Founder, Editor The HCITExperts Blog

The Week that Was: 11 Oct – 17 Oct 2015

Team @HCITExpert presents “The Week that Was” a community driven newsletter, that brings you the rerun of the Tweets shared most by our community. You could call it a crowdsourced newsletter !!

As the community shares their stories with the audience, we try to bring out the most memorable tweets that you can come back to, from the great information being shared on twitter.

We collate these tweets using Storify, our chosen tool to bring together these tweets that you can read today and come back to review anytime in the future.

This post covers the week: 11 Oct – 17 Oct 2015 

To review our Storify from this week …

#INFOGRAPHICS & #comicgraphics #Doodling A powerful way to share ideas

We have attended some conferences recently, virtually, and we saw an interesting trend emerging of various attendees and conference organizers making use of Comics, doodles  and Infographics Boards at the site of the conference to capture the essence of what the speakers and the attendees were sharing.
We started out this storify to include the doodling shared during various conferences and have now started to include additional comics and doodles by the twitterati every day. 
We propose to keep adding the various #Infographics, Doodles and #comicgraphics to this Storify as and when we come about something interesting.

So Do bookmark this link to see update and use for your talks and articles and presentations that might be making to your audiences.

And perhaps, the next time you are heading or organising a conference, call up the folks in this storify to capture the essence of your conference !!

Click on the link below to view our Storify … 

Technology Predictions during #GartnerSYM

We all want to know what technologies will provide us with that competitive edge and help us connect with our customers in newer ways. And traditionally, the Gartner Hype Cycle has been relied upon to help us come to that conclusion. 

So during the recently concluded #GartnerSYM in october, we were able to capture the snapshots shared by the technology community of the 10 Technology Predictions presented during the Gartner Conference, by Gartner of course. 

It provides the future of Technology for the next 5-10 years. 

Head on over to our Storify capturing the Gartner Hype Cycle for Digital Marketing and the Top 10 Technology Predictions

The Week that Was: 13th Sep – 19th Sep 2015

Team @HCITExpert presents “The Week that Was” a community driven newsletter, that brings you the rerun of the Tweets shared most by our community. You could call it a crowdsourced newsletter !!

As the community shares their stories with the audience, we try to bring out the most memorable tweets that you can come back to, from the great information being shared on twitter.

We collate these tweets using Storify, our chosen tool to bring together these tweets that you can read today and come back to review anytime in the future.

This post covers the week: 13th Sep – 19th Sep 2015 

To review our Storify…

The Week that Was: 6th Sep – 12th Sep 2015 – Part 2

This week was the #HIMSSAP15 Conference Week, with the @HIMSSAP Conference in Singapore. This is a yearly conference hosted by the Asia Pacific Chapter of HIMSS.

The hashtag #HIMSSAP15 trended in Singapore for the duration of the conference, with some great content being shared by the participants from across the world. 

Due to sheer amount of content being shared by the community we have presented the tweets across two storify ‘s. 

We collate these tweets using Storify, our chosen tool to bring together these tweets that you can read today and come back to review anytime in the future.

This post covers the week: 6th Sep – 12th Sep 2015 

To review our Conference Storify – Part 2 …

The Week that Was: 6th Sep – 12 Sep 2015 – Part 1

This week was the #HIMSSAP15 Conference Week, with the @HIMSSAP Conference in Singapore. This is a yearly conference hosted by the Asia Pacific Chapter of HIMSS.

The hashtag #HIMSSAP15 trended in Singapore for the duration of the conference, with some great content being shared by the participants from across the world. 

Due to sheer amount of content being shared by the community we have presented the tweets across two storify ‘s. 

We collate these tweets using Storify, our chosen tool to bring together these tweets that you can read today and come back to review anytime in the future.

This post covers the week: 6th Sep – 12th Sep 2015 

To review our Conference Storify – Part 1 …

The Week that Was: 09 Aug – 14th Aug 2015

Team @HCITExpert presents “The Week that Was” a community driven newsletter, that brings you the rerun of the Tweets shared most by our community. You could call it a crowdsourced newsletter !!

In this week the community members shared the following stories:

  • 20 Doctors you should be following on Twitter
  • 40 key trends shaping the future of medicine
  • Virtual Reality in healthcare
  • How to build a minimum viable product, an interesting infographic for a MVP
  • Some statistics for healthcare
  • And a link to dive into HL7 Standards, just to name a few

This post covers the week: 09th Aug – 14th Aug 2015 

To review our Storify from this week …

Dhanvantri Aarogya Saanchara Sevaa (DASS) : A framework for a low cost and far reaching solution towards the #DigitalIndia initiative

DASS: Dhanvantri Aarogya Saanchara Sevaa

Dhanvantri Aarogya Saanchara Sevaa: A Mother and Child care Management System developed as a mHealth (mobile app) platform to enable the FLWs and subscription members to be updated and informed via Alerts, Reminders, Data Capture and Analytics. 

The DASS system will enable the smooth interlay of the existing governmental machinery with the m-Health capability to deliver focused result oriented outcome based solutions in the rural parts of India. 

DASS has all the potential to demonstrate the capability of m-Health solutions around low cost phones in aiding the fulfilment of Millennium Development Goals (MDG) and the #DigitalIndia initiative.

The DASS system proposes to be used to create an Alerts, Data Collection & Registry, Location and Data Analytics platform for the subscribers of the DASS system. The framework proposes to build the DASS system to incorporate services as a mHealth app. These services are proposed to be covering various aspects of the public health programs.
As a first step we propose to use the DASS system to create a Mother and Child welfare framework that will allow the “connect” to be established between the Frontline Healthcare Workers, Healthcare Services and the Women patients who have subscribed to the program. 
The DASS program will cover the Ante Natal, Peri Natal and Post Natal aspects of a Woman’s pregnancy (18 months – 9 months + 9 months). The DASS program proposes to allow the users to choose the list of services that she wants to subscribe to. Once the user has registered and subscribes to the specific services, the DASS program will enable the delivery of the information to the relevant subscribers, thus giving a double impetus to the name of our project:
  • Dhanvantri – The God of Medicine
  • Aarogya – Health in Sanskrit
  • Saanchara – Mobility, works for both the Mobile platform using the mHealth platform and the Mobile Medical Units (MMUs)
  • Seva – Service

