Thursday, 16 April 2015

Building a Solution compliant to Indian EHR Standards

Those were the early days at Lifetrenz. We were all very excited with our experiences and learnings in the US market. The excitement of building an Inpatient Electronic Health Records (EHR) product compliant to standards, seeing the product go through Meaningful Use (MU) certification and going live at Hospitals. It was no mean achievement for a Healthcare IT Startup based in Bangalore.

We then decided that we had to build an EHR solution that can address the needs of Healthcare providers in India. This country did not have a single standards compliant product then (not sure if there are true EHR standards compliant products available in market even today). However, we weren’t sure where to start with the Indian products. There were no official EHR standards for India then, unlike the US market. We had a number of discussions and debates, led by our CEO, Joe and Chief Medical officer Dr Pramod. After a number of brain storming sessions and pitchers of beer, we decided that the best bet is to adopt the leading standards for each of the major components of the EHR products that we were planning to build.

Thursday, 13 November 2014

Part 1 - Delivering Cloud services in challenging markets : Managing costs

At Lifetrenz, we started out to build a true multi-tenant cloud service specifically for the Healthcare vertical. As we planned our development and initial roll-out, we were faced with some challenges in making our business viable both for us and our customers.

Our primary target markets were very price sensitive and so we had to maintain a very low TCO for our application to remain competitive. This meant keeping a tight control of the total end to end costs involved in the service delivery to the users. I will focus on two of these - processing load on the cloud servers and the Internet bandwidth costs at the client side - which could be managed using technology.

Tuesday, 11 November 2014

Why India needs Healthcare Information Technology

India with its population of  over 1.25 billion firstly has  a challenge in keeping a track of this vast population's health, much less keep them healthy. The major reason for this is lack of timely, accurate and reliable healthcare information in today's paper world

State of Health in India
In healthcare India ranks very poorly, even compared to our neighboring countries . For example in the following health indicators

Maternal Mortality Rate : defined as number of women who die during pregnancy and childbirth, per 100,000 live births. India is ranked at 142 with a rate of 200 maternal deaths per 100,000 live births, which is worse than Bhutan ( 180/ 100,000) or Nepal (170/100,000)

Infant Mortality Rate : defined as number of children less than one year of age per 1000 live births. In India the figure is 52 per 1000 live births, ranking us at number 144 in the world behind Nepal (ranked 132) and Bangladesh (ranked 142).

The Differences in Development, Design and Deployment of Electronic Health Records (EHR) between USA and India

With innovators and early adopters among Indian Healthcare Organizations deploying Electronic Health Records (EHR) and the ARRA/HITECH program in the US having a major influence on policies and guidelines on EHR deployments in other countries, this article attempts to point out the differences between the needs of the two countries and ensure adoption of appropriate policies for India.

It would be unwise to blindly follow the federally backed program of EHR implementation that is ongoing in the US with Meaningful Use (MU) certification and the associated gated funding, without observing, studying and analyzing what is applicable and more importantly recognizing and adapting for what is different for the Indian Healthcare scenario.

Overall intent of design and development for the new Lifetrenz Hospital Application

The new Lifetrenz Hospital application is a completely new and developed ground up to address a lot of technology challenges experienced with the previous application. Below are some of the intended outcomes of the effort invested into the development of the new application.

User experience
  • Modern tile theme and soft colors to make the application pleasing to the eyes. Creates less strain on the eyes even with prolonged usage.
Tile View

Friday, 17 October 2014

Why we chose Smart Client over Browser application for Lifetrenz?

At the start of our journey, when we were developing the architecture for Lifetrenz platform, we had two distinct choices in front of us for developing the UI – Smart Client and Browser app. Considering the future scalability & security and to keep the option of technology choices open, we finally took a decision in favour of going with the Smart Client architecture.

Though both the approaches leverage the open web standards for the delivery of the intended functionality, they do it very differently. Below I am trying to capture some of the reasons that influenced our choice, so that anybody finding themselves in our situation may find it useful.

Basically, with Browser based applications, the entire code resides on the server and is received and executed at the client side inside a browser. Once the requirement is completed the client may not retain any code for reuse later. The applications layers in this architecture need not be abstracted fully, as they all reside on the server. In case of a Smart Client application the application and UI layers are abstracted fully, with the client side code residing on the client at all times. The client and server side codes communicate using open protocols and web standards and only data is exchanged between them.