The Role of Health Information Technology in Post Acute Care

Post Acute Care and Health Information Technology

In the British Medical Journal post ‘The Stress of Sending Patients Home’, physician David Oliver recalls how he was publicly threatened by the relative of a patient in the supermarket. Seemingly, the patient had suffered from complications after he had been sent home, and the relative was unhappy with the doctor’s decision to discharge the patient. Oliver goes on to state post-discharge problems are a growing concern.

Although Oliver admits that there is no single solution to solving such problems, he suggests that post-acute care could be a panacea for improving patient care outcomes. In this context, this blog highlights the problems in post-acute care and suggests how post-acute care strategies can be developed effectively using health information technology.

Post-Acute Care
Post-acute care is defined as the ‘rehabilitation or palliative services that beneficiaries receive after, or in some cases instead of, a stay in an acute care hospital’. After the hospital stay, a trouble-free transition is essential for ensuring that readmissions are low. However, at present, a disproportionate focus is placed on the quality of care received by the patients during the hospital stay, and post-acute care tends to be overlooked.

[Transition in Care. Adapted from]

Data Integration
For ensuring the smooth transition between care settings, providers undertake the process of discharge planning. This includes outlining activities ranging from follow-up tests and appointments to the usage of exercise equipment for the patients. However, fragmentation in data systems prevents providers from getting a comprehensive picture of the patients’ requirements. In order to overcome this problem, providers could use an integrated Electronic Health Record functioning across different care teams. At the same time, a real-time communication channel between different care teams could help in the meaningful interpretation of data present in the EHR. This would allow providers to get the necessary information to plan the discharge process.


Follow-Up Consultations
Follow-ups are essential for monitoring the disease parameters, and failing to do this could result in future complications. Evidently, the problem of irregular follow-ups has worsened due to the perception of hospitals being high-risk zones during the ongoing pandemic. To ensure the successful follow-up of patients, providers could consider the usage of telemedicine. Telemedicine can allow remote monitoring, and ensure that the patient is able to successfully manage the disease post-discharge with the assistance of his provider.


Patient Education
Essentially, post-acute care involves equipping the patients with the ‘skills required for caring for themselves.’ However, in a short amount of time, transferring these skills to the patients could be difficult. For making sure that this information stays with the patients, providers can make use of health information technology tools. This could include a digital record of the necessary information, along with baseline assessments to ensure that the patient understands what has been told to him at his own time.



In conclusion, it is evident that technology could help us improve post-acute care. However, to ensure widespread adoption, it would be essential that these technologies are both provider-friendly, and patient-centric.

Cyber Security in Hospitals and Healthcare Facilities

“Early last summer, Chinese and Indian armies clashed in a surprise border battle in the remote Galwan Valley…Four months later and more than 1,500 miles away in Mumbai….Hospitals had to switch to emergency generators to keep ventilators running amid a coronavirus outbreak that was among India’s worst…those two events may have been connected — as part of a broad Chinese cyber campaign…”

In the ongoing tensions between India and China, cybersecurity has become a hot button issue. Recent reports suggest evidence of foreign malware targeting critical operations in India. Among other operations, Indian healthcare facilities are being perceived as key objects of cyber attacks. With the recent digitisation of operations, hospitals are particularly vulnerable to these attacks. In this background, this blog explores the sensitive nature of healthcare data, and suggests ways for hospitals to protect against cyber attacks.


Healthcare data is sensitive as it deals with both Personally Identifiable information, and Protected health information. Personally identifiable information refers to data that could ‘possibly identify a specific person’. Examples include address and credit card details. Protected health information refers to ‘any information in a medical record created in the healthcare process’. This could refer to health information such as blood type and allergies. Arguably, PHI is even more sensitive to handle since it cannot be changed.

Incidents of Data Breach

The extent of damages done to hospitals can be reflected in incidents of data breaches. In July, 2015, UCLA health reported a data breach of the records of 4.5 million patients. Investigation revealed that basic encryption of medical data had not been carried out, which made the data vulnerable. As a consequence, ​​names, dates of birth, Social Security numbers, Medicare and health plan identification numbers as well as some medical information were exposed to hackers.

Measures for Protection

For effectively protecting the healthcare facilities from cyber attacks, we outline the following 1​

measures​ :

● Robust IT platforms: It is important for hospitals to have robust IT platforms with a strong application base. These applications should not constantly break down. If they do, they should be restored quickly.

  • ●  Responsible Planning: Hospital staff should carry out regular planning to review the risks posed to the systems. Anti-malware software needs to be installed and regularly updated. And if possible, data needs to be encrypted.
  • ●  Training and Awareness: Humans can make mistakes, and can err in judgement. For reducing the risks in decision making, regular training and awareness is a useful tool. has a course on cybersecurity, which can be useful for hospital staff.In conclusion, increasing digitisation will expose hospitals and healthcare facilities to new risks. Healthcare facilities face extra responsibilities due to the sensitive nature of the information. For securing all grounds, strong technology partners can be critical.References: go-out/articleshow/81266286.cms?utm_source=contentofinterest&utm_medium=text&utm_campaign=cppst

    Argaw, S.T., Troncoso-Pastoriza, J.R., Lacey, D. e​ t al.​ Cybersecurity of Hospitals: discussing the challenges and working towards mitigating the risks. ​BMC Med Inform Decis Mak​ 20, 146 (2020).

