Study Of Implementing Information Technology In Health Care Industry

Published Date: 02 Nov 2017

I, Indira Priyadarsini J, do hereby declare that the dissertation entitled Study of implementing Information Technology in Health Care Industry has been undertaken by me for the award of Master of Business Administration. I have completed this study under the guidance of Prof Arcot Purna Prasad, Lean Operation and Systems, Christ University Institute of Management, Bangalore.

I also declare that this dissertation has not been submitted for the award of any Degree, Diploma, Associate-ship or Fellowship or any other title in this University or any other University.

Place: Bangalore (Signature of the Candidate)

Date: 09.03.2013 Indira Priyadarsini J

Register No 1121442

ii

CERTIFICATE

This is to certify that the dissertation submitted by Indira Priyadarsini J on the title Study of implementation of Information Technology in Health Care Industry is a record of research work done by her during the academic year 2012 – 13 under my guidance and supervision in partial fulfillment of Master of Business Administration. This thesis has not been submitted for the award of any Degree, Diploma, Associate-ship or Fellowship or any other title in this University or any other University.

Place: Bangalore (Signature of the Guide)

Date: Prof Arcot Purna Prasad

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ACKNOWLEDGEMENTS

I am indebted to many people who helped me accomplish this thesis successfully.

First, I thank the Vice-Chancellor Dr. (Fr.) Thomas C. Matthew and Pro Vice-Chancellor Dr. (Fr.) Abraham V.M of Christ University for giving me the opportunity to do my research.

I thank Prof. Ghadially Zoher, Associate Dean, Fr. Thomas T.V., Director, Prof. C. K. T. Chandrasekhara, Head - Administration of Christ University Institute of Management for their kind support.

I thank Prof Arcot Purna Prasad, for his support and guidance during the course of my research. I remember him with much gratitude for his patience and motivation, but for which I could not have submitted this work.

I thank my parents for their blessings and constant support, without which this dissertation would not have seen the light of day.

Indira Priyadarsini J

Register No 1121442

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Abstract:

The research helps to understand the extent of use of Information Technology in health care industry. The main objective is to find out the effect of Information Technology on the Health care industry. The other objective is to find out the factors which are favouring Information Technology implementation and also to what extent it is being used while delivering of services to the patients/customers.

Primary data was collected through questionnaires which were given to doctors in various hospitals and the sample size is 57. The sampling technique which was used is stratified sampling as samples were collected from different hospitals in various places. Chi-Square test was performed in order to check the goodness of the data and Factor Analysis in order to find weather the data collected is reliable or not.

Even though the primary responsibility of health care industry is to treat patients, but Information Technology has its own significance in this sector as it helps in making the delivery of services easy and effective. This survey tries to bring the level of implementation of Information Technology in the health care industry and also its effectiveness.

The result of this dissertation would help me understand the level of knowledge of the industry in this concept. This knowledge can be used in the later stages to facilitate the implementation of Information Technology in much better ways and hence to make this sector an organized one in India.

Health care industry is the booming industry in India , with many number of doctors increasing year by year and cost of expense is also less compared to many other countries. With the implementation of Information Technology in this sector it will become easy to deliver the services, centralize many actions on global scale and transparency of actions at all levels also can be achieved.

Index:

1. Introduction 1

2. Literature Review 2

2.1. Health Information Systems 2

2.2. Computerised Provider/Physician Order Entry(CPOE) 2

2.3. Clinical Decision Support Systems(CDSS) 3

2.4. Picture Archiving and Communication Systems(PACS): 4

2.5. Bar coding 4

2.6. Radio Frequency Identification(RFID) 4

2.7 Automated Dispensing Machines(ADMs) 5

2.8. Electronic Materials Management(EMM) 5

2.9. Interoperability

3.DesignStudy and Methodology 6

3.1. Objective 6

3.2. Problem Statement 6

3.3. Hypothesis 6

3.4. Sample and Population 6

3.5. Sampling Plan 6

3.6. Data Type and Collection 8

3.7. Questionnaire 9

CHAPTER 1

INTRODUCTION

The quality, safety, and efficiency of health care can be improved by Information Technology(IT) by providing new ways for providers and their patients to readily access and use health information. Diffusion of IT in health care is generally low. Integrating complex information from many different sources helps in improving the delivery of quality health. Thus, increasing the ability of physicians, nurses, clinical technicians, and others to readily access and use the right information about their patients should improve care. The ability for patients to obtain information to better manage their condition and to communicate with the health system could also improve the efficiency and quality of care. This potential to improve care makes broader diffusion of IT desirable.

Current IT in health sector is mostly built as patient-centric rather than confining themselves to being traditional computers. The basic features of this include a software that supports core medical processes, hardware the supports easy access of information and mostly the standards that made integration of different systems easy. 

Drivers of investment in IT are the promise of efficiency and quality. Barriers include the implementation cost and complexity, which often results in significant work process and cultural changes, payment policies that reward volume rather than quality, and a fragmented delivery system.

