Ms. Jyoti Manjramkar* M.Sc. Biotechnology 2015 ...

Information Technology (IT) Tools and Indian Healthcare Sector- The present status and roadmap

Ms. Jyoti Manjramkar* M.Sc. Biotechnology 2015 Batch, School of Life Sciences, SRTMU, Nanded, INDIA *To whom correspondence should be addressed E-mail: [email protected] ABSTRACT: A secondary research was undertaken to get an idea about the present status and roadmap for advancement and applications of information technology (IT) in Indian healthcare sector. Primarily the IT applicability can be divided into pharmaceutical IT and health IT.1 As a current status, mainly seven broadly used tools have been described under this paper. The paper also makes an attempt to highlight the future probable highly sophisticated IT tools to be used by pharmaceutical sector in India. INTRODUCTION: We are witnessing that how information technology (IT) is an important emerging sectors of the Indian economy. The size of this sector has increased at a tremendous rate of 35% per year during the last 10 years.2 India is considered to be the most favoured destination for IT (IT) companies while Indian pharmaceutical industry is the world’s third largest in terms of volume. Today the pharmaceutical industry relies heavily on technology in terms of process management, data analytics, content management, identify cost effective therapy and to engage with the customers. Moreover, the medical devices, which form an integral part of our healthcare system are heavily dependent of software technology.3 Indian pharmaceutical industry is third largest in the world and is one of the most developed industries. India has a total of 24,000 pharmaceutical companies, of which around 250 fall under the organised category. These 250 organised units control nearly 70 per cent of the market. About 8,000 small scale units together form the core of the pharmaceutical industry in India, including 5 Central Public Sector Units. About 75% of the top 20 pharmaceutical companies are Indian owned.4 However, in order to stay more competitive in the future, Indian companies will have to refocus and invest heavily in R&D. The Indian pharmaceutical industry also needs to take advantage of the recent advances in IT. The future of the industry will be determined by how well it markets its products to several regions and distributes removing risks, its forward and backward integration capabilities, its R&D, its consolidation through mergers and acquisitions, co-marketing and licensing agreements.5 OBJECTIVES: The principal objective of this paper is to study the current status and roadmap of applications of IT tools for healthcare sector in India through the secondary research. KEYWORDS: Indian healthcare sector, IT, Government and management.

1

Ms.Jyoti Manjramkar, M.Sc. Biotechnology 2015 Batch, School of Life Sciences, SRTMU, Nanded, INDIA

2

Information

technology

in

India:

Present

status

and

future

prospects

for

economic

development

by

Sanjay

K

Singh

www.iitk.ac.in/directions/may2006/PRINT~SANJAY.pdf 3

Impact

of

IT

on

Indian

pharma industry

http://www.financialexpress.com/article/pharma/management-pharma/impact-of-it-on-indian-

pharmaindustry/56552/ 4 Investment Opportunity: Pharmaceuticals Sector Overview http://www.investindia.gov.in/pharmaceuticals-sector/ 5 Pharmaceutical Drug Manufacturers: Indian Pharmaceutical Industry available at http://www.pharmaceutical-drug manufacturers.com/pharmaceutical-industry/