Optimising Communication in Healthcare

In today’s world, several individuals are involved in a patient’s care journey. And all of these individuals constantly share information with the patient. Often, these micro-level interactions determine patient satisfaction.

Poor interactions could lead to dissatisfied patients. Pleasant interactions could result in satisfied patients. Consequently, for improving the patient experience, streamlining communications is essential. In this post, we present the advantages and disadvantages of different communication channels.

Type of Communication
Based on the nature of the interaction, communication can be classified as synchronous or asynchronous. Synchronous communication includes two way interactions such as telephony.
Asynchronous communication involves one way interaction such as text messages.

Synchronous Communication
In healthcare, telephones are commonly used for synchronous communication. They involve simultaneous interactions. However, telephonic interactions are known for regular interruptions. Due to these interruptions, individuals with a heavy workload could face problems in recollection. For example, a busy clinician could forget to take notes if he is interrupted often.

Asynchronous Communication
Asynchronous communication does not involve simultaneous exchange of information. This form of communication could involve SMS messages and whatsapp texts. Although asynchronous communication excludes the possibility of interruptions, it is ineffective in getting urgent messages communicated.

Given their advantages and disadvantages, healthcare facilities need to utilize both synchronous and asynchronous forms of communication. The communication channel can be determined depending on the type of message that needs to be communicated. Consequently, metahOS allows for both forms of communication to take place in a seamless and secure way. This helps in increasing patient satisfaction.

Coiera E. Communication systems in healthcare. Clin Biochem Rev. 2006;27(2):89-98.

7 Little Changes That’ll Make a Big Difference With Your Hospital Contact Center

The majority of the patients prefer to connect and talk to a hospital representative over the phone in spite of the advancements and introduction of chatbots and AI engines. In the time of distress, it is natural to have human interaction and reassurance, which dissolves most of the anxiety and ambiguity. 

In most of modern hospitals there exists a telephone EPABX and intercom framework for structured internal communication. The external communication through inbound telephone calls needs a streamlined workflow and systematic log mechanism to keep track on the number of missed calls, type of calls, proper tracking for quality and training among the front office. In many cases, these records come in handy in case of medical-legal matters.


The majority of the small, mid-size and large hospitals have an in-house front office team. However, all the hospital administrators or hospital owner-doctors indicate a high amount of attrition in front office staff leading to high costs in training and drop-in communication chain against the set internal policy. In many cases, it is being observed that some hospitals and health service providers choose to delegate contact center work process, staffing, and training to a third party service provider which has its own set of advantages and disadvantages.

While most of the hospitals have an in-house front office team, the traditional intercom system is not able to keep pace with the smartphone revolution. Doctors, nurses Hospital staff start communicating using several private chats and messaging systems outside of the legacy EMR or HIS systems, complicating the communication channels, inability to track details of message exchanges for accountability purposes. This may also be against the communication and patient privacy policy regional laws, opening up a new channel for the medico-legal lapse. 


With this background, it is recommended by a team of policy and hospital administration experts that modern 21st-century hospitals should adopt the following :

  1. Transition from paper / emr/ traditional his systems to a contemporary hospital operating system.
  2. Introduce administrative policies preventing hospital staff from exchanging patient-related data on private chat / messaging systems.
  3. Adapt a seamless unified digital platform which is a streamlined single window for all internal and external communications.
  4. Track inbound patient communication missed calls, outbound calls using an advanced contact center system, get more professional. 
  5. To solve the staff attrition problem, choose a system that does not require intense training. Any new staff with basic telephone and computer skills should be able to adapt to the new system. 
  6. Smartphones are a new normal, Millenials / gen x / gen y are going to be the major workforce in the coming decades. Instead of forcing them to adapt to a 4-decade old system, the hospitals need to transform their software to work across devices while maintaining the required security. 
  7. The front office and billing department and the clinical services teams should be able to communicate seamlessly to ensure the patient experience is enhanced. Modern day hospitals need to look at adopting a patient centric platform which has the ability to provide single window tool to manage the patient journey 

Budget 2021 and Digital Health

Digital Health

In the 2021 budget, healthcare has been the key focus area. With an increase of 137%, the amount earmarked for healthcare for 2021 is Rs 2,23,846 crore. Specifically, the government wants to strengthen its focus on ‘preventive health, curative health and overall wellbeing’ for all the citizens of this country. 