Given IT’s potential, both the private and public sectors have engaged in numerous efforts to promote its use within and across health care settings. These include developing and standardising industry wide standards, funding the research on investments in Information technology in health care sector where IT is used very less, strategies being developed to improve the flow of information amongst the providers. Additional steps could include financial incentives (e.g., payment policy or loans) and expanded efforts to standardize records formats, nomenclature, and communication protocols to enhance interoperability. However, any policy to stimulate further investment must be carefully considered because of the possibility of unintended consequences which may include implementation failures due to organizations’ inability to make the necessary cultural changes.

The role of IT in health care is known very less. The factors which are to be considered about IT in this sector are as follows :

What types of IT are being used?

What is the link between use of IT and quality improvements?

How much investment have hospitals and physicians already made in information technology, and in what kinds?

What factors like financial returns, quality improvement goals, etc drive IT investments

What factors which include work flow changes, lack of compatibility with other IT, costs hinder IT investments and implementation?

What current steps are being taken by public and private entities to encourage further diffusion of IT?

What additional actions might make sense?

CHAPTER 2

LITERATURE REVIEW

In the 1960s, computer-based experiments in medical recordkeeping and management began. The technology improvement in healthcare is regarded as a strategy for coping with the cost and inefficiency of healthcare systems. But still most of the hospitals operated manually and only large organizations had implemented automated billing systems.

In the 1970s, patient records began to be used both medical and administrative data for the increasing number of review and audit purposes and physicians began adopting EHR systems and most medical facilities

In the 1980s maintained both paper and computer-based record system. By the late 1980s, ideal computer-based patient records had to be designed so as to provide some combination of time-oriented, source-oriented and problem-oriented. The Institute of Medicine (IOM) established the Patient Record Project to develop generally acceptable computer-based patient records in 1989.

While purchasing or deploying an IT one must consider multiple functions and various applications provided by numerous vendors available in the market. Here the various IT applications are classified into three categories:

HOSPITALS:

Administrative and Financial systems – Billing and General ledger, Cost accounting systems, Patient registration, Personnel and payroll, Electronic materials management.

Clinical systems - Computerized provider order entry for drugs, lab tests, procedures, Electronic health record, Picture archiving and communication systems for filmless imaging, Results reporting of laboratory and other tests, Clinical decision support systems, Prescription drug fulfilment, error-alert, transcriptions, Electronic monitoring of patients in intensive care units.

Infrastructure - Desktop, laptop, cart-based, and tablet computers, Servers and networks, Wireless networks, Voice recognition systems for transcription, physician orders, and medical records, Bar-coding technology for drugs, medical devices and inventory control, Information security systems.

PHYSICIANS:

Administrative and Financial systems – Billing, Accounting, Scheduling, Personnel and payroll.

Clinical systems – Online references (drug compendia and clinical guidelines), Receiving lab results and other clinical information online, Electronic prescribing, Computerized provider order entry, Clinical decision support systems, Electronic health record, E-mail communication with patients.

Infrastructure - Desktop and laptop computers, Handheld technology, Servers and network.

The following are the terms which usually are surfed out or discussed in case of Information technology in Healthcare :

2.1 HEALTH INFORMATION SYSTEM

The basic purpose of implementing IT in health care is for collecting, storing, retrieving and transferring information electronically. Recently Health Information Technology (HIT) is been developed and is one of the challenges which could change the face of health care drastically. HIT can be classified into six types as follows:

Electronic prescribing

Electronic lab results

Electronic clinical note systems

Electronic images

Electronic lab orders

Electronic reminders for guideline based intervention

Implementing HIT has direct and indirect benefits.

The direct benefits include:

Improved quality of care; medical error reduction; adherence to guide-line based support; effective disease management; improved efficiency; reduced use of paper; effective drug utilization; improved laboratory tests; improved patient safety; reduction in various transcription costs.

The indirect benefits include:

Improvement in operational efficiency and work culture; efficient flow of information; improved service levels and customer services; potential for strategic re-engineering; better business control; reducing the procurement/sales cycle; reducing inventor breaks, increasing productivity; employee empowerment and customer satisfaction.

2.2 COMPUTERISED PROVIDER/PHYSICIAN ORDER ENTRY(CPOE):

CPOE is a prescription ordering or fulfilment system that helps a physician to enter an order directly into a computer instead of writing which can cause medical errors. According to Baxter International reports the medical errors arising from prescriptions are 39%. It can help physician’s decision support at the point of ordering along with providing the latest information about a drug and cross reference allergies, interactions, and other problems of a patient ,thus improving the patients safety which is the major factor in the health care industry. More advanced CPOE will also include lab orders, radiology studies, procedures, discharges, transfers, and referrals. The benefits include:

Allowing interaction checking; reducing turnaround time for ordering; improving the ordering process; avoid illegible handwriting or redundancy; reduce healthcare costs.

2.3 CLINICAL DECISION SUPPORT SYSTEMS(CDSS):

It recommends the physicians and nurses with real time diagnostic and treatments. It covers a variety of technologies ranging from full clinical pathways and controls to simple alerts and prescription drug interaction warnings. It may be used a s a part of HIT or CPOE.

