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 1 The Healthcare Industry in India In India, the Healthcare industry is split into a public sector, a private sector and a wide network of informal healthcare providers operating together in a large and unregulated network. This irregularity has caused wide disparities in access, especially in regional and rural distribution of healthcare infrastructure. Currently, the Indian healthcare sector is valued at Rs.1, 360 (US $34) billion roughly 6 per cent of GDP. The healthcare business is projected to grow to over Rs.1, 600 (US $40) billion or 8.5 per cent of GDP by 2012, according to Price Waterhouse Coopers (PwC) report, 'Healthcare in India: Emerging market report 2007'. INFORMATION TECHNOLOGY IN HEALTHCARE INDUSTRY The healthcare industry today after twenty five years, since computers started influencing our society, is standing at the threshold of a world of possibilities thrown up by technologies such as Virtual Reality, Cyber surgery, Micro - robotic Surgery and 3D image modeling. It is said that the Internet should be used for the benefit of mankind. Internet pundits have always felt that development and delivery of Medicine will be one area where this medium is likely to have immense benefit to mankind. For e-healthcare and telemedicine to emerge as a viable alternative modality for delivering medical care and expertise there are a few preconditions that are to be met. Some of these are, 1. Adaptation of Information technology by hospitals especially in terms of networking and Hospital Management systems. 2. Increasing awareness on IT among medical professionals. 3. Better Internet access; possibility the madvent of broadband in I ndia that can transfer video files faster. 4. Standardization of various protocols (like DICOM in teleradiolo gy) and acceptance of these protocols by the relevant equipment manufacturers. 5. Decline in the cost of telemedicine hardware to make it more financially viable. 6. Govt. encourages a Public  Private enterprise. 7. Large Corporate leading in overseas healthcare contracts - T CS, Cognizant, etc. At present, the major constraint is in terms of the financial viability of e-healthcare initiatives. However there have been several isolated initiatives from various organizations and hospitals for implementation of projects. For example The Indian Space and Research Organization has today 32 telemedicine location in India and is investing heavily to help Indian healthcare to graduate in this technology and then use it for its own purpose in the future to monitor Indian astronauts who undertake journeys in space. Most of the developments in this field are likely to focus around the needs of ISRO. The answer to make projects financially viable also

Use of Information technology on Healthcare

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The Healthcare Industry in India

In India, the Healthcare industry is split into a public sector, a private sector and a wide

network of informal healthcare providers operating together in a large and unregulatednetwork. This irregularity has caused wide disparities in access, especially in regional and

rural distribution of healthcare infrastructure. Currently, the Indian healthcare sector is valued

at Rs.1, 360 (US $34) billion roughly 6 per cent of GDP. The healthcare business is projected

to grow to over Rs.1, 600 (US $40) billion or 8.5 per cent of GDP by 2012, according to

Price Waterhouse Coopers (PwC) report, 'Healthcare in India: Emerging market report 2007'.

INFORMATION TECHNOLOGY IN HEALTHCARE INDUSTRY 

The healthcare industry today after twenty five years, since computers started influencing our

society, is standing at the threshold of a world of possibilities thrown up by technologies suchas Virtual Reality, Cyber surgery, Micro - robotic Surgery and 3D image modeling. It is said

that the Internet should be used for the benefit of mankind. Internet pundits have always felt

that development and delivery of Medicine will be one area where this medium is likely to

have immense benefit to mankind.

For e-healthcare and telemedicine to emerge as a viable alternative modality for delivering

medical care and expertise there are a few preconditions that are to be met. Some of these are,

1. Adaptation of Information technology by hospitals especially in terms of 

networking and Hospital Management systems.

2. Increasing awareness on IT among medical professionals.

3. Better Internet access; possibility the madvent of broadband in India that can

transfer video files faster.

4. Standardization of various protocols (like DICOM in teleradiology) and

acceptance of these protocols by the relevant equipment manufacturers.

5. Decline in the cost of telemedicine hardware to make it more financially viable.

6. Govt. encourages a Public – Private enterprise.

7. Large Corporate leading in overseas healthcare contracts - TCS, Cognizant, etc.

At present, the major constraint is in terms of the financial viability of e-healthcare initiatives.

However there have been several isolated initiatives from various organizations and hospitals

for implementation of projects. For example The Indian Space and Research Organization

has today 32 telemedicine location in India and is investing heavily to help Indian healthcare

to graduate in this technology and then use it for its own purpose in the future to monitor

Indian astronauts who undertake journeys in space. Most of the developments in this field arelikely to focus around the needs of ISRO. The answer to make projects financially viable also

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probably lies in pooling together resources by various facilities within a geographic locality

and sharing the benefits and revenues thus created. To elaborate on this point, several

hospitals within a city like e.g. Salem can share a common Tele-pathology service or

Teleradiology service. The benefits of such a pooled service are obvious. Investigations canbe viewed by a group of expert consultants. Such a model will reduce the initial project costs

and with the patient traffic from several affiliated hospitals can achieve economy of scale and

thus reduce costs of trained manpower and material costs and also provide a very efficient

and optimal service to the community.