The 2021 budget has given an enormous boost to the initiatives of m16 Labs. From our inception, we have worked on making healthcare more accessible in Tier II and Tier III cities. And in the process, we have worked to reduce healthcare costs and improve quality in care provision.


Since our technology integrates all aspects of care provision, it enables reduction in healthcare costs through avoiding the duplication of efforts in care facilities. On the other hand, it improves care quality for patient through enabling coordination among providers, and by making information accessible to patients across the care continuum. The use case of a PHC in Karnataka is a testimony to how our solutions can make care accessible to the last mile, while improving quality and reducing costs. 


Use Case: A PHC in Karnataka   

Dr. Sathish Pai, Consultant Dermatologist at a super speciality hospital and, Mr. Harish, Chief Pharmacist at a Primary Health Care Centre decided to provide free teleconsultations using WhatsApp for the villagers in a remote region of Shimoga District in Karnataka. 


Due to the lack of hospitals in the area, the villagers would have to travel a long way to consult a specialist doctor in the city. Initially, Mr. Harish collected the patient data, such as the patient name, previous history, symptoms, and pictures of the affected area. Then, he sent them to Dr. Sathish via WhatsApp. After a thorough analysis of the pictures and symptoms of the patient, he established a diagnosis and sends across the prescription, only if the ailment is treatable through teleconsultation or else the patient is asked to either consult him in-person or is suggested to see a doctor nearby in their area. 


The process was strenuous and required to keep multiple documents on a day-to-day basis like patient details, diagnosis, and physical consent forms which the Government has made mandatory for the patient to sign to show they are willing to receive teleconsultation.


With Primary Health Care Centres now providing easy accessibility to super speciality services, patients suffering from diseases need not travel to hospitals in the city to seek treatment instead can stop by the PHC and obtain quality treatment free of cost and once cured can resume their day-to-day work without causing a hindrance to their survival. Given the current situation, it won’t be wrong to say that telemedicine has indeed augmented health care delivery in India especially in such trying times.


Referral Management Systems: Will they ever Rule the World?

MetahOS Referral Management System



In most countries, the two main types of care facilities include clinics and hospitals. As gatekeepers, clinics are expected to provide services for uncomplicated cases. From the clinics, the more serious cases are referred to the hospitals. This pyramid of care facilities results in reducing costs for the payer and improving quality of care within the health system. Apart from the transition from primary to specialist care, referrals occur from specialist to specialist care or from an inpatient setting to emergency care. This post looks at the challenges and enablers to electronic referral management systems. 

Referral Management System 

The WHO defines a referral ‘as a process in which a health worker at one level of the health system […] seeks the assistance of a better or differently resourced facility at the same or higher level to assist in, or take over the management of, the client’s case’. Broadly, the usage of referral management systems is carried out to improve health outcomes by monitoring the patient’s journey across the care pathway. 


Since the need for referrals occurs due to the escalation in need or change in diagnosis, referral management systems play a critical role in effective care provision. 


Challenges to Referral Management Systems 

The key challenges to referral management include: 


  • Care provision in clinics is considered to be of a lower quality. This results in people seeking care directly at the tertiary facility.
  • Impersonalized system of record keeping, which results in patients feeling lost. 
  • Paper records result in difficulties in data collection and storage. Because of these problems, there is a lack of accurate information. 
  • The presence of different languages and standards in healthcare creates difficulties in making use of stored information to improve health outcomes.
  • The presence of different record keeping mechanisms results in the fragmentation of information.
  • Difficulties in managing care systems.


Enablers of Referral Management Systems:

To a large extent, problems in referral management systems can be overcome with the usage of electronic patient records. 


  • Electronic record keeping mechanisms result in increased transparency in care systems.  This increases patient trust.  
  • Information is streamlined through different languages, standards, and record keeping mechanisms in order to improve health outcomes. 
  • Maintaining both provider directories and patient records is easier digitally. 
  • Communication between care providers is streamlined through the use of a single platform. 


In conclusion, referral management systems are effective tools for improving quality of care provision, and reducing costs. Despite its effectiveness, several challenges hinder the effectiveness of referral management systems. However, these problems can be overcome with the usage of technologies, which streamline information to improve outcomes. 



Bossyns P and Van Lerberghe W, 2004, The weakest link: competence and prestige as constraints to referral by isolated nurses in rural Niger, in Human Resources for Health 2004, 2-1, available on line at:

Cervantes K, Salgado R, Choi M and Kalter H. 2003 Rapid Assessment of Referral Care Systems: A Guide for Program Managers, published by the Basic Support for Institutionalizing Child Survival Project (BASICS II) for the United States Agency for International Development, Arlington, Virginia, available on line at:

Department of Health, Republic of South Africa, 2003, The Clinic Supervisor’s Manual, Version 3, see Section 6: Referral System Guidelines, available on line at: 

Barnett M, Sirui S, Landon B. Trends in Physician Referrals in the United States. Arch Intern Med. 2012; 172(2): 163-170. doi:10.1001/archinternmed.2011.722.