2.4 PICTURE ARCHIVING AND COMMUNICATION SYSTEMS(PACS):

It captures and integrates diagnostic and radiological images from various devices (e.g., x-ray, MRI, computed tomography scan), stores them, and disseminates them to a

medical record, a clinical data repository, or other points of care.

2.5 BAR CODING:

It is similar to bar-coding in other environments where an optical scanner is used to capture the image information encoded in a product, electronically. Initially it is used for medication but now being used for medical devices, labs and radiology.

2.6 RADIO FREQUENCY IDENTIFICATION(RFID):

This technology uses a wireless communication system to track patients throughout the hospital and links lab and medication tracking. It can be considered an alternative to bar coding.

2.7 AUTOMATED DISPENSING MACHINES(ADMS) :

This technology distributes medication doses.

2.8 ELECTRONIC MATERIALS MANAGEMENT(EMM):

This technology is used to keep a track of inventory of medical supplies, pharmaceuticals and other supplies. It is similar to ERP used in outside environment of other organizations.

2.9 INTEROPERABILITY:

This is about the electronic communications among organizations so that data in one IT system is incorporated into the other one. It focus on development of standards for content and messaging, among other areas, and development of adequate security and privacy safeguards.

CHAPTER 3

DESIGN STUDY AND METHODOLOGY

3.1 OBJECTIVE

Primary :

> To understand to what extent can IT be implemented in the Health Care industry

> To analyse how effective usage of IT in such kind of industry will be.

Problem Statement :

IT is been implemented in many industries and is showing its impact. Health sector is the industry where IT had started to show its inception recently. So this study aims at how IT is implemented in Health Care industry, till what extent it is been used/preferred, professionals perception towards it and the impact it is having cause of implementation.

3.2 HYPOTHESIS

> Hypothesis 1:

Null Hypothesis( H0): IT implementation in Health Care sector has positive impact .

Alternate Hypothesis(H1): IT implementation in Health Care sector hasn't positive impact.

> Hypothesis 2:

Null Hypothesis(H0): Implementation of IT has improved the patients health care.

Alternate Hypothesis(H1): Implementation of IT has no effect on improving the patients health care.

> Hypothesis 3:

Null Hypothesis(H0): Doctors and Hospital administrations are preferring to implement IT in various sectors of Health care industry.

Alternate Hypothesis(H1): Doctors and Hospital administrations are not preferring to implement IT in various sectors of Health care industry.

3.3 SAMPLE AND POPULATION

The first step in conducting the research is to identify the people who are concerned with the respective area of research. Based on this data, the sample can be determined through which the research can be conducted. The population of the research would be Doctors who are both in practise and teaching and administrative staff of Hospitals in various cities and towns.

3.4 SAMPLING PLAN: STRATIFIED SAMPLING

Since there are many sectors prevailing in the health care industry , it would be difficult to conclude on the data obtained. Therefore, the data will be collected by selecting few professionals in particular sectors( teaching, practising professionals, administrative staff of hospitals, etc) of this industry as a stratified sample. This stratified sample will consists of different professionals from various areas. This would help me in identifying the samples and understand their respective practices.

3.5 DATA TYPE AND COLLECTION :

The data collected would mainly be primary data. The questionnaires will be sent to various professionals in the health care sector. In cases where I can have a direct interaction with the them, I will get a hard copy filled by the them.

4. Industry Analysis:

4.1 HEALTH CARE INDUSTRY:

The health care industry is a vast industry which is very difficult to fragment it into a significant parts of a supply chain. The industry provides it services through various private, public and voluntary organizations with various organization structures and personnel like doctors, nurses, compounders, hospital administrations, lab technicians, etc. The industry analysis can be done at a few stages as follows:

Providers:

Under this sector usually comes the providers of these services at a core level which may include physicians, dentists, nurses, pharmacists, medical technicians, radiological technicians, health workers, therapists( physiological and psychological), hospitals, clinics, nursing homes, rehabilitation centres, etc.

Hospitals:

These are the organizations which usually employee 35 % of the core health care providers but constitute 1% of the sector. These can be considered as a one stop facility for the health care services depending on what a hospital administration decides to provide according to the facilities available. Usually they can be for-profit hospitals, not-for-profit hospitals, state/central hospitals and government hospitals.

Third party players:

This is the prevailing model of the health care industry presently where the third party player(i.e other than the patient who receives the services) pay the provider with minimal immediate out of pocket patient contribution. As patients have a little or almost no knowledge about the way the services are provided to them due to the complexity of this kind of service, so they cannot estimate the cost or expenses incurred for the services received by them. Usually a government provides subsidies or pays some of the amount of the bills of the patients as a third party player in most of the cases in order to reduce the cost of expense on the common public.

Suppliers:

The major supplier of a health care industry is the drugs manufacturer, i.e the pharmaceutical industry. These constitute the major portion of the supporting industries of this industry. The other supporting industries are usually the wholesalers, distributors, retailers, salesmen of the medical equipment, etc related to this industry.