While creating the system we envisage the creation of a location based information delivery mechanism that will allow the users to be delivered with location specific services. For instance, we propose to create a location based hierarchy that is specific to the country where the system is proposed to be deployed. If the DASS program is rolled out in the State of Karnataka, the location based hierarchy that we propose for the categorisation of the data, services, alerts based on the following classification shown below:
 Zones -> State or UTs -> District -> Taluk -> City, Town or Village
We propose to capture the location for all the services to enable the data aggregation and collection to contain the location specific information. We propose to use this information to deliver location specific services.
We have envisaged the Dhanvantri Aarogya Sanchar Seva’s Mother and Child services to be categorised under the Ante-Natal Services, Peri-Natal Services and Post Natal Baby and Mother Health services.
C.1 ANTE NATAL – Mother and Child Care SERVICES
Under the proposed system we envisage a list of services to be built for the 9 month period of the pregnancy. The list of services we propose to cover under the DASS – ANTE NATAL Mother and Child Services are elaborated below.
C.1.1 Pregnancy Checklist
The Pregnancy Checklist service provided by the DASS system proposes to allow the health worker to create templates comprising of various tests, pregnant mother care, schedule of visits to the doctor/ healthcare worker, the patient information alerts that are generated on a daily basis and based on the current stage of the mother’s pregnancy. Once the template has been created by the healthcare workers, the same will be released for the location based services to be delivered for the patients subscribing for the services.
C.1.2 Mother Gestational Diabetes Tracking and Alerts System (MGDTAS)
For the pregnant mothers who are identified with having gestational diabetes, the DASS system will allow the patients to subscribe to the service. Once the patient has subscribed to this service, the system will start sending alerts regarding the specific condition of the patient. Also the system will allow the patient to record specific parameters as defined by the checklist created for mother’s with Gestational Diabetes.
The MGDTAS service will consist of the following aspects: 
  • Capture of mother’s EDD (expected date of delivery)
  • Recording of blood sugar of mother based on the alert. Once the patient enters blood sugar information, the MGDTAS service will advice the patient on the amount of insulin to be taken (or be administered by the family member)
  • Adherence to the schedule
  • Blood parameter trends (last 5 results)

We propose to expand the DASS system’s “specialised” services by incorporating other services as required.
C.1.3 Antenatal Health Checkup Alerts
The DASS system’s Antenatal Health Checkup Alerts system allows the delivery of reminders to the patient about the dates (based on the patient’s pregnancy stage and the EDD captured at the time of registration to the DASS system) when the patient needs to go to for the health checkup.
C.1.4 Complicated Case Referral System
In case of a complication being identified in a patient’s pregnancy, the FLW will raise a request for additional care and refer the patient to a more specialised care at a well-equipped healthcare facility that can handle the case of the patient. The details of complications and the referral locations will be identified and uploaded in the system allowing the FLW to capture this information and generate the referral request.
C.1.5 Pregnant Women MMU Appointments
The DASS system is proposed to be location aware and hence will utilise this functionality in the system to do the following:
  • once the mother has registered with the DASS system, the system will keep track of the location of the patient.
  • Whenever a MMU (Mobile Medical Unit) is available in the vicinity of the location of the patient, the system will aggregate the list of patients within an ‘X’ mile radius of the location.
  • Once the list of patient’s have been identified by the system, the DASS system will send alerts to these patients, informing them about the availability of a MMU in their specific location by providing the patients with the date and time when the MMU available.

C.1.6 MMU (Mobile Medical Unit) Location Alerts
The purpose of the MMU location alerts is alert the patient population in a particular location about availability of the MMU in the patient location. This will allow the patient’s with specific needs to approach for specialised care for any complications etc.
Additionally the MMU location alerts are going to be used for providing the FLW with the visibility on the current location of a MMU at any given point in time, by typing a simple coded message.  Once the FLW receives the message regarding the location of the MMU, the FLW could “forward” the same message to patient’s registered for the service in the location.
C.1.7 Location Based MMU Alerts
The DASS system proposes to alert patients about the availability of the MMU in a specific location to the registered FLWs in the location. This information will be used by the FLW to inform patients.
Additionally, the system will also allow for the delivery of these alerts to patients registered in the DASS system as unsolicited information informing them about the MMU in their area.
C.2 PERI NATAL – Mother and Child Care SERVICES
C.2.1 Medical Health Worker Referral System
The DASS system will allow the FLW to generate and alert specific healthcare facilities to take referrals made by the FLW for patient’s in critical and urgent need of specialised care because of any complications during birth.
C.3 POST NATAL – Mother and Child Care SERVICES
C.3.1 Child Immunisation Alerts
Once the Child has been born, the information will be updated in the system regarding the date of birth of the baby. Once the date of birth has been registered in the system, the DASS system will generate alerts based on the age of the baby about the vaccination schedule.
The FLWs, MMU and the parents of the child will have the ability to update the administration of the vaccination to the child. This information will also be used to update the Data Analytics aspect of the DASS system.
C.3.2 Child Care Alert Info
The DASS system will be used to send information regarding the various aspects of the child care to the mother. These alerts will be used as primary child care options by the FLWs to inform and educate the patient’s in their specific locations. The DASS system will allow the users to create these alerts specific to their respective locations.
C.3.3 Health Worker Information Alerts
The DASS system will also be used to send important alert information to the FLWs regarding various aspects of the DASS services, new options in the system, new protocols of care for the mother and child, alert messages to the FLWs regarding their village, district, state level meetings, availability of the MMU in their locations, etc.
C.3.4 NRHM Data Collector System
While creating and using the DASS system, we propose to align the platform to have the ability to generate analytical reports that can be used by the NRHM personnel for their monthly reporting of data collected during specific time frames. 
With this ability the DASS system will allow the users of the system to have a real-time and up-to-date information database for relevant reporting.
C.3.4.1 Infant Birth/ Death Child Registry
This service in the DASS system will allow the users to record the birth or death of an infant. This information will be logged into the system to enable or disable the alerts for a particular mother, to ensure relevance of the messages and alerts sent to the mother/ FLWs, etc.
C.3.4.2 Mother Mortality Registry
In the unfortunate event of a complication at birth, the DASS system will allow the users to update any mother related unfortunate outcome.
C.3.4.3 Child Immunisations Registry
Each time a vaccination has been given to an infant, the system will update this information in the database. The information captured in this registry will allow the users to report the child immunisations performed based on the location (district/ village/ state etc).
C.3.4.4 Communicable/ Infectious Diseases Registry (CIDR) 
The DASS system will have the CIDR service which will allow the FLW to identify an outbreak of any disease in a specific location. Based on this information, relevant alert messages can be sent to the FLWs to organise correct responses from the local government agencies to this outbreak. The DASS system will allow the users to define the trigger criteria for generating the alerts from the system.
  • The DASS system is proposed to be a modular system, thus allowing relevant services to be enabled to various FHWs based on their expertise and area of work, based on an authentication and authorisation functionality within the system. For instance, the Gestational Diabetes (MGDTAS) module can be used as a standalone app to capture the occurrences of gestational diabetes in a particular location.
  • We also propose to link the Patient Registration modules within our proposed system with the Aadhar system to identify beneficiaries and patients being registered within our system. This will allow integration with existing systems thereby reducing the data duplication across multiple systems.

