Healthcare IT Market Scenario - India

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Understanding Healthcare IT Market in India. Challenges and potentials....

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Healthcare IT Market Scenario – India
Quazi Faizan Ahmad Market Manager – India
Wolters Kluwer Health | UpToDate Email : [email protected] Cell: +91-9312932620

Scope…
 Indian Market – An Overview  Medical Education System in India  Teaching Institutions – Major & Minor  Medical Libraries & Library Consortia‟s

 Beta Sites survey
 Champions survey  Summary
2

Prelude….
This is an effort to project a more realistic and ground situation, generally, on overall Healthcare market in India with a focus on Healthcare IT market.
During the entire presentation all the data are presented as it is and references are cited wherever required. Any classified data, during survey or elsewhere has not been reproduced here and cannot be shared on request. The survey was done for UpToDate‟s market analysis and only some excerpts are presented here. Though, a summary is given at the end, any conclusive inference is avoided.
3

Indian Market – An Overview
 Overall Healthcare market estimated at $ 40 B, and growing @ 12–14% annually  59% of total expenditure is on Primary healthcare while 39% is on Secondary and Tertiary Care  Private healthcare providers accounts for almost 80% of total expenditure  Institutions, both Public & Private, are involved in Teaching and Healthcare deliveries  Like any market, Institutional market in India can be segmented as Teaching & non-Teaching and Private & Public  Though monitored, market is open for private investment at both teaching and non-teaching front
Healthcare in India Emerging Market, a report by PriceWaterhouseCoopers, 2007 Retrieved from www.pwc.com/globalhealthcare on August 2, 2011

4 Indian Healthcare Sector, a report by Indian Law Offices, Retrived from www.indialawoffices.com on August 5, 2011
HEALTHCARE, a report by Indian Brand Wquity Foundation, 2007, Retrived from www.ibef.org on August 5, 2011

Indian Market – An Overview
Facts & Challenges
 India has only 0.7 beds per 1,000 people, far below the global average of 2.6.

 Needs to add 2 million beds to the existing 1.1 million by 2027, and requires immediate investments of $82 billion to make up for its infrastructure deficit.  Needs $50 billion annually for the next 20 years to meet the healthcare needs of its rapidly expanding population.

Healthcare in India Emerging Market, a report by PriceWaterhouseCoopers, 2007 Retrieved from www.pwc.com/globalhealthcare on August 2, 2011

5 Indian Healthcare Sector, a report by Indian Law Offices, Retrived from www.indialawoffices.com on August 5, 2011
HEALTHCARE, a report by Indian Brand Wquity Foundation, 2007, Retrived from www.ibef.org on August 5, 2011

Indian Market – An Overview
Private Contribution
 Healthcare emerged as an industry for both deliveries and teaching  Private segment in India is one of the largest in the world  80% of all qualified doctors are involved in private practice  75% of all dispensaries are private  70% of hospitals and 40% of the hospital beds are private  Over 80% new investments are private

 Private investment revamping the industry as funds are available readily
 Infrastructure and technology improving drastically due to fast private investments  Majority of leading Tertiary Hospitals are privately managed
Healthcare in India Emerging Market, a report by PriceWaterhouseCoopers, 2007 Retrieved from www.pwc.com/globalhealthcare on August 2, 2011

6 Indian Healthcare Sector, a report by Indian Law Offices, Retrived from www.indialawoffices.com on August 5, 2011
HEALTHCARE, a report by Indian Brand Wquity Foundation, 2007, Retrived from www.ibef.org on August 5, 2011

Indian Market – An Overview
Healthcare IT Adoption
 Current Situation:

 Despite recent ascendancy as the hub of the IT and IT-enabled services, lagged tremendously behind other countries in Healthcare IT adoption
 Unlike Finance, banking & education, Healthcare is one sector where IT impact not so conspicuous yet