Regulators:

This industry is highly regulated by both the public and private entities. Usually the government takes care of framing the rules and also setting the prices for most of the services. The government forms a body comprising of various proffesionals from this industry to help in framing the policies. The other private entities include various outside bodies like associations, professional groups, societies , etc. All these play a significant role in developing the industry.

4.2 Health Care industry in India:

The health care industry in India is by now growing at a very large pace and is expected to become $280 billion industry by 2020. Few of the demographic changes like large population, increasing living standards and thereby quality of living, knowledge availability, awareness amongst the people, etc are the significant factors to make this industry grow at a rapid pace in India. The number of public and private hospitals are growing at around 20% rate every year. The private health care industry accounts for 65% of primary care and more than 40% of hospitals. The information technology in health care has the potential to improve the quality, safety and efficiency of health care.

This industry can be classified into 5 segments:

Hospitals (generate 71 per cent revenue), Pharmaceutical (generate 13 per cent revenue), Diagnostics (generate 9 per cent revenue), Medical Equipment and Supplies (generate 4 per cent revenue) and Medical Insurance (generate 3 per cent revenue).

Delivering healthcare services in India has become a challenging one as one have to deliver an affordable services to its billion plus population. It also signifies enormous opportunities for the medical providers along with the other secondary service providers in this industry. RNCOS in its latest report, "Indian Healthcare - New Avenues for Growth", says that India represents a splendid investment opportunity in the healthcare sector with ever-growing population and the continued rise in the number of diseases.

The Planning Commission has allotted US$ 83 billion under the 12thth Five Year Plan for healthcare spending; this is about US$ 60 billion more as compared to the 11th Plan. As a result, the share of healthcare in total plan allocation is set to rise to 2.5 per cent of GDP in the 12th Plan from 0.9 per cent in the 11th Plan.

4.3 Future of the Industry:

The present Health Care industry which is at $65 billion is expected to reach $155 billion by 2017.Presently the public health care is still in a dormant stage and the government isn't utilizing this opportunity or concentrating on this , whereas the private health care industry is shining with many more developments both financially and technologically. The current doctor- patient ratio is 1:1700 whereas in rural areas it is 1:25000. So this segment of the market is still unexplored by the public sector and as well as the private sector. But the future of this industry lies in exploring this untapped market which has a huge potential. India is expected to develop in this sector as it is will be seeing huge mergers and acquisitions along with many FDI and FII in this sector.

CHAPTER 5

ANALYSIS

5.1 INTRODUCTION

Analysis is performed on the primary data which is collected thorough questionnaires. The questionnaires are been filled by the doctors who are identified from Bangalore, Hyderabad , Vishakhapatnam and Rajahmundry either manfully or through online. Out of total 100 questionnaires sent, got responses from 57 doctors and so the sample size has been set to 57.

The data collected has been copied into SPSS software and few tools has been used inorder to analyse it so as to support the hypothesis taken. The tools used are Factor analysis to determine the reliability of the test and also to determine the major factors effecting the decision, Chi-Square test in order to verify the Hypothesis determined and few graphs to interpret the data obtained.

5.2 PRIMARY DATA ANALYSIS:

5.1 Information Technology used in health delivery process:

Table 5.1 Respondents response about the use of IT in health delivery process

Type of response

Number of responses

YES

50

NO

7

Figure 5.1

Table 5.1 shows:

Out of the 57 respondents 50 agree that they use Information Technology either directly or indirectly in health delivery process.

Majority i.e 87.72% use IT and most of the respondents are Doctors and Hospital Administration.

Interpretation:

This shows that IT is used in most cases by most of the health care providers. It has spread enough to leave an impact in the Health care industry.

5.2 Importance given to various jobs by a health care provider( mostly a doctor)

Table 5.2 :

The identified jobs and their score

Jobs identified

Score

Patient care and treatment

219

Supervision

140

Teaching

124

General Administration

107

Others

47

Figure 5.2

Table 5.2 shows:

Each respondent is given a score of 10 points and asked to allocate to all the 5 given jobs as per the time spent by them for a particular job such that all the points adds up to 10.

Out of the five identified jobs a doctor primarily spends his time in the following descending order :

Patient care and treatment> Supervision> Teaching> General Administration> Others

Interpretation:

Supervising and Teaching almost are of same score as most of the respondents are from medical colleges where their responsibilities lie both in teaching to the students and supervising various activities of the department they belong to.

As seen from above the primary responsibility of any doctor is patient care and treatment.

General administration is where the doctors hold the positions of top management in a hospital.

The "others" include various activities like attending/conducting seminars and workshops, suppliers relationships, recruiting/selecting, etc.

5.3 Hands-on experience a doctor has with respect to few technologies

Table 5.3 The technologies identified are:

Software/experience

NONE

<1 year

1-5

years

6-10

years

11-15 years

16-20 years

>20 years

Computers

1

4

20

19

2

0

1

CPOE

4

12

29

6

1

2

0

HIT

5

13

24

6

2

3

0

Figure 5.3

Table 5.3 shows:

There are 10 respondents out of 57 forming 17.5% of sample population who doesn't have hands on experience in any of the three identified technologies.