Manish Sharma

Founder HCITExpert.com, Digital Health Entrepreneur.

Additional Articles by the Author

  1. Health ID as Patient IDs unifier in India  by Manish Sharma  
  2. 5 Steps towards an Integrated Digital Health Experience in Indian Healthcare in 2016 
  3. Top Healthcare & Digital Health Predictions for 2016
  4. Zen Clinicals: An Activity & Workflow based solution (1 of 3)
  5. RFID in Healthcare: Usecases from Hospitals
  6. 10 Solutions for the Healthcare IT Fringes

Setting up a WinMac Machine on Macbook Air Yosemite

I have been using a Mac since 2010 (yes i was initiated a little late into the Mac World of users). Over these years of being a Win user I am yet to come to grips with the iWork productivity suite purely since I have been used to creating my documents in the Microsoft Office Suite. Also I have felt the need to use some of the project management tools from Microsoft such as Microsoft Project for the nature of work I am involved in.

I therefore have been trying to find an option wherein I can use the ultimate in engineering MacBook Air (2014) and the Office Productivity Suite I have been used to all these years, in a Single Machine.

I started out by defining my requirements:

– I should be able to have MAC OS and Microsoft Windows OS in the same machine
– I should be able to use the MAC OS for my Multimedia Software and Windows system for the productivity suite (I needed the pure windows experience since some of the features of the Microsoft Office for Windows were not part of the Microsoft Office for Mac 2011, and the upgrades had not been released for the newer version of the Microsoft Office for Mac since a long time)
– I should be able to “seamlessly” “switch” between the two systems.
– Ideally I should be able to have the ability to have the “ease” in the switching process

Based on these criteria I went about finding out the technology and applications that would allow me to achieve my requirements.

1. Scouting for VMs: I started out by scouting the variour VMs that are available in the market. There are many with varying features and functionalities. However, I was able to shortlist the VMWare Fusion 7.0 purely because it provided me with the Unity View.

VMWare Fusion 7.0 download (Free Trial available on registration, can buy the product license key online from the same link).

Unity View: Plainly speaking the Unity View allows the MAC OS and Windows OS to run “simultaneously” on the same machine without the need to use either ONE of the systems.

2. Installation Procedure: Once I was able to identify the VM of choice. I went about creating a virtual machine of my existing Windows 8.1 Laptop. Follow the steps indicated below.

a. To create a VM of an existing machine you can download onto your laptop the VMWare vCenter Converter Standalone from here
b. To view the steps please watch the following video link and perform the exact steps to create a WinMac machine on your MacBook Air.

Please note, before you start to watch the video,

– Install the VMWare Fusion on your Mac.
– Install the VMWare Converter on your Windows PC you want to convert.
– Keep a USB Drive with about 100GB of free disk space available. This is required to transfer the VM created on the laptop to the Mac Air.

3. Post Installation:

Once you have followed the steps indicated in the video, we hope you have been able to get the VM Up and running on your MAC.

a. Enable the Unity View: On the top right corner of the VM window, you will find an icon which is the Unity View Icon. Click on the icon to enable the unity view.

b. Open System Preferences and move the Dock to the Left or Right. This will allow you to view the Windows Taskbar at the bottom of the screen when you move the mouse to the bottom of the screen. This is a personal choice of where you would like the Mac Dock to be and the Windows Taskbar to be.

c. In the unified view, “Mac ” and “Windows” applications open in the Mac Dock. However, the Windows Application (of the VM) are only displayed in the Windows Taskbar.

d. Using the browser in the VM was found to be lagging a bit. And the VM seemed to restart at times (luckily without loss of work). Perhaps the VM needs to be fine tuned, either while being created or after installation in fusion.

These are some of my initial thoughts. More once I am able to learn to tweak the VM.


  1. Do not upgrade the Windows 8/ 7 VM to windows 10, apparently some users have had issues and the VMWare folks have suggested downloading the Windows 10 .ISO file to perform the upgrade.
  2. Download the Windows 10 .ISO file from the following link: http://ow.ly/QNnIT
  3. Make sure you have your existing Windows product key with you.
  4. Take a snap shot of the current VM, in case you want to rollback.
  5. Mount the .ISO on the VMWare Fusion to perform the upgrade.
VMWare Fusion 8 is going to be launched this summer, keep a lookout at these pages for further updates.

The #HIMSS15 Wall of Stats

While reviewing the twitter wall on our @HCITExpert account came across a lot of posts from the twitterati stating Stats they had come across.

We have been going through the steady stream of these tweets and now bring these to you. We will keep updating this list as the conference progresses.

We will work to attribute the tweets to their rightful authors soon… Thank you so much for these insights.

UPDATE – We have attributed the tweets to the rightful owners. !!

Do tag us on any “data-stat” tweet you are sharing, using our twitter handle @HCITExpert or using our #hashtags #HITSMIND or #hcitexpert. You can also tweet with the hashtag #wallofstats and we will update the #HIMSS15 Wall of Stats with your post. And of course update you too !!

