is the key reasons as to why the IT penetration has been at a distant in the Indian Hospitals. There are quite a few valid reasons and I also encountered one other not-too valid reason, but will have to give it a benefit of doubt.

Time factor – One of the key factor why Hospitals see resistance from Doctors to use IT systems is because of the number of clients (patients) they need to see. On an average, a Doctor in any Hospital in India see’s an average of one client every two minutes (the raw data might be even more). In these two minutes, the Doctor has to understand his client problem, establish a connection (Important in the Indian Context), provide guidelines for the analysis and prescribe. The complete process takes definitely more than two minutes, and if the Doctor tries to spend time on the computer taking notes, his/her client might not appreciate it and not return back to them. People in Cities understand the importance of technology, however, in India, as 80% of the population still lives outside Cities, it might not be practical for the Doctor/Hospital to make them understand the same.

Cost – The second most important reason which needs serious consideration. 70% of HealthCare costs are “out of pocket”. Hence, when Hospitals/Doctor’s Clinic implement the use of technology, client tends to understand that cost of treatment is “higher” and hence avoid’s those kind of Hospitals/Doctors.

There is no support for Hospitals/Doctor’s to use Technology from the Government. Hence, the cost has to be shared by the client, which directly impacts their revenue.

Technology Education – There are no initiatives by the Government to spread awareness of the benefits of using Technology to end users. Even though there might not be immediate acceptance for this, on the long run, people would definitely see the benefit.

As an illustration, Government of India spend considerable time and money on the “Eradicate Polio” initiative and this has been a success. Even though initially the message was not taken seriously, now when a child is born even in the remotest place of the Country, parents immediately inquire of the Polio Drops schedule and ensure that their child gets them. The results speak for themselves – Today, India is “Polio Free”.

Variety of HealthCare Practices – India is a very large country and has variety of HealthCare Practices – Homeopathy, Allopathy, Unani etc. People change their practice depending on the kind of ailment. I have also seen and known people who follow a certain practice sticking to the treatment in serious conditions too, but very rare.

This does not have a direct impact on the HealthCare System/Process, however, this plays a vital role when people shift their accustomed practice.

More detailed information on various practices and Infrastructure in my earlier post.

Acceptance by all Stakeholders – Even though every Individual accepts that IT is an integral part of delivering Quality HealthCare, acceptance by all stakeholders also plays a very vital role in rolling out technology solutions.

As an Illustration, Government employees need to submit manual receipts and documentation for their medical reimbursement. Also, many Insurance providers do not completely follow the approval and reimbursement process online.

In summary, a Hospital/Doctor’s office is not encouraged in all aspects to implement Technology. There are many a times when they need manual documentation. To avoid multiple process flows, Hospitals keep their Technology inquisitiveness away.

However, things are changing. With a recent success story of how the Andhra Pradesh Government implemented Aarogyasri, many states have been trying to follow the same.

There are quite a few other concerns and problems for Hospitals to implement IT, however, if we have a humble beginning, success will definitely follow.

1 Comment

  1. Dear Hari,
    Nice article. I would add one more point.
    IMHO, the biggest factor working against IT adoption in India is the questionable ROI. IT applications for healthcare have existed for more years in USA than in India. Even so, American hospitals are not yet fully convinced about the ROI with EMRs & EHRs. A few months ago, Health Affairs, a very reputed journal in US published a study that claimed that a physicians access to EHRs actually increased the requests for tests – implying that it is not necessary that EHRs reduce costs. In the Indian context, specially keeping in mind the resource-constraint setting, anything that has a debatable ROI will show a very slow adoption rate – even in the cities, even in large private hospitals.

    Over all, I enjoyed reading the article.
    Thank you,
    Urvi

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