 Large corporate hospitals in India spend under 1% of their operating budget on IT, while spending is closer to 3% in the West
 Barring a few preliminary attempts to computerize basic hospital administrative and some clinical functions, there has been little appreciation or impetus given to HIT adoption  Major investments are towards upgrading basic infrastructure & networking
7
India HIT Case Study, by Pushwaz Virk, Harvard University; Sharib Khan, Columbia University; Vikram Kumar, Dimagi Inc. The National Bureau of Aasian Research, 2007

Indian Market – An Overview
Healthcare IT Adoption
 Recent Trend:  Healthcare organisations are presently aggressive in adopting IT solutions  Though, official HIT adoption or implementation policies are almost nonexistent however, there are serious exploratory initiative by government to facilitate HIT adoption through:
1. Framework for Information Technology Infrastructure for Heath: A guideline document and comprehensive roadmap that prescribe IT standard 2. National Knowledge Commission: A high level advisory body with the objective of transforming India into a knowledge society, ranging from education to e-governance of a working group focused on Health Information Technology

 India has the fastest growing healthcare IT market in Asia, with an expected growth rate of 22 %, followed closely by China and Vietnam
8
India HIT Case Study, by Pushwaz Virk, Harvard University; Sharib Khan, Columbia University; Vikram Kumar, Dimagi Inc. The National Bureau of Aasian Research, 2007

Indian Market – An Overview
Healthcare Providers
 Healthcare is delivered at all the levels – Individual Physicians, Specialist clinics, Primary Healthcare Centres, Nursing Homes/Poly Clinic and Hospitals

 Primary health centres are the cornerstone of the health care system
 A tiered health care system that funnels more difficult cases into hospitals while attempting to provide routine medical care at primary level

 Most in-patient services are delivered through 1–10 bed nursing homes, which are usually staffed by a single physician.
 Secondary Care is provided at district level while Tertiary Care is limited to few major cities only

Healthcare in India Emerging Market, a report by PriceWaterhouseCoopers, 2007 Retrieved from www.pwc.com/globalhealthcare on August 2, 2011

9 Indian Healthcare Sector, a report by Indian Law Offices, Retrived from www.indialawoffices.com on August 5, 2011
HEALTHCARE, a report by Indian Brand Wquity Foundation, 2010, Retrived from www.ibef.org on August 5, 2011

Indian Market – An Overview
Healthcare Providers
 Summarily :

Level Primary Secondary Tertiary

Public PHC and its Sub-Centers District Hospitals Teaching Hospitals

Private  Traditional Practitioners  Private Clinics  Small Nursing Homes  Private Clinic  Nursing Homes  Corporate Hospitals

10

Indian Market – An Overview
Healthcare Providers
 Public:  The government provides and manages the majority of the services through a hierarchical network of Primary, Secondary and Tertiary Hospitals at various rural and urban areas
Structure of Government Healthcare Services

Primary Care (in rural areas)
Secondary Care (in smaller towns and cities) Tertiary Care (In Major Cities)
11

 22,271 - Primary Healthcare Centers  137,271 - Sub-Centers
 1,200 - PSU (public sector units) hospitals  4,400 - district hospitals  2,935 - community healthcare centers  117 Hospitals (mainly attached with medical colleges)

Healthcare Indicators, a report by Ms. Srimoti Mukherji, Commercial Specialist at The U.S. Commercial Service in India, Retrieved from www.trade.gov on July 28, 2011

Indian Market – An Overview
Healthcare Providers
 Private:  A fee-levying private sector, assumed to be more responsible, co-exists with public healthcare  Consist of individual private practitioners at Primary level and nursing homes, charitable hospitals and corporate hospitals at Tertiary level  Numerous and fragmented, an estimated 45,000 Hospitals & Nursing Homes (Secondary & Tertiary)

 Average size of private hospitals/nursing homes is 22 beds, which is low compared to other countries.
Average size of Private Hospitals & Nursing Homes > 200 Bedded = 1% 100-200 Bedded = 5%

30-100 Bedded = 10%
12

<30 Bedded = 84%

Healthcare Indicators, a report by Ms. Srimoti Mukherji, Commercial Specialist at The U.S. Commercial Service in India, Retrieved from www.trade.gov on July 28, 2011