Approximately 50% of the doctors with 1-5 years of experience use CPOE which shows it is a current technology and doctors are getting updated with current technologies.

Interpretation:

Almost all of the doctors use computers.

Next to computers the highest used technology is CPOE followed by HIT.

The doctors above 10 years of experience are more into using computers as a part of IT usage in their health delivery process.

The doctors who have started their practise recently i.e. with 1-5 years experience are those who are more into usage of IT for the health delivery process and are updated according to the current technologies.

As evident from the graph the doctors with increasing experience , the usage of IT decreases as the boom of IT into this sector is a current trend.

For those who have experience less than 1 year, are more into using HIT, so as to gain information and thereby knowledge in order to provide better services.

5.4 Familiarity of the doctors towards identified technologies

Table 5.4 : Identified Technologies

Technology

Total Rating

Laptop/Computer

243

HIT

184

CPOE

173

HER

174

Figure 5.4

Table 5.4 shows:

Of all as it is obvious, the maximum usage of IT is seen in the use of laptop/computer i.e most of the doctors are familiar with it which forms 85.15% on the allocated score of 285 for each category.

It is followed by HIT as knowledge gaining is a very critical factor in this industry and so is the standardization of the procedures.

CPOE and HER are been equally common preceded by HIT.

Interpretation:

The use of Laptop/computer indicates the usage of some software like Excel, Power point, internet usage, etc.

The above identified technologies which usually any doctor on an average is expected to be familiar with so as to be considered using IT in health care delivery process are laptop/computer, HIT,CPOE and HER.

5.5 Effect of IT on the working conditions of the Health Care sector

Table 5.5: The jobs identified as the parameters of working conditions are

Nature of the job

No. of positive responses

Patient care and treatment

24

Supervision

13

Teaching

34

General administration

38

Others

5

Figure 5.5:

Table 5.5 shows:

Out of the 57 responses for each category the general administration is the one which is been identified as the most benefited one( with 66.67%) because of the advent of IT in health delivery process.

Follows it are teaching and patient care and treatment with 59.6% and 42.1% respectively which are believed to be more effectively delivered to the patients because of the use of IT in them.

Interpretation:

Even though most of the doctors work is concerned with patient care and treatment as observed from table 5.2 , but still the usage of IT is more evident in general administration, making it significant. The respondents who belong to the Hospitalist specialization are more into usage of IT in this category.

The 'others' category which considered some acts like practising operations, training to the workforce, etc are also using IT in order to deliver an effective performance.

5.6 Favourability of IT for improving the health conditions of patients

Table 5.6: Responses of the doctors:

Type of response

No of responses

YES

53

NO

4

Figure 5.6

The table 5.6 shows:

Out of the 57 respondents 54 i.e. 94.74% feel that IT has favoured them in improving the health conditions of the patients.

The rest i.e. 5.26% feel that IT hasnt favoured much in improving the health conditions of the patients.

Interpretation:

This 4 respondents supports their response by stating the reasons like even with the advent of IT , the patient health care depends on the doctor's skill and knowledge along with the willpower of a patient.

But the majority feel IT has a favourable effect which is a positive support to the IT use in health care sector.

5.7 Factors which are responsible for implementing IT in a Hospital

FACTOR ANALYSIS:

Table 5.7 Correlation Matirx

Correlation Matrix

ease

knowavail

sopequip

Easeofadmin

integration

training

competitors

Correlation

ease

1.000

.051

-.087

.018

.157

-.037

.091

knowavail

.051

1.000

-.004

.156

.131

.331

.179

sopequip

-.087

-.004

1.000

.093

-.019

.162

.092

Easeofadmin

.018

.156

.093

1.000

.101

.234

-.059

integration

.157

.131

-.019

.101

1.000

.103

-.032

training

-.037

.331

.162

.234

.103

1.000

.513

competitors

.091

.179

.092

-.059

-.032

.513

1.000

Sig. (1-tailed)

ease

.353

.261

.447

.122

.394

.251

knowavail

.353

.488

.124

.166

.006

.091

sopequip

.261

.488

.245

.445

.115

.247

Easeofadmin

.447

.124

.245

.226

.040

.333

integration

.122

.166

.445

.226

.222

.406

training

.394

.006

.115

.040

.222

.000

competitors

.251

.091

.247

.333

.406

.000

Table 5.7 shows:

The co-relation matrix above indicates how one of the factor effects the other factors. ( Any factor with a value greater than or equal to 0.05 means it's a strong correlation and vice versa. Negative correlation means both the factors are inversely related.) For example:

Ease of operating and knowledge availability have 0.051 which means they are strongly correlated. This means that due to availability of knowledge it's easy to perform operations.

Ease of operating and Ease of administration have 0.018 which means they have a weak co-relation. This shows that they both don't effect each other much.

Sophisticated Equipment and Integration have -0.019 which means they are negatively correlated. This shows that with increase in sophisticated equipment, it will be difficult to integrate all of those.

Training and Ease of administration have 0.234 which means they share strong correlation. This shows that with good training measures it will become easy to organise or administer many factors in the hospital.