METHODOLOGY: Secondary research about getting general overview on current status and roadmap of applications of IT tools for healthcare sector in India by referring various articles, data, and findings from various sources including journal papers was conducted. BROADER CLASSIFICATION ON APPLICABILTY OF IT TOOLS: 1. Pharma IT The new field of science which includes the application of IT systems in pharmaceutical industry, that deals with biomedical information, data and knowledge- their storage, retrieval and optimal use for problem-solving, decision-making and promoting safe pharmaceutical care. The few major applications which force a pharmacist to use Pharma IT i.e. prevents medication errors, interconnect clinicians, crossing the quality chasm, personalize care, improve population health, along with benefits like decreased manual work, smooth & ease of work flow, strict security, reduced paper work i.e. e-documentation and time efficient. Some of the examples of an automated IT systems in Pharma sector are CPOE (Computerized physician order entry),ERP (Enterprise resource planning), LIMS (Laboratory Information Management System), SFA (Sales Force Automation),e-BR(Electronic Batch Records), CRM (Customer Relationship Management), CTMS- (Clinical trial Management System), CAPA (Corrective Action & Preventive Action), DCS- (Distributed Control System) and CMMS (Computerized maintenance management System)6. 2. Health IT (HIT) According to the Office of the National Coordinator, HIT is defined as the application of information processing involving both computer hardware and software that deals with the storage, retrieval, sharing, and use of healthcare information, data, and knowledge for communication and decision making.7 Its now reality that HIT is growing day by day8. CURRENT STATUS: a. Mobile based applications There are 913 million mobile subscribers in India as per the estimates of Telecom Regulatory Authority of India (TRAI) for August 2012. 9 Mobile based application has advantage of eliminating the need to be restricted to a specific geographic location and portability.10 Pharma companies can use mobile devices to deliver information about their products to physicians, in a format and at a schedule that can be customised to individual preferences. Counterfeit drugs are a major source of worry for pharma companies. In response, pharma companies have started fitting special codes on medicine packages to tackle this menace. When a customer buys a bottle or strip of medicine, he/she sends the code as a text message or a scanned image to a specified phone number. A return message verifies whether the medicine purchased is counterfeit or not. Service providers like Sproxil and PharmaSecure have partnered with telecom operators to offer this service in emerging markets where the threat of counterfeit drugs is high.11 6

Role of Information Technology in Pharmaceutical industry http://www.slideshare.net/shivamthakore/role-of-information-technology-in-

pharmaceutical-industry 7

Health IT terms glossary. HealthIT.gov website. http://healthit.hhs.gov/portal/server.pt/community/health_it_hhs_gov glossary/1256. Accessed

December 7, 2012. 8

Jyoti Manjramkar, M.Sc. 2015 Batch, School of Life Sciences,SRTMU, Nanded, INDIA

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Pharma summit report 2012 India Pharma Inc. Gearing up for the next level of growth www.pwc.com/india

10 Demiris G, Afrin LB, Speedie S. Patient-centered applications: “Use of information technology to promote disease management and wellness”. A white paper by the AMIA knowledge in motion working group. J Am Med Inform Assoc. 2008;15:8-13. 11 Pharma summit report 2012 India Pharma Inc. Gearing up for the next level of growth www.pwc.com/india

b. Context-based Services Context is fast becoming a buzz word across many industries, and can be defined as the convergence of the real and virtual worlds, orchestrated by 3G- and 4G-enabled smartphones and typically making use of location-based services. For the pharma industry the approach is already helping companies to engage directly with patients, with a good example being a smartphone app developed by Merck Sharp & Dohme for users of its allergy treatment Clarityn (loratadine) 12. c. Converging data architectures There has been an explosion in the amount of data that pharma companies have to deal with, and this is likely to be exacerbated in the future. For example, AstraZeneca was a pioneer in the sector when it added serial numbers to Nexium (esomeprazole) to help track products through the supply chain and help combat medicines counterfeiting. Serialisation is now increasingly common, but what is not widely understood is the sheer volume of data that needs to be handled and retained. The Nexium dataset is now by far the largest in AZ, so imagine the size of the task when all products need to be serialised, as mandated by the EU Falsified Medicines Directive.13 d. Technology in medical devices Globally, the medical devices today are based on wireless communication technologies such as Bluetooth smart and IrDA which are connected to smart phones, tablets, computers and other medical devices. Advancement have been made in India on the various medical device front. Mobile hand held devices are being developed in India where a device can monitor blood sugar level, pulse rate, blood pressure, oxygen level of a patient in remote area and can transmit the same to the healthcare service provider or practitioner to enable quick treatment support. This is based on integration of wireless technology in medical device which is remote patient monitoring (RPM) and medical body area network (MBAN). Today, there are a few downloadable applications available which can be used to activate and run medical device connected to the computer thus taking the innovation to a new horizon.14 e. Social-driven IT Like other sectors have been benefited by social media, health sector is not an exception to it 15. The power of social media and the impact it has on the customer has been realised by the pharma companies. The pharma industry is bound by strict marketing and FDA regulation, but some of them are trying to build new forum to get associated with the customers. An example of this is Sanofi, which has experimented with social media by building Facebook community for diabetes patient who share their experience with the disease. This helps in improving and has focus on the health and wellbeing of the patient and builds the company’s image as a responsible service provider for the society.16 f. IT including Electronic prescribing and Telecare Electronic prescribing (EP) systems automate prescribing, supply and administration of medicines in hospitals, where they have been shown to reduce medication errors and have a major impact on patient safety. However, the effect on error reduction is dependent on system design and a poorly implemented system can actually increase error rates. Telecare involves the use of digital communications technology (audio and visual) to provide healthcare consultations and services to patients remotely at home. Telecare has various potential benefits: it puts patients at the centre of 12 Investment Opportunity: Pharmaceuticals Sector Overview http://www.investindia.gov.in/pharmaceuticals-sector/ 13 Investment Opportunity: Pharmaceuticals Sector Overview http://www.investindia.gov.in/pharmaceuticals-sector/ 14 Impact of IT