Indian Market – An Overview
Healthcare Providers – Accreditation
 There is no minimum quality standard laid down by Government  Accreditation of healthcare providers is voluntary  The most respected accreditation for healthcare providers in India are:
1. NABH (National Accreditation board for Hospitals & healthcare Providers): an initiative by the government under Quality Council of India to establish & operate accreditation programs for healthcare organizations 2. Joint Commission International: An independent international body involved in the provision of accreditations for healthcare organizations

 Under both of them PoC tool is recommended but not compulsory

 As of date there are only 101 Hospital (94 private) and 16 hospitals(all private) have been accredited by NABH and JCI

13

http://www.nabh.co/main/ Retrieved on August 23, 2011 http://www.jointcommissioninternational.org/ Retrieved on August 23, 2011

Medical Education System
Governing Bodies
 There are 2 bodies under Ministry of Health & Family Welfare which governs & monitors Medical Education in India
1. Medical Council of India: The council affiliates to all medical colleges in the country to conduct Under-Graduate & Post-Graduate medical courses
2. National Board of Examination: The board gives recognition to medical colleges & Hospitals to conduct Diplomat of National Board (DNB) examination

 Besides, Directorate General of Health Services is an attached office which renders technical advices on all medical and public health matters

14

http://mohfw.nic.in/ Retrieved August 6, 2011

Medical Education System
Courses available
 Major courses are offered by MCI & NBE
Courses Graduate Post-Graduate Diploma Post-Graduate Masters DNB Super Specialty Doctorate Duration (Years) 5 2 3 3 2 3-5 Doctors Profile [after the course completion] Intern, Resident [student] Resident, Registrar, Junior Doctor, Consultant‟s Assistant [student] Consultant Consultant Consultant Consultant Governed by MCI MCI MCI NBE MCI MCI

15

http://www.mciindia.org/ Retrieved August 8, 2011 http://www.natboard.edu.in/ Retrieved August 10, 2011

Teaching Institutions
Major & Minor
 Various institutions, both public & private, are engaged in teaching
 These can be defined as Major & Minor as:
1. Major: Institutions (both Public & Private) set up mainly for the purpose of teaching and are affiliated by MCI. These institutions also have a hospital attached 2. Minor: Institutions (both Public & Private) set up mainly for the purpose of healthcare delivery but are also recognized by NBE to conduct DNB examinations

 DNB is a prestigious certificate considered equivalent to PG Masters  Some Major Teaching hospitals also have DNB courses  All major corporate hospitals have DNB courses since it helps them retaining quality residents and also positions them as academic oriented quality healthcare provider
16

Teaching Institutions
Major
 An institution in India can conduct medical teaching for any of the courses offered by MCI as long as it meets the minimum requirement defined by MCI  A total 396 institutions in India have been affiliated by MCI to conduct any medical teachings
1. Graduate 2. Post Graduate Diploma 3. Post Graduate Masters 4. Super specialty 5. Doctorate

 An institution may offer one or more than one courses  All these institution have a full fledged hospital attached

17

http://www.mciindia.org/ Retrieved August 8, 2011

Teaching Institutions
Major
 Accordingly these institutions may be defined as Level-1, Level-2 or Level-3 institutions
1. 2. 3. Level -1: Institutions offering only Graduation courses Level -2: Institutions offering both Graduation & Post Grad Courses but may or may not have super specialty program Level -3: Institution offering either Post Grad, Super Sp or Doctorate but no Graduation program

 Rational of levels:
1. Level -1: These are smaller institutes thus, invest less on training and development as well as on library 2. Level -2: These are the large and the major teaching institutions and also have good library budget 3. Level -3: These institutions are generally involved in major research works so has only subject oriented library
18

Teaching Institutions
Major
 Following are the numbers:
Total Teaching Institutions Public
Private

396 208
188

 Numbers according to Courses:
Courses Public Private Total

Graduate PG Diploma
PG Masters Super specialty Doctorate
19
http://www.mciindia.org/ Retrieved August 8, 2011