Table 5.8 : Test for Reliability

KMO and Bartlett's Test

Kaiser-Meyer-Olkin Measure of Sampling Adequacy.

.509

Bartlett's Test of Sphericity

Approx. Chi-Square

35.079

df

21

Sig.

.028

Table 5.8 shows :

KMO and Bartlett's test is done to test the reliability of the data. If its value is greater than or equal to 0.60 then it is reliable and we can carry forward our research. Here since the sample size is less i.e. 57 only, the value is 0.509 which is almost near to 0.60. So it can be accepted and so the data collected is reliable enough to carry forward this survey.

Table 5.9: To determine which factors affect the most.

Total Variance Explained

Component

Initial Eigenvalues

Extraction Sums of Squared Loadings

Rotation Sums of Squared Loadings

Total

% of Variance

Cumulative %

Total

% of Variance

Cumulative %

Total

% of Variance

Cumulative %

1

1.818

25.974

25.974

1.818

25.974

25.974

1.695

24.208

24.208

2

1.225

17.502

43.477

1.225

17.502

43.477

1.269

18.124

42.332

3

1.107

15.809

5.285

1.107

15.809

59.285

1.187

16.953

59.285

4

.924

13.199

72.484

5

.825

11.787

84.272

6

.721

10.301

94.573

7

.380

5.427

100.000

Extraction Method: Principal Component Analysis.

Table 5.9 shows :

From all the seven factors component 1, 2 and 3 have the highest values 1.818, 1.225 and 1.107 in descending order respectively which shows these three are the major factors which are responsible for implementing IT in delivery of Health Services.

Table 5.10: Factors affecting

Rotated Component Matrixa

Component

1

2

3

ease

.123

.110

.724

knowavail

.495

.400

.122

sopequip

.174

.149

-.609

Easeofadmin

.031

.777

-.260

integration

.026

.592

.419

training

.814

.239

-.182

competitors

.861

-.251

.038

Extraction Method: Principal Component Analysis.

Rotation Method: Varimax with Kaiser Normalization.

a. Rotation converged in 4 iterations.

Table 5.10 shows:

Knowledge availability, Sophisticated Equipment, Training and competition with competitors are one family of factors - Unique Service Proposition.

Ease of Administration and Integration are one family of factors - Virtual Centralization

Ease of operating, Integration and Competitors are one family of factors - Differentiation strategy

Interpretation:

As derived from the above factor analysis, it is known that

in order to create a Unique Service proposition for a hospital in this highly competitive industry

in order to make administration easy by following virtual-centralization/physical-decentralization philosophy in this globalized world

to Differentiate amongst its competitors

Hospitals use Information Technology in the current scenario.

5.8 Factors which favoured the improvement of conditions of health care

Chi-Square Test :

Table 5.11 : Core Performance

Chi-Square Tests

Value

df

Asymp. Sig. (2-sided)

Pearson Chi-Square

4.203a

6

.049

Likelihood Ratio

4.226

6

.646

Linear-by-Linear Association

.752

1

.386

N of Valid Cases

57

a. 9 cells (75.0%) have expected count less than 5. The minimum expected count is .04.

As table 5.11 shows:

As the significance level is less than 0.05 reject H0 and accept H1 i.e. the Core Performance is one of the factors which had favoured in improving the health conditions.

Table 5.12 : Medical Errors

Chi-Square Tests

Value

df

Asymp. Sig. (2-sided)

Pearson Chi-Square

2.991a

6

.010

Likelihood Ratio

3.214

6

.782

Linear-by-Linear Association

.814

1

.367

N of Valid Cases

57

a. 9 cells (75.0%) have expected count less than 5. The minimum expected count is .02.

As Table 5.12 shows:

As the significance level is less than 0.05 reject H0 and accept H1 i.e. the Medical Errors is one of the factors which had favoured in improving the health conditions.

Table 5.13: Patients Safety

Chi-Square Tests

Value

df

Asymp. Sig. (2-sided)

Pearson Chi-Square

1.862a

6

.032

Likelihood Ratio

2.297

6

.890

Linear-by-Linear Association

.570

1

.450

N of Valid Cases

57

a. 9 cells (75.0%) have expected count less than 5. The minimum expected count is .02.

As Table 5.13 shows:

As the significance level is less than 0.05 reject H0 and accept H1 i.e. the Patient safety is one of the factors which had favoured in improving the health conditions.

Table 5.14: Quality Care

Chi-Square Tests

Value

df

Asymp. Sig. (2-sided)

Pearson Chi-Square

2.363a

8

.068

Likelihood Ratio

2.657

8

.954

Linear-by-Linear Association

.171

1

.679

N of Valid Cases

57

a. 12 cells (80.0%) have expected count less than 5. The minimum expected count is .02

As Table 5.14 shows:

As the significance level is less than 0.05 reject H0 and accept H1 i.e. the Quality care is one of the factors which had favoured in improving the health conditions.