Here goes :

DAY 1: (14th April 2015)
PwC 57% of CEOs across all industries worried about integrating technology.  #HIMSS15 – @Yolanda0704

Healthcare data is growing 48% per year. How do you keep up? – @Allscripts

44 Zetabytes of health data; a number equivalent to known stars in the universe and drives IBM’s investment in #healthcare – @LizGoodale

“RestfulAPI” a big topic in #HIE at #HIMSS15 – @karenrclark 

Time to Rally: One Million Ask For Their Records #RecordsNow @Farzad_MD #HIMSS15 #engage4health #HIT @myopennotes – @SueWoods

“A staggering 85 percent to 90 percent of medical records contain errors…” http://t.co/82FqoNTlt8 #HIMSS15 – @Medline

Did you know that 5% of patients account for 45% of costs. Find your high risk patient population #HIMSS15 http://t.co/XtOqKuc8Lh – @medicity

81% of clinicians use mobile devices to collect patient data. More #healthcareIT info via @Avnet infographic #HIMSS15 http://t.co/x6sWKB2Ago – @marciachapman

1185 data breaches reported by HHS since 2009, speaker at hipaa presentation says #HIMSS15 – @lschencker

Laptops are the most common source of #HIPAA breaches #HIMSS15 http://t.co/PNiTsWIoGi – @AimeeTetu1

Great presentation @tzmeadows #HIMSS15  – 80% patient self registration! Patient and Physician satisfaction improve! Revenue cycle uptick! – @ToddCharest

64% of health care extenders believe that technology has impacted the quality of interactions with patients! #HIMSS15 – @GetReal_Health

#HIMSS15 Tweetable Takeaway #25:Consider multichannel. Integrate check-in kiosks with patient portals for faster check-in and bill payment. – @MarilynECox

Dr. Porter: Health literacy is in crisis. 88% of US adults have inadequate health literacy. #HIMSS15 #GMK2020 http://t.co/AS17F2VMgE – @MerckManual

Providers are drowning in data: clinical info in the US = 150 billion GB + dbls every 18 months #HIMSS15 #GMK2020 – @judithconsult

Wanted: 1 registration, 1 health record, 1 standard of excellence, 1 bill, and 1 relationship -Jon Velez #HIMSS15 ID:33 #checkup

Did you know: 40% of unanticipated hospital deaths in the U.S. happen in the General Ward? http://t.co/IvHrCveIAx #HIMSS15 – @philipshealth

#HipaaJAL “@MerckManual: Providers are drowning in data: clinical info in the US = 150 billion GB + dbls every 18 months #HIMSS15 #GMK2020” – @judithconsult

Listening to @IntelHealth at #HIMSS15: 70% of clinical data in EHR is unstructured – @carlos_ariza
As expected, with more than 22000 tweets today, downtown Chicago has seen extensive #HIMSS15 storm activity @Scraawl – @thowave
60% of doctors feel social media can enhance the quality of patient care [NEWS]: http://t.co/rRVoEPrteM #HIMSS15 – @ONC_HealthIT
#HIMSS15: 70% of Physicians Believe Health IT Decreased Patient Engagement http://t.co/t5PKA0RWnP – @rasushrestha
Less than 1/3 of 1% of individuals w/#autism actually get services for its primary treatment in the US. It’s time to #RxTech #HIMSS15 #ABA – @autismu

Day 2 (15th April 2015)

@HIMSSAnalytics 52% respondents utilize a clinical and BI solution @PrimeTGI Predictive Analytics #healthIT #HIMSS15 http://t.co/4lN2z2QYKO – @PrimeTGI
62% #healthcare orgs. are now looking to focus on the individual needs of their consumers. Read more: http://t.co/ZG3f9wqPJ9 #himss15 – @HeatherEFraser
Humana Estimates Medicare Funding Will Increase 0.8% In 2016 #HIMSS15 http://t.co/zfoHIW7UDP – @SegueHealth
Humana CEO: We’re Going To Make The Communities We Serve 20% Healthier http://t.co/Xct5EGL0Os #HIMSS15 – @SegueHealth
Peer reviews RT @RasuShrestha 41% said #SoMe would affect their choice of doctor, hospital or med fac http://t.co/6JJ2MZ0WqC #HIMSS15 #HITsm – @DashaBushmakin
mT @jeffbullas: 33 #Hcsm Facts and Statistics You Should Know in 2015 http://t.co/wpFX77y7fH http://t.co/SEMFF96BAA #HIMSS15 – @drnic1
U.S. prescription drug spending jumped 13% in 2014 – Modern Healthcare http://ow.ly/3xJLR6 

Venture funding for #digitalhealth and #healthIT down ~35% in Q1 of 2015, but #mHealth is up http://t.co/FYoZZKkIEM #HIMSS15 – @dsgold

Benefits of Patients with online Access to Care Team #HIMSS15 – Less clinic interruptions by calls http://t.co/RtamVG3c0M @Cascadia #mHealth – @vishalpanchal85

@HIMSS: Latest #HIMSS15 numbers: 42,314 attendees and 37,749 tweets in two days! http://t.co/RxMvLn5qgA http://t.co/K4Op0hnbm5 

9 out of 10 #physicians surveyed are interested in #mHealth technology. #HIMSS15 http://t.co/X89cf30svw – @GordonSamanthaM

69% of US adults track health indicators. #improvement #healthIT #HIMSS15 – @GetReal_Health

60% of Alzheimer’s patients will wander – of these 46% will die if not located within 24 hours. Locate them! #HIMSS15 http://t.co/hVbSpxFuv1 – @locatible

Prediction: 60M US households to own a connected fitness tracker by 2019 http://t.co/lqfUrxWPD8

66% of Americans Would Use Mobile Health Apps to Manage Their Health

RT @bruno_rocca: RT @DrJenPlatt #HIMSS15 survey shows >70% #healthcare providers use #mhealth 2engage patients & red… – @byod_news

@stanleyhealth: @Cascadia point of clarification. Our 17k customers include senior living, but we are > 5k hospitals globally #himss15 – @2healthguru

Inforgraphics: 31 % of providers have a non-generic patient-facing app http://shar.es/1gSHBp #DigitalHealth #HIMSS15 – @vishalpanchal85

Medical data is expected to double every 73 days by 2020. http://ibm.co/1aKWPWg #IBMWatsonHealth – @IBMWatson

No question… “Our health system wasn’t built for chronic care. It was built for episodic.” @BruceDBroussard #HIMSS15 @Humana” – @ItsDisruptive