Healthcare

India is well placed and potentially the ideal location for experimenting with e-healthcare

solutions for the following reasons:

India has best computer Technocrats India has a very skilled medical fraternity private

healthcare emerging as a key-player in the country Indian Healthcare spending likely to

increase to 200,000 crores by 2012 from present 86,0000 crores. Potentially India a very

suitable location and resources pumped in this sector now are likely to be of great benefit

Fortis Healthcare is engaged in providing the latest in internationally recognised medical care

to patients with a variety of ailments and medical conditions.

Fortis HealthCare’s Network consists of Super Speciality Hospital Hubs that concentrate on

one or more specialities. These hospitals are interconnected to a larger network of multi-speciality hospitals that ensures patient access to expert care for any speciality.

This unique network architecture provides expert care to our patients and a level of 

confidence in receiving the latest medicine has to offer.

Telemedicine

Telemedicine in principle is well suited for countries like India, Africa and South America

where there is a large rural based population separated by large distances and needing access

to regular medical care of quality. The telephony revolution of nineties of India has linked

most of our smaller towns and villages with rest of the world. The railway also has a vast

network of fibre-optics cables already laid out on many of its routes. The Space scientist of 

our country have placed strategic satellites of communication making a broadband network 

not too difficult to achieve with expenditure of minimum resources, These gateways of 

communications should be all used to help with the project of telemedicine and hence reduce

applications costs. Even subsidies could be incorporated to facilitate telemedicine projects in

our country.

Fortis Healthcare has built a tele-medicine network, which connects each of its facilities, soexpert care is never out of reach. In addition, Fortis Healthcare facilities are also working

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with both private and public partners in the Indian Healthcare industry to provide Super

Speciality and quality healthcare services.

Fortis Healthcare provides services covering ICU Management, ER Management, OPDManagement, Radiology Reporting, Pathology Reporting as well as Training and Education

Opportunities.

Utilising our strong HIS backbone, and PACS technology, we are able to seamlessly transmit

patient information in a secure and confidential environment. The use of tele-medicine has

provided a much-needed boost to the Indian Healthcare sector. It has also allowed our

network to expand its presence by extending quality healthcare treatment to the remote areas

of Northern India as well as overseas

Fortis Healthcare network structure ensures quality healthcare and utilizes 

  VPN - Virtual Private Network 

  Firewall protection

  Data transfer speeds of 128Kbs or higher

  Security : Encryption and Confidentiality

  Alternate pathways

  Web access for clients

  Use of IHE and HL7 framework 

  Integrating Healthcare Enterprise  Health Level 7

Fortis Healthcare Tele-medicine Software are: 

  Browser based

  Built on HL7 and DICOM standards

  Open Source Technology Linux

  Offers Real time and delayed Access

  Streaming without transfer, real-time ECHO, US

  Statistical Reporting

  Interface with Legacy Machines

  Flexible clinical reporting formats

Security 

  User authentication by individual usernames and passwords

  Restricted study access for users and groups

  Extensive logging for system audit

 Automatic log-off 

  Self-defining and self-expiring passwords for maximum privacy

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  Data encryption

Five force model:

Key points:

Porter's Five Forces Analysis is an important tool for assessing the potential for profitability

in an industry. With a little adaptation, it is also useful as a way of assessing the balance of 

power in more general situations.

It works by looking at the strength of five important forces that affect competition:

• Supplier Power: The power of suppliers to drive up the prices of your inputs; eg: 1. brand

reputation. 2. Geographical coverage. 3. product/service level quality etc.

• Buyer Power: The power of your customers to drive down your prices, eg: Buyer choice

buyers size/number , change cost/frequency , product/service importance, volumes, JIT

scheduling

• Buyer Power is strong, again implying strong downward pressure on prices; and

• Competitive Rivalry: The strength of competition in the industry; eg: number and size of 

firms, industry size and trends, fixed v variable cost bases, product/service ranges, etc.

• Competitive rivalry is extremely high: if someone raises prices, they‟ll be quickly undercut.

Intense competition puts strong downward pressure on prices;

Compititive

rivalery

within the

insdustry

Threat of 

New

entrans

Bargening

power of 

customer

Threat of 

substitutes

Bargening

power of 

supplier

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• The Threat of Substitution: The extent to which different products and services can be

used in place of your own. eg: alternatives price/quality, market distribution changes, fashion

and trends, legislative effects.

• There is some threat of substitution.Ex Telemedicine or shifting to other medicine likeayuraveda or natural care.

• The Threat of New Entry: The ease with which new competitors can enter the market if 

they see that you are making good profits (and then drive your prices down). By thinking

through how each force affects you, and by identifying the strength and direction of each

force, you can quickly assess the strength of the position and your ability to make a sustained

profit in the industry.

• The threat of new entry is quite high: if anyone looks as if they‟re making a sustained

profit, new competitors can come into the industry easily, reducing profits; Ex.- Apollos ,

Max, Escort , WOCKHARDT and DUNCANS GLENEAGLES INTERNATIONAL

Worries Fortis hospital:

Unless it is difficult to find some way of changing this situation, this looks like a very tough

industry to survive in. Maybe he'll need to specialize in a sector of the market that's protected

from some of these forces, or find a related business that's in a stronger position.