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Advancement in healthcare
Technology
An Analytic Modelling in Healthcare Industry :
Current Status !!
“The new wave “
DR DEEPAK YADUVANSHI Ph.DMBBS.MD.DNB.FCCM.MHA
Head & Chief Consultant
Department of Respiratory Medicine
Manipal Hospitals
acknowledgment!
Teachers & well
wisher’s
Family
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3
Key Question ?Objective…Cochrane review !
Hospital is good
Hospital is bad
4
Patient’s are changing & demanding so is
Technology …
Bigger change to patient DNA in <5--10
years than past 2000 years
< healthcare +Technology = advancement >
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Presentation Plan….!
• Augmented Reality
• Patient Access solution
• In silico Clinical Trials
• Genomics ……”designer baby “
Medical Education
• Biosensors
• Wearable watches …..devices
• CPAS ….Clnical Pt access solutions !!!
• PPP……Patient provider Payor analytics
Internet of Things (IoT)
• Heart In a Box
• Artificial Lung , kidney
• Targeted Immunotherapy
• 3D Printed Drugs +Implants Clinical
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AR / VR
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3D Printing …drugs /implants
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Internet of things
IoT
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I-oT
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4PPersonalized
Predictive
Participatory
Public
EHR
IoT
Biosensor
Insulin delivery
Non Invasive Monitoring
5G e-ICU
Artificial Organs
Block chain
Healthcare payor
Providor
3D Printed Drugs
12
Impression……….
Information Overload
Routine noninvasive monitoring
• EKG
• Arterial blood pressure
• Heart rate
• Respiratory rate
• Temperature
Fluid balance
• Fluid IN
• Fluid OUT
• Urine output
Laboratory blood
• Hemoglobin
• Serum electrolytes
• Blood chemistry
Invasive hemodynamic monitoring
• Central venous pressure
• Arterial blood gases and pH
• Pulmonary arterial pressure
• Oxygen transport variables
• Intra-arterial blood pressure
Natural contexts
• Demographic data
• Chronic diseases history
• Allergies
• Stress
• Pain
Tissue perfusion / oxygenation monitoring
• Pulse oximetry
• Transcutaneous oxygen and carbon dioxide monitoring
Ventilator monitoring
• FiO2
• PIP
• PEEP/CPAP
• Mean Airway Pressure
• Tidal Volume
Brain function monitoring
• Electroencephalography
• Intracranial pressure
Routine cardiac monitoring
• Cardiac output
• Hemodynamic variables
• Blood volume
• Colloidal osmotic pressure
Average data points per day
Per Patient Per 24 bedded ICU
Labs 60 1440
Drug Orders 10 240
Microbiology 2 48
X ray 2 48
Vitals 1950 46800
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Data sources
•Ventilator devices
•Bedside devices
•Medication monitoring
•Online monitoring
•Blood work
•X-rays
•Nurse’s station &
patient records
•Doctor’s records
•Physical therapy
•Well-Being sheets
•
Hospital Matrixes
nursing indicators
Needle Stick Injury
Patient Incidents (Falls)
Patient Incidents (Pressure Ulcers)
Potential Medication Error
Average time to start treatment at ward / ICU/ HDU
Actual Medication Error
MRD
Completion of History & Physical Sheet within 24 hours of admission
Allergy documentation on drug chart
% of Death Notification (in 7 days)
OPD
Total No. of New Consults
Revisits - within 7 days
Percentage of Drs. arriving beyond scheduled OPD time
Average waiting Time for Consultation
Average delay in start of Ist consult
Average queing time for Billing
Patients delayed >15 mts. post appointment
Average waiting time for appointment
Appointments cancelled
No. of Refunds due to Errors
cath
Procedures for the week
Number of day-care procedures
No of daycare procedures delayed beyond the day
% of elective proceudres scheduled
Cath lab Utilisation (8 am to 8 PM )
Primary PTCA (Door to balloon time)
Reports signed by Consultants se day
Financial counselling &billing
% age of step downs planned
%age of discharges planned
Discharges with billing estimate off by >5% (Surgical cases)
Patients having cash positive balance at the time of discharge
Billing time for discharge (Discharge intimation to bill handed over to attendant)
Bill clearance time (Bill handed over to attendant to bill clearance)
IPD Admissions met by Counsellor
HRAttrition Rate
Nursing staff Utilisation
Avg per bed BMW in kgs
Medical Data Mining
P
P
P
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Medical Data Mining spectrum
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Q - Index….for hospital
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Hospital Data Mining <PhD.. 2012-17>
Topic
• Pre PhD Course work : Conceptual Framework 10/2012
• Stage I Research design and methodology 03/2013
• Research Topic Finalized 06/2013
Data
• Sample Work commenced 06/2014
• AS –IS –SOP and baseline parameters 11/2014
• Data Collection 1/11/2014 – 31/07/2015
Analysis
• Preliminary Analysis 10/2015
• Data Interpretation and compilation 12 /2015
• Research committee revision suggestion for Data Analysis in May 2016
• Revised & submission May /2017
• Lean Hospital Index …(LHI )
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Score card “18c Manipal way ……
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Medical Data Mining ( MDM)
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Marriage with Healthcare Technology
What
When •
Way • ??
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4PPersonalized
Predictive
Participatory
Public
EHR
IoT
Biosensor
Insulin delivery
Non Invasive Monitoring
5G e-ICU
Artificial Organs
Block chain
Healthcare payor
Providor
3D Printed Drugs
24
25
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BlockChain : Healthcare Ecosystem
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Healthcare +tech=Holy alliance
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Challenges !
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Diagnostics…..POC
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Technology ….bliss or curse!
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AI
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Practical Implications Technology
A: Hospital Managers & Administrators
❑ a)Quality assurance
LHI : Vital Instrument to assess and measure the goodness of HMS , As
has clinical Processes and Non clinical Processes
❑ b) Hospital Administration
It helps for early identification of selected quality problems of different
units in a health organization and accreditation pathway
B:Academicians & Researchers :
❑ Data Analytics:Predictive Model
▪ The opportunity for Data mining huge as model developed encompasses hospital
operation systems as whole
▪ Data analytics is a predictive model for a healthy hospital in terms of not only financial
health but also structurally .
▪ Big Data of admissions , diagnosis , outcomes , services and clinical outcomes .34
?Health care tech…
35
Healthcare Industry…indices 3 level
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Adapted from Robert S. Kaplan and David P. Norton, “Using the
Balanced Scorecard as a Strategic Management System,” Harvard
Business Review (January-February 1996): 76.
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Practical Applications
Bench to bedside
Huge unmet need efficient hospital operations analysis
Cost advantage
Opportunity to innovate
Competition for operational efficiency …focus on Processes
Transparency
Operational Efficiency
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• Medical Education
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