10 Solutions for the Healthcare IT Fringes

Recently I came across a video from one of the conferences on Healthcare IT. The panelists were talking about how technology can enhance patient care and delivery of Healthcare services. A specific point of discussion was implementation of Hospital Information Systems (HIS or HIMS) within the hospitals. Its been well established the need for IT systems in Healthcare which has traditionally lagged the other industries in the scale of Automation. We know now for instance, having a patient record for administrative, clinical and financial aspects does provide benefits to the patient care process flow within the hospital.
World over IT implementations have focused on the need to implement solutions that bring efficiencies to the Hospitals process flow.
But Does implementing an ‘ONLY’ HIS in an hospital truly provide for an enhanced patient experience?
In my review of Healthcare IT Implementations at various hospitals I have seen, the HIS implementations have their own unique issues and I am sure we in our own experiences have “lessons learnt” scenarios to make IT work better.
But the purpose of this post is to discuss the “Fringes”, the solutions in the periphery of the Healthcare organization’s processes that are woefully left out of the purview of a traditional HIS or are treated as “customisations” to the HIS solution. Or are perhaps considered to be traditionally not part of the IT strategy for the management. I believe these solutions on the “Fringes” are specialised and are equally important to provide fillip to an efficient care delivery in a Hospital. And that was also one of the points made during the discussion.
I list below 10 Fringe solutions which in my opinion should be also included within the IT Strategy of a hospital and product strategy of a Startup or an Healthcare IT Vendor.
  1. Patient Engagement: Patient Engagement is a framework by which hospitals provide their patients with tools (read as “apps”) and resources (read as social media engagement, etc) to strengthen their patient engagement activities. A great resource that provides various levels of patient engagement can be found here. There needs to be a concerted effort from the Hospitals to understand what level of engagement they want to enable for their customers. Patient Engagement has been termed as the “blockbuster drug of the century”
  2. mHealth Apps for Patients: It became quite evident by the end of 2013 that mHealth was here to stay and a ‘mobile-first” approach is one which has shown to provide some really innovative solutions being “prescribed” now by the doctors. But as is the case with every new idea, care must be taken to enable the mHealth App strategy with the patient engagement framework.
  3. Cloud Telephony for Hospitals: I recall when we used to talk about the “future of healthcare” in our pitch to various customers, we used to mention the “Dominos” example. Wherein as soon as a patient calls up the hospital she is greeted with a “Hello Ms. Doe, what can I do for you?” Today this kind of a scenario is available on our mobiles with the Truecaller app, but we are yet to achieve this within our hospitals. Even if you have called the hospital a number of times, are such solutions available right now? Therefore, with the availability of Cloud Telephony solutions each customer touch point with the hospital can now be integrated with a CRM solution and enable your customer facing staff to more effectively track customers and offer a superior customer experience to your patients – existing and new. For instance, a patient calling for a followup appointment need not be routed through the IVR options, instead she could be directly taken to the department with she already has an appointment scheduled or has had a visit in the past 10 days.
  4. Unified Communications for Care Coordination: Recently was reading an article on the “EHR and Paper record Usage” by young and old physicians. It spoke about what each type of patient record was used by these two types of users. It mentioned that the “older physicians use it to get information, and the younger docs do activities on it”. Now with this kind of a scenario it becomes important to provide the right information at the right time to the right care providers. This is where unified communications can provide efficiencies of operation by presenting information to the doctor that pertains to the current care scenario rather than the “whole patient history and record”. Recently we have the case of the patient who had been “let-off” home, when in fact the patient should have been quarantined. Difference in the way users interact to the system allows for simple handover tasks to be missed out. A unified communication solution sitting over an EHR has the ability to present “relevant” information with Efficiency in Workflow and Speed in communication
  5. eClaims & Payments: We all have now got very accustomed to making our payments online, be it banking, eCommerce, air travel, etc. Healthcare woefully lags behind in this regard. It will be great to see innovations happening in this area that allows for faster turnaround times for receivables for instance, from an insurance company. With advent of payment options from using hashtag payments on twitter to the payment gateways, healthcare needs to embrace technology across the various departments for a faster receivables management.
  6. Procurement and Supply Chain Management: The innovations seen in the eCommerce of late provides for a great case study, and for incorporation of “lessons learnt” and best practises into the healthcare procurement process. Instead of utilising technology to allow for increasing the efficiency of the procurement process within the purchase department, healthcare organisations majorly still rely on the traditional approach. The incorporation of a closed loop procurement process that connects the vendors and the hospitals is limited to emails, faxes and phone calls. Negotiated prices on the contracts are stored still in excel sheets and undergo revisions for each order placed. We believe this space surely requires some change to bring the benefit to both the hospital and the vendor. After all each call, email and fax adds up to the cost of the procurement. eProcurement can also benefit large organisations in putting together group purchase organisations which have the ability to get better pricing for the enterprise in a multi-location scenario. Vendor contracts managed through such a system have proven to provide a measurable ROI for such systems. Manage by exception in this scenario does provide a faster turnaround times.
  7. Laboratory Reagent Procurement and Management System: As is the case for the procurement of drug and non-drug items, laboratory reagents too require a solution that provides the equipment vendor the visibility on the number of reagents that need to be supplied based on the number of tests performed by the lab. This process automation will also allow for better inventory management of the reagents and procurement process can be streamlined.
  8. Move from “Relational-First” to “Analytics-First” HIMS: We have seen the progress of Healthcare IT in the hospitals and have often been faced with the requests from the users (clinical, administrative, financial, etc) for “reports” based on the data being collected. In each of these scenarios, you will find the vendor generating the report from the database and “delivering” the same to the customer. Apart from the transactional ability of a HIM solution, customers look at the ability and ease of generating the “insightful” reports from the system. Now, with the advent of analytics, traditional relational structures in HIMS should be reviewed to bring in a more “Analytics-First” approach. With our understanding of the healthcare processes and the types of reports that are generated from the HIMS, vendors should look at enabling data structures that are geared for a dimensional analysis of the data that is being captured within the HIMS system. IT should not be approached to generate this report or that report, rather the physician should be able to easily get a response for the effectiveness of a drug regime on a patient, or the billing department should be able to get information regarding the outstanding bills or the inventory department has a “Dashboard”, enabled by default, showing the items that need to be replenished.
  9. Telemedicine Solutions: With the advent of 3G and 4G services, Telemedicine is on the cusp of going mainstream. We have been for years having Tele-Consultations with our physicians and doctors via phone and email. These consultations generally stay out of the view of a health record and could be prone to errors and is perhaps a safety issue. But with the advent of the underlying services that can support a more comprehensive approach to telemedicine, we can now allow for patients to have Tele-consultations for specific scenarios, for instance, followups to review lab results. Which can lead to follow up visits by the patients to the hospital if so required by the doctor. We also feel that telemedicine will, in the future, also bring into the ambit the traditional “black box” area of a patient care, i.e. the patients’ home. Technology will enable many more data points to be captured and relayed live or periodically to the patients’ physician. Anomalies in the data will be analysed using the “Analytics-First” systems and provide specific tasks to be performed via the unified communications solutions available with the doctor.
  10. Workflow Management Systems: I have kept this aspect at the end, purposely. This is one area which needs to be incorporated within the healthcare systems at the earliest. I feel that the 80 percent of the processes within a healthcare organisation are handled easily by the traditional way of coding, But there are 20 percent of the workflows and rules that need to be implemented as a “customization” by most vendors. This brings ‘up’ the cost for implementing a healthcare solution. There is a need now to bring in BPM, rules engines, notifications (push-pull) and alerts into the base framework of the HIMS so that coding for exceptions can be reduced and incorporated with much ease and simplicity using these tools. Each hospital is unique in their requirements and there will always be a use case scenario that would not have been handled earlier, incorporating workflow technologies into the solution will only enhance the delivery process for the customer, thereby keeping the cost of implementation under control.
These are some of the “Fringe” systems which I consider, are also required to provide a better quality of care and service delivery. After all, it’s about “Speed in Communication and Efficiency in Workflow” that enables a more evolved care delivery process.
Lastly, would also like to point out that implementing these systems in conjunction with an HIMS requires interoperability of patient, administrative and care information, I strongly recommend the use of HL7 based standards for exchange of healthcare information. The standard allows for the information to be accurate and has the ability to be used across multiple “fringe” systems and enables you to evolve your solutions as the standards evolve. Proprietary approaches to integration and interoperability are fraught with issues of evolution and maintainability.
Looking to join the Healthcare innovation drive?