Table 5.15 : Job Satisfaction

Chi-Square Tests

Value

df

Asymp. Sig. (2-sided)

Pearson Chi-Square

10.641a

4

.631

Likelihood Ratio

7.188

4

.126

Linear-by-Linear Association

.347

1

.556

N of Valid Cases

57

a. 6 cells (66.7%) have expected count less than 5. The minimum expected count is .12.

As table 5.15 shows:

As the significance level is greater than 0.05 accept H0 and reject H1 i.e. the Job Satisfaction is not one of the factors which had favoured in improving the health conditions.

Interpretation:

This is because most of the doctors feel that Job Satisfaction is derived on the skill of the doctor to treat a patient and not on the way a service is delivered to him.

Table 5.16 : Productivity

Chi-Square Tests

Value

df

Asymp. Sig. (2-sided)

Pearson Chi-Square

9.348a

6

.005

Likelihood Ratio

9.560

6

.144

Linear-by-Linear Association

4.050

1

.044

N of Valid Cases

57

a. 9 cells (75.0%) have expected count less than 5. The minimum expected count is .02.

As Table 5.16 shows:

As the significance level is less than 0.05 reject H0 and accept H1 i.e. the Productivity is one of the factors which had favoured in improving the health conditions.

Table 5.17: Staff Expenses

Chi-Square Tests

Value

df

Asymp. Sig. (2-sided)

Pearson Chi-Square

5.303a

6

.106

Likelihood Ratio

7.111

6

.311

Linear-by-Linear Association

.255

1

.614

N of Valid Cases

57

a. 9 cells (75.0%) have expected count less than 5. The minimum expected count is .05.

As Table 5.16 shows:

As the significance level is greater than 0.05 accept H0 and reject H1 i.e. the Staff expenses is not one of the factors which had favoured in improving the health conditions.

Interpretation:

The hospital administration felt on implementing more technology even though the number of manual jobs were reduced but the expenses or the pay in hiring maintenance staff who are expensive is enough to compensate it or in fact go beyond the original expenses.

Table 5.18: Storage costs

Chi-Square Tests

Value

df

Asymp. Sig. (2-sided)

Pearson Chi-Square

6.697a

6

.050

Likelihood Ratio

8.583

6

.198

Linear-by-Linear Association

1.829

1

.176

N of Valid Cases

57

a. 9 cells (75.0%) have expected count less than 5. The minimum expected count is .05.

As Table 5.18 shows:

As the significance level is less than 0.05 reject H0 and accept H1 i.e. the Storage costs is one of the factors which had favoured in improving the health conditions.

Table 5.19 : Patients Satisfaction

Chi-Square Tests

Value

df

Asymp. Sig. (2-sided)

Pearson Chi-Square

4.187a

4

.001

Likelihood Ratio

5.938

4

.204

Linear-by-Linear Association

2.336

1

.126

N of Valid Cases

57

a. 6 cells (66.7%) have expected count less than 5. The minimum expected count is .26.

As Table 5.19 shows:

As the significance level is less than 0.05 reject H0 and accept H1 i.e. the Patients Satisfaction is one of the factors which had favoured in improving the health conditions.

Table 5.20: Paper Reduction

Chi-Square Tests

Value

df

Asymp. Sig. (2-sided)

Pearson Chi-Square

5.835a

6

.042

Likelihood Ratio

5.528

6

.478

Linear-by-Linear Association

.057

1

.811

N of Valid Cases

57

a. 9 cells (75.0%) have expected count less than 5. The minimum expected count is .04.

As Table 5.20 shows:

As the significance level is less than 0.05 reject H0 and accept H1 i.e. the Paper Reduction is one of the factors which had favoured in improving the health conditions.

Table 5.21: Pharmacy inventory costs

Chi-Square Tests

Value

df

Asymp. Sig. (2-sided)

Pearson Chi-Square

4.904a

8

.048

Likelihood Ratio

6.291

8

.615

Linear-by-Linear Association

.020

1

.888

N of Valid Cases

57

a. 9 cells (75.0%) have expected count less than 5. The minimum expected count is .05.

As Table 5.21 shows:

As the significance level is less than 0.05 reject H0 and accept H1 i.e. the Pharmacy inventory costs is one of the factors which had favoured in improving the health conditions.

Table 5.22: Doctor Response

Chi-Square Tests

Value

df

Asymp. Sig. (2-sided)

Pearson Chi-Square

4.778a

6

.003

Likelihood Ratio

4.538

6

.604

Linear-by-Linear Association

2.007

1

.157

N of Valid Cases

57

a. 9 cells (75.0%) have expected count less than 5. The minimum expected count is .02.

As Table 5.22 shows:

As the significance level is less than 0.05 reject H0 and accept H1 i.e. the Doctor Response is one of the factors which had favoured in improving the health conditions.

Table 5.23: Hospital Image

Chi-Square Tests

Value

df

Asymp. Sig. (2-sided)

Pearson Chi-Square

1.364a

6

.038

Likelihood Ratio

1.854

6

.933

Linear-by-Linear Association

.021

1

.886

N of Valid Cases

57

a. 9 cells (75.0%) have expected count less than 5. The minimum expected count is .02.

