Tuesday, 17 February 2015

My Health Account: Can I do Internet Health?

If money is widely considered as “Wealth”, there were many innovations done to safeguard the wealth. Supported hugely by technology, such innovations have created an avenue for the mass customers to track their wealth and feel a sense of higher security. Starting from the revolution in the simple bank account management to evolution of technologies to simplify the complicated equity and mutual fund management, technology has really shown its true colour in creating value to the community. Understanding financial market has had never been so easy without the introduction of innovative technology.
The concept of health account is the same as your bank account. The way bank account creates, holds and manages all of your finance requirements; the health account would create your health records, holds all the records for retrieval and would help to manage your health in a better and more effective way. Many times there is a strategic approach gap between health account and the Electronic Health Records (EHR).
Many of the hospitals have initiated the efforts in this direction which is often termed as EHR. EHR systems enable hospitals to store and retrieve detailed patient information to be used by health care providers, and sometimes patients, during a patient’s hospitalization, over time, and across care settings. The Centers for Medicare and Medicaid Services (CMS) calls EHRs, “the next step in continued progress of health care that can strengthen the relationship between patients and clinicians.” Even with a huge perceived utility of EHR, the implementation is very low. Although EHR penetration is growing at 13.5% in India  many hospitals are struggling to deal with challenges like limited knowledge and application of IT in the desired area, shortage of trained manpower, sizable initial investments, physician and staff buy-in, training to the hospital staff etc.
While the challenges are genuine for the successful implementation of EHR, I personally feel there is an issue in the approach of implementation of EHR. Almost all the strategic papers on EHR state that the value derivation for the hospital operation, quality of care for the said hospitals. However, it has not spelled out the value being created for the patients, thus the demand component from the patients are completely ignored. Positioning of the EHR from patient perspective would definitely help in bringing the EHR in fast track.
Another strategic issue of EHR is the lack of integrated approach. Most of the times the strategy revolves around the hospital and the Information Technology (IT) solution providers, leaving other major players like diagnostic centers, pharmacy, insurance companies and training institutes and consultants. It must bring them into the fold if the EHR in India would make an impact in the health care industry.
The EHR must be people centric. The awareness programme would also be initiated so that the patient feels he is empowered and a considerable amount of value is being provided through the health account. This may be powered by issue of the health cards, which can be resembles like credit and debit cards and also functions like them as well. The way the bank accounts are tracked for any transaction and financial status, the people with health account can track their health related transactions like various diagnostic parameters, annual health check up report and take a holistic view of the overall health status. The account must be done on a web based application, so that customers can access their account any-time any-where. This would enable the patient to do the “Internet Health”.
The hospitals here are synonymous to banks for opening of health accounts. Hospitals must take a lead in bringing more value addition services and provide integrated services like consulting, IPD, diagnostic services, pharmacy etc. In such case the functionalities of health account become more effective as it does not require integrating other service providers except the insurance.
Healthcare in India is at the cross roads. Although hospitals and health care industry has taken stride to bring innovations in using technology for scaling up in the operation, improvement in the clinical services, the optimal use of technology is way far. The patient centric and partnership based approach would bring the desired result with the healthcare customers experiencing the true use of information technology by internet health.

The writer is Dr Biranchi Narayan Jena, Director, Institute of Health Management Research(IHMR), Bengaluru.

Tuesday, 13 January 2015

Vibrant Bangalore - Dr. Biranchi Jena, Director - IIHMR, Bangalore speaks to Deccan Herald

'Bengaluru is a vibrant city'

Tini Sara Anien, Dec 31, 2014, DHNS:
Melting Pot
Content: Biranchi Narayan Jena and Pratibha with daughter Shravanee.

Those who come from different parts of the country enjoy their stay in the City due to its alluring cosmopolitan nature and the fantastic weather. 

Dr Biranchi Narayan Jena is one such person who came to Bengaluru because of work and loves living here. 

Jena, who is the director of Institute of Health Management Research, is from Puri in Orissa while his wife Pratibha is from Mumbai. They have been in the City with their daughter Shravanee for two years now.