on

Indian pharma industry http://www.financialexpress.com/article/pharma/management-pharma/impact-of-it-on-indian-

pharmaindustry/56552/ 15 Jyoti Manjramkar, M.Sc. 2015 Batch, School of Life Sciences,SRTMU, Nanded, INDIA 16 Impact of IT

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their care and supports personalised medicine; it improves access to healthcare by reducing the need for hospital attendance (for people with poor mobility, or those in remote areas); and it can reduce the travelling times and costs of healthcare professionals. However, the exact benefits provided by telecare vary between different applications and care scenarios, and, at present, the literature suggests that more evidence of outcome benefit and more cost-effectiveness data are required to justify further investment in telecare. In pharmacy, use of remote consultations, together with electronic prescription service i.e. EPS release 2 and an internet pharmacy supply service, could transform the way that pharmacy services are provided. However, adoption of telecare in pharmacy would be dependent on the availability of reliable communications and integration architectures, the willingness of pharmacy operators to invest in these and also a critical mass of domestic use of digital technologies in all patient demographics. The major need for IT in pharma industry was felt to decrease the manual work, e-documentation, high competition and less time to reach market. IT is the application of computer and the equipment to inter connect clinicians, prevent medication error, store and retrieve pharma data, data analytics related to the industry or business. The automation of the work process of the pharma industry is the essence of IT system. For the pharma industry, there are various automated IT system available like computerised physician order entry (CPOE), enterprise resource planning (ERP), laboratory information management system (LIMS), customer relationship management (CRM), clinical trial management system (CTMS), sales force automation (SFA), electronic batch records (eBR) to name a few17. g. PaaS-enabled agility Cloud computing is fast becoming old hat for larger pharma companies with GlaxoSmithKline, Roche and Novartis all adopting the technology to reduce IT costs and improve scalability. 18 Taking this to the next level, Accenture also has great expectations for platform-as-a-service (PaaS) – an extension of the software-as-a-service (SaaS) model that combines cloud computing with a series of software applications – called solution stack, which allows apps to be created by users. 19 So far this has been the domain of the sales and marketing functions of biopharma companies, with a proliferation of apps and sales force enablement tools aimed at providing real-time, content-rich capabilities to boost effectiveness, and small-scale R&D applications.20 'Cloud services provide the companies with an ideal opportunity to switch from capital-intensive IT to a more variable operational cost model,' says Accenture. 'With PaaS, it becomes possible to innovate rapidly and react to market shifts. 21 THE ROADMAP: “In a future in which personalised (or precision) medicine has become a reality, new sources of information – including genetic profiling – will enable biopharma companies to target participants more effectively for clinical trials and treatment,” says Accenture. The new generation of wireless sensors will be able to provide more sophisticated real-time insight,' says the report, which notes it can be applied equally to the clinical trial process ahead of product registration, as well as for internal corporate functions such as sales. 22 Going forward, better growth in domestic sales would also depend on the ability of companies to align their product portfolio towards chronic therapies for diseases such as such as cardiovascular, anti-diabetes, anti-depressants and anti-cancers that are on the rise. The Indian government has taken many steps to reduce costs and bring down healthcare 17 Examining the role of new technology in pharmacy: now and in the future http://www.pharmaceuticaljournal.com/publications/supplements/focus-community-pharmacy/examining-the-role-of-new-technology-in-pharmacy-now-and-in-thefuture/11134174.article 18 Investment Opportunity: Pharmaceuticals Sector Overview http://www.investindia.gov.in/pharmaceuticals-sector/ 19 Investment Opportunity: Pharmaceuticals Sector Overview http://www.investindia.gov.in/pharmaceuticals-sector/ 20 Investment Opportunity: Pharmaceuticals Sector Overview http://www.investindia.gov.in/pharmaceuticals-sector/ 21 PM Live News: Technology trends facing pharma in 2013 http://www.pmlive.com/pharma_news/technology_trends_facing_pharma_in_2013_463678 22 Investment Opportunity: Pharmaceuticals Sector Overview http://www.investindia.gov.in/pharmaceuticals-sector/