154 124
149 78 4

181 85
114 25 0

335 209
263 103 0

Teaching Institutions
Major
 Numbers according to Levels:
Courses Level -1 Only Graduate Level -2 Graduate + Post Grad Level -3 Either Post Grad, Sup Sp or Doctorate but No Graduation Public 38 115 84 Private 68 113 7 Total 106 228 91

20

http://www.mciindia.org/ Retrieved August 8, 2011

Teaching Institutions
Minor
 An institution in India can apply for and conduct examination for Diplomate of National Board (DNB) as long as it meets the minimum requirement defined by National Board of Examination (NBE)  A total 204 institutions in India have been recognized by NBE  An institution may offer one or more than one courses  NBE may de-recognized any institution thus, numbers keep changing
Total DNB offering Hospitals (2012) Public Private 204 33 171

http://www.natboard.edu.in/ Retrieved August 10, 2011

21

Medical Libraries & Library Consortia‟s
Library’s basic requirement
 Every medical teaching institution is required to maintain a library  The library‟s richness in public institutions depends on the funds made available by the Government  For private institutions (Major), there is a minimum requirement guideline by MCI:
 Level -1 Institutions: Minimum 100 journals subscribed in first 5 years including at least one third of them should be international Title
 Level -2 & Level -3 Institutions: Minimum 7 Journals in each specialty including minimum 4 international Title

 Digital library has not been mandated by MCI  For DNB besides textbook, institution is required to maintain a digital library with DELNET network and should have at least one international and one national journal in each specialty
http://www.natboard.edu.in/ Retrieved August 10, 2011

22

MCI Guideline for Medical college with 50 admissions

Medical Libraries & Library Consortia‟s
Library’s current situation
 Institutions traditionally maintains a print library as it is also easy to produce during audit by MCI  Almost 50% medical libraries has 1-10 computers only

 In many institutions a digital library is limited to open access resources
 Most of the institutions are lacking necessary infrastructure to maintain e-resources  Only few (25%) medical libraries in India has a separate digital library with electronic database, full text e-journals etc  Consortia based e-resource subscription is gaining popularity as many consortia have formed  Most of the digital library with e-sources are part of any consortium
23
Farahi and Gandhi, Adoption of information technologies in medical libraries in Karnataka, India and Iran: A comparative study, International Journal of Library and Information Science Vol. 3(2), pp. 38-45, February 2011

Medical Libraries & Library Consortia‟s
Consortia’s
 India does not have a very rich tradition of consortia arrangements or resource sharing amongst libraries
 Post 1990s, a few efforts have been made in different levels to provide shared web-based electronic resources amongst the research, academic, and technical libraries in India  Few important consortia's among medical libraries are
1. 2. UGC-INFONET E-Journal consortium ERMED Consortium (Electronic Resources in Medicine)

3.
4. 5.

HELINET (Health Science Library and Information Network)
NTRMED (NTR MEDNET) A country wide license of the Cochrane Library by ICMR for every Indian

 Besides, National Medical Library is a „free to all‟ medical reference library
Jiban K. Pa and Prabir Kumar Das, “Progress Through Partnership” Consortia Based e-Resource Subscription Initiatives in India, Library Documentation & Information Science Division, Indian Statistical Institute 24 Satish S Munnolli, An Overview of Health Science Information System in India: Librarian‟s Point of View, Advanced Centre for Treatment, Research & Education in Cancer Kumar & Murthy, Consortium for Medical Libraries in India Abroad: A Study, 6th Convention PLANNER - 2008, Nagaland University, Nagaland, November 06-07, 2008

Medical Libraries & Library Consortia‟s
Consortia’s
1. UGC-INFONET E-Journal consortium
 UGC has initiated the UGC-INFONET E-Journal consortium  The largest consortium in India with a vision to reach every university  Under the consortium, about 494 full text scholarly electronic journals in Medicine and open access databases like PubMed Central, Biomed Central, High wire Press and Public Library of Science, Directory of online journals etc can be accessed  Open to all UGC Funded (Public) University  UGC affiliated (Private) universities can also join @ Rs. 5,000.00 per annum and enjoy prices as low as 60-90%  Access through IP address validation  Currently 294 universities are member of this consortia
GUIDELINES FOR UGC-INFONET Digital Library Consortium during the XI Plan Period (2007 - 2012), UNIVERSITY GRANTS COMMISSION, BAHADUR SHAH