Jena did his schooling and graduation in Puri. “The culture is different. I have worked in Mumbai and Hyderabad before this. Bengaluru is a vibrant city. A lot of things are happening here. It has a developing health industry and is known for its IT sector. The marriage of these sectors is essential for the progress of any city,” says Jena. 

The work environment is different here, says Jena. “In Mumbai, people are too professional. When they work, they don’t think about their personal lives; their day begins and ends with work. Everyone also discusses work a lot over there. But Bengaluru is the perfect blend of both professional and personal lives. Comparing the three cities I have worked in, Bengaluru is the perfect place to be at,” Jena says.

He and Pratibha love the food here. “There are many varieties of rice here. There is the ‘tomato bath’ and coconut rice. In other places, one can only find plain rice,” he says. In Orissa, a lot of fish is consumed as part of their daily diet.

“In vegetarian options, we prepare plain rice and dal with vegetables, which is called ‘dalma’. This is why I love ‘bisi bele bath’, in which everything is cooked together,” he says. He says he doesn’t miss much from back from home because there are a lot of restaurants which offer Orissa cuisine. 

The family agrees in unison that there weren’t many adjustments that they had to make. Jena says, “Getting a house was a difficult task. We have to pay an exorbitant amount in the form of advance here.” Traffic is another issue. “Though I stay three kilometres away from work, I’m stuck in traffic for almost an hour. This is another daily battle which is unpredictable,” he adds.

His wife Pratibha says that the people here are warm-hearted. “People are really nice and always rush to help,” she says. Jena recollects how once while he was travelling in a bus, he had requested the conductor to inform him when his stop came. “The conductor kept updating me every two minutes and I was genuinely impressed by his kind heart,” Jena says with a smile.

Their daughter Shravanee, a student of Whitefield Global School, says that she likes the City as it is very fashionable. “Things aren’t very different from Hyderabad. But Bengaluru is very trendy. I like the fashion trends people follow here,” says Shravanee.

Pratibha feels that the City is very welcoming. “Bengaluru is a very nice City. Everything is organised here. I have a good circle of friends here,” she sums up.


Research report on reproductive health issues

IIHMR Bangalore reaches out to women in Koppal District, Karnataka for creating awareness on reproductive health issues

  • IIHMR Bangalore was funded by ICMR to undertake the project spanning over one and a half year
  • Around 1200 women Self Help Groups were imparted with knowledge on women’s health
  • Awareness on cervical cancer and other reproductive issues were discussed with women
December 15, 2014: IIHMR Bangalore undertook an action research demonstration project (funded by Indian Council of Medical Research (ICMR) to empower women Self Help Groups (SHGS) in talking about various issues faced by women in the area of reproductive health. IIHMR went about sensitizing, mobilizing and engaging women with series of sensitization workshops and refresher trainings for one year, so that they can act as change agents for other women in the community. Bangarpet taluk in Koppal district of Karnataka was the intervention site for the study.
The study undertaken over a period of one and half years (from May 2012 to October 2013)has revealed that with improved knowledge in women there is a greater impact for healthier lives and families as they can act as change agents for other women in the community. With Sustainability of Sensitizing Self Help Group to Reproductive Health via Empowerment and Engagement (SSSTREE) project intervention, thousands of women have so far benefitted, in turn benefitting thousands of families. IIHMR conducted a ‘Health Mela’ as part of the project where nearly 1000 women were addressed through trainings on various reproductive health issues. Around 1200 women SHG were imparted with knowledge on all aspects of women’s health.

In a conservative society like India where talking about sex, RTI/STIs and other gynecological problems of women is a taboo, the greatest achievement of the project was that women have learnt and understood more about their health and have broken the point of hesitation to talk about such intimate issues and empowered themselves. Critical issues like awareness on cervical cancer were easily conveyed to them, which in turn will help keep a check on the incidence and treatment-seeking behavior of them.