Start at the Fringes.
Manish Sharma

Founder HCITExpert.com, Digital Health Entrepreneur.

Additional Articles by the Author

  1. Health ID as Patient IDs unifier in India  by Manish Sharma  
  2. 5 Steps towards an Integrated Digital Health Experience in Indian Healthcare in 2016 
  3. Top Healthcare & Digital Health Predictions for 2016
  4. Zen Clinicals: An Activity & Workflow based solution (1 of 3)
  5. RFID in Healthcare: Usecases from Hospitals

#HITSMIND Tweetchat on 19th Oct 2014: #HIMS Solutions for Hospitals

There has been a great amount of buzz around HealthIT, i.e., EHRs, EMRs, mHealth, Telemedicine, Teleradiology etc. 

Implementing a HealthIT solution in a hospital provides some unique insights into what goes into the selection of a system for the hospital and what are the benefits that a hospital derives from installing and implementing such a solution.

So lets take a few steps back and consider the various aspects of a Healthcare Information Management System (HIMS) in a hospital. After all, for our #DigitalIndia initiative, the hospitals that treat the patients need to enable the capturing of patient records in an EHR system as a first step.

  1. Introductions
  2. T1: Why should a hospital in India go in for a HIMS System?
  3. T2: What are the benefits of installing a HIMS System? Experiences: Good and Bad.
  4. T3: Does a HIMS differ for a Clinic, General Hospital to a specialty hospital? How does a hospital select the right system for their need?
  5. T4: When choosing a HIMS System, What are the factors that should be considered by a single location hospital and multi-location hospital, while choosing a HIMS system?
  6. T5: What initiatives should be taken to enable the clinical data recording to help generate and maintain the electronic medical records for the patient? Billing Vs EMR?
  7. T6: What are the various ways to build a partnership with your HIMS Vendor?
  8. Closing Remarks and suggestions
  9. Call for moderators for upcoming chats. Please inbox us via @HCITExpert twitter account. Or you can email us at: info@hcitexpert.com

We are sure there will be more discussions around this topic in the future. Based on these discussions and feedback from various quarters, we propose to generate a report that brings out the list of Features and Functionality of an HIMS, for various types of hospitals.

#HITSMIND: October 12th, 2014

The past Sunday we had a great start to our #HITSMIND weekly TweetChat / TweetUp

The Symplur Analytics showed about 300+ tweets with about 40 people participating in the conversation.

Thanks again to all the participants and hope you are able to get the message out to your friends and colleagues and request them to join us for the upcoming weeks.

Today we are going to discuss about how the hospitals can make use of the social media to engage with the patients. And what are the type of engagements that can be enabled by the hospitals to engage with their clients.

T1: How can the hospitals enable engagement with their patients?

T2: What are the current engagement channels used by the Indian hospitals?

T3: How should the social media engagement be used to assist patients?

T4: What are the innovative use cases you have come across in the use of social media for treatment/ wellness  related information?

T5: Closing thoughts.

Thanks for joining us today. 

First Ever #HITSMIND Chat!!

Welcome for the first ever #HITSMIND TweetChat

The agenda for today’s #HITSMIND Tweetchat are defined below. We will be taking up each of the following topics for discussion.


1. Greetings and Introductions

2. All about Tweets, RTs, Hashtagging, MTs

2. T1: What are the benefits of a TweetChat. Share Your experiences

3. T2: What are the tools you use to follow a TweetChat

4. T3: Live Tweeting at Conferences: Best Practices

5. T4: Live Tweeting your speech

6. T5: Closing remarks on TweetChats

Look forward to seeing you at the #HITSMIND TweetChat

Team @HCITExpert

#HITSMIND Tweet Chat – Every Sunday 6pm – 7pm IST

Hello from Team HCITExpert !

We are announcing a Tweet Chat that will happen every Sunday 6pm – 7pm IST. 

We have seen a great trend happening across the Twitterspace – the tweet chats. They are engaging, provide a perspective of the experts from across the world and provide an insight into what will be the future of Healthcare IT (that is our focus area) not only in India, but the trends that are being observed from across the world. 

The purpose of this tweet chat is to bring together Healthcare IT Experts from across India to provide an insight to the need for implementing IT systems in the delivery of Healthcare Services.