25 ZAFAR MARG, NEW DELHI
Kumar & Murthy, Consortium for Medical Libraries in India Abroad: A Study, 6th Convention PLANNER - 2008, Nagaland University, Nagaland, November 06-07, 2008

Medical Libraries & Library Consortia‟s
Consortia’s
2. ERMED Consortium (Electronic Resources in Medicine)
 ICMR (Indian Council of Medical Research), established ERMED-India Consortium to support Biomedical Research & Development in India  Initially, 39 centrally funded Government Institutions including 10 Director General of Health Services libraries, 28 ICMR Libraries and AIIMS library were given membership  Today, it‟s the largest medical e-resource consortia  Now also open to select private teaching institutions on cost sharing basis  1812 Tittles available through various publishers

Jiban K. Pa and Prabir Kumar Das, “Progress Through Partnership” Consortia Based e-Resource Subscription Initiatives in India, Library Documentation & Information Science Division, Indian Statistical Institute 26 Satish S Munnolli, An Overview of Health Science Information System in India: Librarian‟s Point of View, Advanced Centre for Treatment, Research & Education in Cancer Kumar & Murthy, Consortium for Medical Libraries in India Abroad: A Study, 6th Convention PLANNER - 2008, Nagaland University, Nagaland, November 06-07, 2008 http://www.nmlermed.in/ Retrieved on August 21, 2011

Medical Libraries & Library Consortia‟s
Consortia’s
3. HELINET (Health Science Library and Information Network)
 Set up 2001 by Rajiv Gandhi University of Health Sciences, Karnataka  Today largest consortia for Private Institutions  Covers 666 institutions including Medical, Dental, Pharmacy, Nursing and other allied sciences colleges in the state (Karnataka)  Major e-resources available
1. 2. 3. 4. Science Direct Ovid MD Consult Annual Reviews 5. 6. 7. 8. Springer Thieme Verlag Taylor & Francis 9. Blackwell 10. Bentham 11. Ebrary 12. Oxford University Press

Satish S Munnolli, An Overview of Health Science Information System in India: Librarian‟s Point of View, Advanced Centre for Treatment, Research & Education in Cancer Kumar & Murthy, Consortium for Medical Libraries in India Abroad: A Study, 6th Convention PLANNER - 2008, Nagaland University, Nagaland, November 06-07, 2008 http://www.rguhs.ac.in/HELINETHOSTCONSORTIUM/homehelinethost.htm Retrieved on August 21, 2011

27

Medical Libraries & Library Consortia‟s
Consortia’s
4. NTRMED (NTR MEDNET)
 Set up in 2005, this is the Digital Library Consortium (named as NTR MEDNET) of NTR University of Health Sciences  Available to all affiliated colleges

 Also member of ERMED

5. The Cochrane Library
 ICMR funded The Cochrane library from 27 January 2007  The Cochrane Library is freely available to all residents of India who has internet access
Satish S Munnolli, An Overview of Health Science Information System in India: Librarian‟s Point of View, Advanced Centre for Treatment, Research & Education in Cancer Kumar & Murthy, Consortium for Medical Libraries in India Abroad: A Study, 6th Convention PLANNER - 2008, Nagaland University, Nagaland, November 06-07, 2008 http://ntrmedmednet.edu.in/ Retrieved August 6, 2011

28

Medical Libraries & Library Consortia‟s
Medical Reference Library
 National Medical Library
 Under administrative support from Director General of Health Sciences and supported by WHO, National Medical Library has set up a network of health science libraries in India  Has 6 Regional Medical Libraries and 8 Resource Medical Libraries in the country  Also the national focal point of HELLIS Network set up by the WHO in Southeast Asia in 1982  Open to all Medical, Para-Medical & Allied Professional  Also member of ERMED