As Table 5.23 shows:

As the significance level is less than 0.05 reject H0 and accept H1 i.e. the Hospital Image is one of the factors which had favoured in improving the health conditions.

Table 5.24: Ability to compete with Competitors

Chi-Square Tests

Value

df

Asymp. Sig. (2-sided)

Pearson Chi-Square

6.422a

4

.010

Likelihood Ratio

7.688

4

.104

Linear-by-Linear Association

.524

1

.469

N of Valid Cases

57

a. 6 cells (66.7%) have expected count less than 5. The minimum expected count is .23.

As Table 5.24 shows:

As the significance level is less than 0.05 reject H0 and accept H1 i.e. the Ability to compete with competitors is one of the factors which had favoured in improving the health conditions.

Table 5.25: Integration

Chi-Square Tests

Value

df

Asymp. Sig. (2-sided)

Pearson Chi-Square

3.641a

4

.007

Likelihood Ratio

3.961

4

.411

Linear-by-Linear Association

1.483

1

.223

N of Valid Cases

57

a. 6 cells (66.7%) have expected count less than 5. The minimum expected count is .16.

As Table 5.25 shows:

As the significance level is less than 0.05 reject H0 and accept H1 i.e. Integration is one of the factors which had favoured in improving the health conditions.

Table 5.26: Collaboration with other hospitals

Chi-Square Tests

Value

df

Asymp. Sig. (2-sided)

Pearson Chi-Square

2.661a

8

.004

Likelihood Ratio

3.427

8

.905

Linear-by-Linear Association

.055

1

.814

N of Valid Cases

57

a. 12 cells (80.0%) have expected count less than 5. The minimum expected count is .02.

As Table 5.26 shows:

As the significance level is less than 0.05 reject H0 and accept H1 i.e.Collaboration with other hospitals is one of the factors which had favoured in improving the health conditions.

Table 5.27 : Effective Patients service

Chi-Square Tests

Value

df

Asymp. Sig. (2-sided)

Pearson Chi-Square

9.461a

4

.001

Likelihood Ratio

7.050

4

.133

Linear-by-Linear Association

3.078

1

.079

N of Valid Cases

57

a. 6 cells (66.7%) have expected count less than 5. The minimum expected count is .12.

As Table 5.27 shows:

As the significance level is less than 0.05 reject H0 and accept H1 i.e. Effective patients service is one of the factors which had favoured in improving the health conditions.

CHAPTER 6

FINDINGS AND SUGGESIONS

6.1 Findings:

Information Technology has a positive impact on the Health care sector.

Most of the doctors are not only into using of computers/laptops but also new software like CPOE, HIT, etc along with sophisticated equipment

Most of the doctors feel implementing Information Technology will make the delivery of service to a patient much more easier than not implementing it.

Other than the mentioned software here, the other information Technology examples are 2D and 3D X-ray machines, X-Ray Elisa Readers, Echo cardiogram with Doppler's, simulation of operating procedures, etc which vary with few changes in every hospital but the internal design of the system is same.

Only few of the technologies are known to the doctors, especially in India where as there are many more highly sophisticated equipment available on the global scale which are to be explored by Indian hospitals.

Since Health Care industry is slowly increasing in India, use of IT is helping this sector to become an organised one.

A hospital with highly sophisticated equipment and new technologies are much more likely to attract patients as they feel IT predicts the state of their health condition much better than human intuition.

Even with the advent of Information Technology , doctors feel that job satisfaction can be achieved only by developing rightful skill set rather than relying on technology. They believe it is a way to deliver the service to the patient in an effective way.

According to the hospital administrations, Information Technology is mostly helpful in the following ways:

Maintaining large volumes of data

Accessibility of data

Integrating all the branches with the central branch thereby implementing virtual centralization - physical decentralization concepts.

Ease of administration by both the top management and also middle level management as most of the practises are transparent.

Standardization of certain procedures in order to create a brand image for the hospital.

6.2 Suggestions:

The Health sector should make use of this Information technology to become an organised one so as to reap more benefits.

The Indian health industry can take the USA system of delivering health services by integrating all the doctors on one platform so as to make it easier for the patients as well as time saving for the doctors.

Dealing with few of the products of Information Technology should be taught to doctors/nurses as a part of their curriculum, else the maintenance costs may rise by hiring maintenance personnel if they don't know the basics also.

Information Technology shouldn't be seen only as software/hardware. It also includes E-Commerce where the health industry hasn't entered into and has a lot of opportunities if explored.

The doctors should be updating their IT skills now and then so that they won't lag behind due to rapid changes in current technologies.

6.3 Future Research:

The continuation of this research would be on single practitioners or small level hospitals and then the difference between both IT equipped and non-IT equipped will give a deep insight why IT hasn't been penetrated into the lower level hospitals sector which is also a major market in India.

The fact that any research hasn't been done in this field in India gives immense scope for further research.

This survey can be expanded if the population along with the doctors include others like administrative staff and top management of hospitals, nurses/compounders, pharmaceuticals companies, suppliers of IT equipment, software companies which are into health care sector, etc.

CHAPTER 7

CONCLUSION