To join the tweet chat you would need the following: 

1. Sign up for a Twitter account.

2. Read the blog post published at The HCITExpert Blog to get to know about the topics of discussion.

3. Tweetiquette for the Chat: 
a. Tweet with the hashtag : #HITSMIND
b. At times there will be topics listed in the Blog Page for that week’s list of topics. Each topic will     be identified by T1, T2….etc. If you replying against a specific topic, start your tweet with that Topic identifier(i.e., T1, T2….etc). It will help bring a context to the tweet post. At the same time ensure you end your tweet with the tweet chat hashtag #HITSMIND
c. The tweet chat will last for an hour, i.e., from 6pm to 7pm Every Sunday IST.
d. Connect with your fellow twitterati post this conversation, it is a great place to connect.

As is the case with all good things, we hope you will share this with your collegues and friends who are working in 
Healthcare – as they will provide us with a perspective of what is their requirements for IT; 
Healthcare IT – as they will be able to provide insights into what is possible with Technology; 
Policy Makers, Nursing professionals, Radiologists, Pharmacists, Pathologists, Allied Medical Professionals.

Please send us your mails and thoughts at manish.sharma@hcitexpert.com with your suggestions and recommendations for the topics to be discussed.

Welcome to the Twitterverse!! Lets Chat!

The HCITExpert Blog

Source of Big Data in Healthcare

Today the source of the information in healthcare is the Patient. The Data created for the Patient is stored in the Electronic Health Records of the various healthcare facilities that a patient goes to. An infographic provided courtsey NetApp on the Body as a source of Healthcare Data.

Maintain a Unified Contacts List across all your devices

I have faced this problem of having to synchronize my contacts list time and again. And this is generally done whenever one is in any of the following situations: 

 – You have a new laptop or multiple laptops or PCs
 – You have a new mobile or multiple mobile devices
 – You have a new email account or multiple email accounts…
 – You have are moving from an old mobile to a new mobile, etc…

During any of the above situations we generally get or send out messages from/to our friends to send us an updated contacts info and such other requests.

Call it the need of the hour, I dug around and found that there are multiple ways one could keep your contacts synchronised between computers, between accounts and phones and devices – call it a grand unification of contacts list.

Right now there are paid apps and there are free apps that you can use to keep your contacts synchronised and since I am an entrepreneur, I for one look to find the most cost effective way which works and with the available email accounts and devices that i had with me.

So to setup a unified contacts list, i did the following (guess now no one will absolve me if i say i did not have your contact or i cannot say, hey i lost your contact, or changed my phone and hence lost your contact, etc, etc. Well i dont intend to do that since everyone of my contacts is important to me.)

Step 1: Consolidate all your contacts to a single source:

A couple of online services (yahoo, gmail, facebook, etc) provide you the ability to upload your contacts as an excel or csv format online. The reason you would do this, is to ensure you are using this service to get all your contacts to one common place. 

I also looked to consolidate my contacts list across these different sources by looking at the inventory of the sources and which source already had the ability to consolidate these accounts. I had a yahoo account, a gmail account and a work account hosted on google apps for business, two mobiles (one a smart phone another a keypad phone), one laptop, an ipad and a old desktop. Each had different email clients and with their own contacts list over the period of time.

After researching on the options that are available in the accounts and devices that i had, I chose the Yahoo Contacts service since, the Yahoo Contacts service had the ability to connect to your gmail account and download the contacts just providing the username and password of your gmail account, and it also had the ability to import csv files.

I exported the contacts in an excel format from the smartphone, keypad phone, and all the other devices like the ipad, laptop, desktop. I uploaded all of these contacts to the Yahoo Contacts service. I connected my gmail accounts to the yahoo contacts services and imported all the contacts.

Please note here, that since you are doing this activity for the first time, you can be rest assured that you might have to update some details manually for at least 5 percent of the contacts, since its not necessary all your devices will output the excel in the way its required by the Yahoo Service. 

So after some initial hiccups and reading through the steps for extracting contacts from each of the devices, i went about and got all the contacts into the Yahoo Service.

Once i had all the contacts uploaded to the Yahoo Contacts Service, i ran the find and merge duplicates option. It threw up suggestions to merge and since this was the first time, i went about manually figuring out which contacts were duplicates and needed to be merged and which were marked by the program as duplicate but were actually different contacts. 

After a couple of rounds of running the merge duplicates, i came to a baseline version of my contacts list, i now had all the contacts from all the devices and services into one single location. This included the contact numbers, email ids and addresses all had been successfully consolidated into this list.

Step 2: Create a Backup

Once i had this baseline version of my contacts list i uploaded this version of my contacts list to the following services:

a. Google Apps for Business domain account; 
b. iCloud account. 
c. Yahoo Contacts

I Choose the Yahoo Contacts to be the “Backup” account since The Yahoo Contacts Service provides an option to download contacts from Gmail contacts.

To keep the backup updated, I created a reminder to go back into the yahoo account and run the import contacts from gmail once in a while. 

Step 3: Keeping your contacts across devices in sync: 

Now with the backup in place, i needed to provide a mechanism to keep the list synchronised. 

I chose the Gmail personal account, as the “Active” account, this would be the account that i could connect to all my devices. I chose this because, Apple does not have a synchronise option with Yahoo Contacts for its address book (https://discussions.apple.com/message/19287741#19287741). 

My Inventory of Gadgets: a Mac Book Pro, iPad, a windows 8 PC and an Android Phone.

a. Mac Book Pro Address Book: 
The MBP Address Book is updated by synchronising my icloud.com account with the google contacts list. Apple provides a service to synchronise your Address Book with your gmail account. This link will provide you with the setup details http://support.apple.com/kb/ph4625

b. iPad: 
I had configured the gmail account to be synchronised as a Microsoft Exchange Service in iOS6 , which allows for the contacts to be synchronised between the iPad and the “Active” gmail account. This link will provide you the setup for the iOS devices
 – http://support.apple.com/kb/HT4872

Update: Apple has now enabled direct google contacts sync in iOS7, find the details in the link below. This would mean, that if you did not have a Mac Book Pro, your iCloud and Google Contacts would still be syncrhonised using iOS 7.

c. Windows 8 PC: 
I configured the windows 8 PC to synchronise my “Active” gmail account using an open source sync tool available at http://sourceforge.net/projects/googlesyncmod/files/.