Satish S Munnolli, An Overview of Health Science Information System in India: Librarian‟s Point of View, Advanced Centre for Treatment, Research & Education in Cancer Kumar & Murthy, Consortium for Medical Libraries in India Abroad: A Study, 6th Convention PLANNER - 2008, Nagaland University, Nagaland, November 06-07, 2008 http://www.nml.nic.in/ Retrieved on August 21, 2011

29

Beta Sites Survey
 11 Beta Sites, which are the sites of Reference Value, selected for survey
 Criteria of Site Selection:
 Various independent studies has reported leading hospitals in the country  11 leading hospital selected and surveyed

 A standard questionnaire used for data collection
 Information collected through websites, personal visit and telephonic calls  Data collected are linked here while Graphics or Matrix format used to present finding in the following slide

30

Beta Sites Survey
Findings
1. Teaching/Non-teaching
Among all Beta Sites, all teaching Sites are Public and Non-Teaching Sites are Private

Beta Sites Surveyed Teaching Non-Teaching 5 6 Public Private

2. Courses Offered
All teaching sites offer UG, PG & Sup Specialty courses while Private sites only Minor Teaching with DNB

Courses Offered Public Private
Under Grad, Post Grad, Super Specialty

DNB

31

Beta Sites Survey
Findings
3000

3. Size
Among all Beta Sites, Public Hospitals are largest where average beds are over 1600 while Private Hospitals have less than 600 beds

2500 2000 1500 1000 500 0

Public

Private

4. Doctors
Number of residents found to be more than consultants in Public sites than more consultants in Private sites

1000 800 600 400 200 0

Consultans

Residents

Public
32

Private

Beta Sites Survey
Findings
5. Full time Consultants
Among all private Beta Sites, all consultants except the ones who are part of management are part time/visiting where as, in public Beta Sites all consultants are full time
Private
8%

Public

0%

92%

100%

Full Time

Part Time

Full Time

Part Time

6. Full Time Residents
All residents in both Public & Private Sites are full time
33

Beta Sites Survey
Findings
7. Library
All public Beta Sites, have full fledged setup for both print & digital library while digital library is not present in every private Beta Sites Site Public

Library
Print 5 Digital 5

Private

6

3

8. E-resources
Electronic resources found in every Public

Resources
Site Public Private Print 5 6 e-resources 5 4

Beta sites while 2 private sites (Lilavati &
Bombay Hospital) does not subscribe any e-resources
34

Beta Sites Survey
Findings
9. Internet Access
Department wise access to internet is the most common among all the sites while wifi is found in only 2 sites. Thus the e-resource is most frequently accessed through the available computers in each department‟s office

Internet Access
Access via Only Library Department wise Through LAN Computer in every chamber wifi
35

Public (total 5 sites) 0 2 3 0 2

Private (total 6 sites) 1 5 5 0 0

Beta Sites Survey
Findings
10. Common e-resource
Science Direct & MD Consult found to the most common e-resource among all the sites while many other resources are also subscribed by Public Sites

Common e-resource
Common e-resources Science Direct MD Consult BMJ Public 5 5 5 Private 4 4 1

Oxford Journals
Ovid

2
5

0
2

36

Champions* Survey
 Criteria of Site Selection:
 A total of 60 champions identified in four cities basis their average weekly usage  Champions with higher usage preferred

 Total 17 interviews were done
 All of them are at consultant level  A standard questionnaire used for data collection  Data collected are linked here while Graphics or Matrix format used to present finding in the following slide

37

* Users of UpToDate with over 50 hits per week

Champions Survey
Findings
1. Average Usage
Of all the champions survey, average weekly usage is 22

Average Weekly Usage
City Interviews Usage

Delhi
Mumbai Bangalore Chennai
6% 12%

5
2 5 5

18
24 22 16

2. How got the subscription
Over 80% reported to have purchased online while few got as a gift by Friend or Pharma companies
Self Purchase Pharma Friend 82%