Talking about the achievement, Dr. Biranchi Jena, Director of IIHMR Bangalore commented, “The study was undertaken by IIHMR Bangalore as part of our research to improve the overall reproductive health in the community. It is truly commendable to see women from rural areas come ahead and talk about their problems with the research team. This is the first step towards improvement of lives, and generations to come.”

IIHMR will be soon undertaking a larger intervention project in other parts of the country also.

About IIHMR, Bangalore

Institute of Health Management Research (IIHMR), Bangalore is the south campus of IIHMR; was established with a fundamental purpose of creating knowledge and developing innovative modes of improving healthcare through management research, education and training. The Institute has significantly contributed to the areas of health research management in the country and in South-East Asia Region.  It has established a new paradigm of management of capacity development among healthcare professionals at the national, state and district levels in the areas of leadership, strategic management, and quality assurance in health care. 

IIHMR, Bangalore has been in operations since 2004 to improve hospital and health care education, research and training especially in South India.

Dr. Biranchi Jena, Director - IIHMR, Bangalore in the media on Patient Safety Practices in Hospitals & Concerns

IIHMR concerned over Indian hospitals unsafe patient safety practicesNandita Vijay, Bengaluru

Tuesday, January 13, 2015, 08:00 Hrs  [IST]

Institute of Health Management Research (IIHMR), Bengaluru is now seriously concerned about the massive unsafe patient safety practices prevailing across hospitals in the country.

The Institute is of the view that only immediate adoption of patient safety practices could bring down the spread of hospital acquired infections, medication errors and prevent wrong diagnosis along with proper communication between patients and doctors.

India accounts for 40 per cent of patient unsafe practices . In Bengaluru alone which is the hub of healthcare majors, reports 68 per cent of hospitals with no adequate patient safety measures which includes absence of handle bars in washrooms for patients to grasp.

Adhering to the basic patient care measures would drastically improve the overall healthcare delivery in India. In fact a simple and low-cost infection prevention and control measures, such as appropriate hand hygiene, can reduce the frequency of hospital acquired infections by over 50 per cent, Dr. Biranchi Jena, director of IIHMR Bengaluru told Pharmabiz.

The purpose of patient safety is to tackle and control patient unsafe issues across hospitals in the country, he added.

Now the practice of hand hygiene which is the most neglected in India needs to be  mandated where use of soap and water after which application of alcohol-based hand sanitisers should be compulsory not just for doctors and nurses but also patient, and their caregivers, he added.

Another critical component in the patient safety agenda listed in the 6 point agenda of WHO is the communication between the patient and doctor where adequate time is set aside to comprehend the health condition. This would prevent incorrect diagnosis and medication which could control the patient’s healthcare expenses. The reason for mistaken disease detection by doctors is largely driven by stress and fatigue. Quoting a WHO study, Dr. Jena said that as doctors and nurses in some hospitals in India work for 30 hours continously as against 16 hours of working in the west make these medical professionals in India far more strained with lack of sleep. This led to 36 per cent of medical errors, of which 21 per cent were serious medication blunders.  Further, illegible handwriting also le to wrong medication dispensing at pharmacy outlets.

“We see the need for comfortable extended working hours to avoid sleep deprivation and roster rotation practices to be implemented in hospitals to avert a crisis during patient care,” pointed out Dr. Jena.

Indian healthcare is at the crossroads and with government’s miniscule 1 per cent GDP allocation there is a serious disparity of hospitals in the rural and urban areas. Adding to these woes is the high unsafe patient safety practices. This is where IIHMR through its two-year fulltime post graduate diploma in hospital management & health management is creating a pool of experts to organise a series of workshops, seminars, lectures to doctors, nurses and pharmacists in the healthcare space, he said.

It has kicked off such initiatives at medical colleges in Pondicherry like JIPMER, Sri Venkateshwaraa Medical College Hospital and Research Centre and Sri Manakula Vinayagar Medical College and Hospital. Besides it has identified medical and nursing colleges in Kochi, Hyderabad and Chennai for similar initiatives. “The key objective is to ensure that Indian hospitals will need to enforce total patient safety practices for its growing patient pool and those coming in for medical tourism,” said Dr. Jena.