expenses. Speedy introduction of generic drugs into the market has remained in focus and is expected to benefit the Indian pharmaceutical companies. In addition, the thrust on rural health programmes, lifesaving drugs and preventive vaccines also augurs well for the pharmaceutical companies.23 The pharma industry is experiencing a paradigm shift with IT advancement. Multiple range of systems are available to support the work flow and they should ensure to harness the technology for industry’s growth. New technology will play an important role in the pharma industry with respect to utilising data analytics to identify best targeted and cost-effective therapy or using social media to get connected with the customers. In India, healthcare has been heavily urban based. The rural area has been under privileged and the pharma industry has not been too aggressive in penetrating into this area. However, today, the focus of the industry is changing, realising the potential of rural India pharma market. It has been realised that with the IT, rural sector can be served much better giving a boost to countries economic growth. India will not reap its full success in IT and pharma industry unless it creates opportunities for local community and rural area. Players who adopt and innovate will be successful in the long term 24. Pharmacists are already using IT systems to support their daily work and, when considering the IT requirements for emerging working practices, pharmacists should consider what functions could be provided by systems that they already use. For example, all pharmacies use pharmacy management systems for medication records, dispensing, labelling, ordering and stock control. However, many pharmacies do not use all of the available functionality of their system, for example, modules to handle patient-centred services, such as medicines use reviews or prescription interventions. Pharmacists should also make the most of services that are available in their locality, for example, electronic prescription service (EPS) release 2. Adoption and use of EPS release 2 in areas where it is available has the potential to make dispensing and reimbursement processes more efficient for community pharmacists and the nomination process may help pharmacists to secure prescription business. CONCLUSION: From the data and information analysed under this paper, the present status of Indian healthcare sectors related to IT tools applications conveys that IT tools have made a great contribution in improving health of the people in India and taking country’s economy to next level in short span of time. More applications of advanced IT tools like- mobile applications, wireless technology, barcode identification, telecare, pharmaceutical IT tools, EP, PERT, RPM, MBAN and social media are proving to be best in managing health by reducing medication errors, time, cost and paperwork along with the enhancement in quality standards, safe pharmaceutical and personalized care and also possibly stopping counterfeit drug uses. In addition to these applications, highly advanced IT enabled innovations like genetic profiling and personalised medicines which we will be reality in near future will certainly play important tools for the enhancement in current status leading to better future. Ultimately, more and more smart use of IT tools in healthcare sector will give a highly productive appearance to present status to healthcare sector in India.

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Information

technology

in

India:

Present

status

and

future

prospects

for

economic

development

by

Sanjay

K

Singh

www.iitk.ac.in/directions/may2006/PRINT~SANJAY.pdf 24 Impact of IT

on

pharmaindustry/56552/