38

Champions Survey
Findings
3. Preferred place of use
Doctors were allowed to choose multiple options where he use UTD mostly. Maximum usage were reported at home while usage in the library was lowest
37% 7% 12% 19% 25% Office at POC Library

Home
Travelling

4. Best utility of UTD
Doctors chose multiple option for what he thought UTD is best suited for. Majority thinks it helps them in their own learning

26%

29%

Conferences

Own Learning

followed by conferences and as tool for
patient management at Point of care
39

45%

PoC tool for Patient Management

Champions Survey
Findings
5. Value of UpToDate
Mostly doctors agreed that UpToDate saves time for them and helps in better treatment decisions
24% 0% 15% 19% 18% 24%

Better Treatment Decisions
Answers Clinical Questions Saves Time Avoids costly errors Improved Patient Care

6. Topic‟s availability
Majority 77% said sufficient topics available or they mostly find a relevant topic while 23% often do not finds a relevant topic

Sufficient Topics available Mostly find a relevant Topic Often relevant Topics are not available

23% 37%

40%

Never found a relevant Topic

40

Champions Survey
Findings
7. UpToDate Quality
Mostly 94% agreed that topics are updated and relevant
41% 53% 3% Topics are updated and accurate Often topics and not updated & not relevant Finds information on all advance topics Generally only Generic information What's New 20% 17% Calculators Easy Search Option Drug Information by LexiComp 33% Quick & updated information

3%

8. Features
Easy Search Option scored highest 33% among the favorite features while Drug Information and Calculators scored lowest
15%
15%

41

Champions Survey
Findings
9. Treatment Recommendations
Only 35% use UTD treatment recommendations
47% 35%

Yes
No No Answer

18%

10. Quality of Treatment Recommendation
Majority 76% are satisfied with the UTD
Treatment Recommendations
18%

0% 6%

Mostly Satisfied Mostly NOT Satisfied Does understand UTD Grading Process No Answer

76%

42

Champions Survey
Findings
11. Whom he recommends UTD
UTD is recognized to be good tool for both consultants and residents
14% 12% 36% Residents Consultants Students Research Scholars 38%

43

Summary
 The Indian healthcare industry is poised to grow at a compounded annual growth rate over 12%
 Being lagged behind, Healthcare IT market in India is fastest growing in Asia at around 22%

 Private contribution in the growth of Indian Healthcare industry is growing rapidly both in medical teaching as well as healthcare delivery.
 While majority of the leading hospitals are corporate, public teaching hospitals are still best in the country due to continued funding for research & development by the government  Due to the permission by government to conduct DNB courses, many private hospitals have emerged as a minor teaching institutions as it helps them retaining quality residents and also positioning themselves as a quality healthcare provider
44

Summary…..
 Investment in the library resources are higher in public institutions due to dedicated government funding while even the leading private institutions have a stingy approach in this area.
 Both Major & Minor private teaching institutions invest in library resources only as much as they feel mandatory  Government has not mandated e-resources and so the institutions traditionally prefers print  A trend of forming consortium is on rise and few strong medical consortia has emerged in the country  Even the leading private hospitals in the country prefer to have part time consultants of multiple specialty rather than full time consultants in few specialty
45

Summary…..
 Private Hospital prefers having few full time residents and more part time consultants
 The library facilities in private Beta site are underprivileged and generally they operate within fixed budget which does not segregate between print and digital  The majority of good users of individual subscription have purchased their own account  UpToDate mostly found to be used at home or in office and is used mostly for self learning and for the conference preparation  UpToDate has not yet recognized as a Point of Care tool and also there are infrastructure limitations preventing UpToDate being used as a Point of Care tool
46

Summary…..
 UpToDate is generally not used at Point of Care due to high number of patients in waiting as well as, „I am the Best‟ mindset of the physicians
 Most UpToDate users in India are satisfied with the utility & quality of UpToDate

 Though probing around price was avoided at moment, there were many suggestions to price UpToDate rationally for the local market and to make it more cost effective

47

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