I used this option instead of Google Sync, since its got a more elaborate process to setup. http://www.google.com/sync/index.html

 Update: Here is a paid version of a mail and calendar sync with Outlook

note: Please do this task after you have completed the above steps.

d. Android Phone: 
I configured my “Active” gmail account to be the only contacts source , (you need to update the settings on your phone to show you contacts only from this source). So now whenever i add a contact on my phone, the system updates my “Active” gmail account with the new contact information across all the devices. Additionally if i were to update any contact information on my phone, the same will be reflected in each of my devices. 

Now with all your contacts consolidated and linked with all the devices, you are well on your way to staying connected with your friends, family and business associates from anywhere and more importantly from any device.

Please do write in with your comments and queries, we will be glad to be of help. 

Note: At this time, try and not connect with your Facebook Contacts since it seems to be forcing duplicate entries for the contacts. It will be great if somehow the Facebook service is able to “update” your existing contacts birthday’s and anniversary instead of creating new entries in your address book.

Part 1. Your online presence, your domain, Linkedin, Facebook, twitter

Establishing a Virtual Presence allows you to expand the reach of your brand and your idea to a really large population. It has been found in many studies that enabling your social network through multiple platforms allows you to address audiences more effectively.

To enable our online presence we went about setting up a domain name. While researching which vendor we wanted to go for, we chose godaddy as our preferred choice as they had a direct link for an automated setup with google apps for business.
We bought our domain from godaddy.com by paying for the relevant fees. You could choose the duration for which your domain should be active. You can extend the domain by setting up a yearly schedule.

Godaddy at any point in time has coupons and deals that allows you to get good offers. In our case we choose the option of picking only the domain from them, as we had planned on setting up our domain on the google business apps. 

However, if you want you could also go for additional services like web-hosting, email configuration, website builder and others.
Once we setup our godaddy account, we went to the Google Setup wizard to setup Google Apps for our domain. Follow the steps indicated by the wizard and voila you have your domain records pointing to the google servers in no time. 
For sure, at this time it will be good to point out to you regarding the cpanel, MX records, A records and other such terms which will help you in locating and setting up your domain. Just copy the above terms onto google and get an understanding of what these mean. And trust me, setting up your domain cpanel and the google admin panel is a really easy task which can be done by meticulously following the documentation.
Now at this time, i would like to point out that till this point in time, i have spent about USD 2.50 to purchase the domain for a year. And starting with buying a subscription for 10 users on the google apps for business. Google provides a fixed plan and a flexible plan (allowing for adding user accounts as your company grows, will recommend this for the starters). 
  • Price: the Annual Plan is $50 per user account per year (billed in monthly installments) and the Flexible Plan is $5 per user account per month, totaling $60 per user account per year.
Once your domain is setup on google apps for business, the next apps that are automatically and immediately available to you are the mail, calender, docs, sites. So now you can get your business cards printed with your domain name and your domain based email id. All in a matter of a couple of days.
Cost of setup up till now : USD 602.50, for 10 users. We opted for a flexible plan.
Next, step would be to create a “company account” which you could use to share not only on your website, but also on all the other social networks. We found this to be really important since we were able to have all the social network chatter routed to this account, which allowed us to be responsive to the chatter from this single company account.
Once you have created the company account, you can proceed to each of the social networks and create your logins using this company account. Please note Google + and Facebook require personal sounding email id’s to create your account on their websites. So be ready to provide your email ID’s on those networks.
We went about setting up our company profile’s on Linkedin, Facebook, Twitter, Google +. We started with these social platforms but there are others like pintrest, foursquare and others that one could add your presence to.
With this we come to the end of the Part 1, of our series of setting up an online presence. We have for the sake of brevity not gotten into giving a step by step account of setting up purely because, the documentation is very elaborate and following it step for step will have you up and running in a couple of days. 
Please note however, while you are setting up your domain records, you might have to wait a while for the new values to propogate in the google servers. For this reason, the entire process might land up going to about 2-3 days.
Do write into us on info@hcitexpert.com with your comments. Alternatively, please leave your comments on our blog page and we will respond back.

How to Setup a Virtual Office – My Journey

In the Winter of 2011, I decided to take the plunge into the entrepreneurial waters. I had been working in a Healthcare IT firm developing Healthcare IT products like HIMS, PHR, EHR, etc. Whilst working in a company most times you are “trained” to work on the specific area that you have been hired for, and generally the knowledge of other setups is gained  by talking to either your system administrator and she explaining the setup in a fleeting instance, as she is overwhelmed with the requests from across the organisation. Or perhaps its not even your focus area and hence you never even thought about it.

Everyone more or less is busy with their activities and working to complete their specific tasks that have been allocated and assigned to be completed “yesterday”. From the comfort of having a system administrator to configure your system for you to access a simple thing as a printer is governed by a “process” and in case you have raised a ticket to the system admin. If the work has not been completed by the allocated person in ‘x’ number of minutes/ hours, customer satisfaction index is calculated for the relevant personnel.

From the confines of the organisation when one “startup” on their own, many things are done on a “First-time” basis. I find the experience very challenging and in some ways broadening of the horizons. You learn to do it all by yourself and from the ground up.

I went through varied experiences whilst setting up my virtual office and will highlight these in this series. I will be discussing on the specific options that presented themselves to me and finally what path I chose, i will not be detailing out the “other options” just so that this series does not get out of hand and become too elaborate and does not focus on the core, which is working very well for me. Well the sum of the parts that i plan to cover are highlighted below so that you will have an idea of steps you need to consider for yourself too. I will however, encourage you to write in your comments and views and questions regarding the options and alternatives, to which i can respond in more detail.

I dont intend this as a series only for budding, current, past entrepreneurs, but also for people working in organisations and who have the opportunity to create a project workspace or a product workspace to share information about their team’s work within their organisation.

Part 1. Your online presence, your domain, Linkedin, Facebook, twitter
Part 2. Setting up your domain, using Google Apps
Part 3. Configure google apps for business
Part 4. Configure Gmail
Part 5. Configure and develop your company website, SEO and the works
Part 6. Configure Google docs
Part 7. Configure the backup NAS
Part 8. Configure CRM, Mailers and other apps with your account
Part 9. Create an electronic signature
Part 10. Configure company calender, share tasks 
Part 11. Configure shared printer using google cloud print, HP ePrint
Part 12. Your UPS
Part 13. Apps for everything
Part 14. My cost of setting up my virtual office
Part 15. Final words, and some more..

This list in itself serves as a check-list for you to get started on creating that online presence for your company, get started and keep checking back to see if there are any additional “options” that you could consider. 
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