We are evaluating a cloud and mobile first approach: CTO, Columbia Asia Hospital

“Over the last couple of years we have been looking at evaluating a ‘cloud-first’, ‘mobile-first’ kind of an approach to ensure that we are able to turnaround IT projects quickly and harness the power of cloud effectively,” says Venkataraman Subramanian, CTO, Columbia Asia Hospital, in a conversation with Ankush Kumar

Edited Excerpts:

Please tell us about the global footprints of Columbia Asia and your association with the institution?
This is the 20th year of Columbia Asia in Malaysia and we also have presence in other countries like Indonesia, Vietnam and India. Our current count of hospitals is 28 worldwide. I have been with the Columbia Asia from March 2012. I joined Columbia Asia India initially and currently I am working out of the Headquarters in Malaysia (Corporate office in Malaysia). I work closely with the CIO and chief of infrastructure services here.

What are the IT trends that are gaining popularity in the healthcare sector? What is your institution’s IT strategy?
If you look at the larger trends in IT, there are three major areas that I would like to reiterate – information security, analytics and adoption of cloud. Now in all these three areas we have invested time and money as we aim to keep improving in each of these areas. Everything that we do in IT, either directly or indirectly, makes a difference to the patient’s experience at the hospital. Whether it’s putting together an IT system that allows paperless movement throughout the hospital or one single bill for every encounter that we have at the hospital or even if it is the implementation of a barcode.

Coming to some of the things that we have managed to do, we have engaged on platform re-modernization for IT which will allow our customers to have more seamless access to their hospital records and also helps them to book appointments. Over the last couple of years, we have been looking at, evaluating a ‘cloud-first’, ‘mobile-first’ kind of an approach to ensure that we are able to turnaround IT projects quickly and are also able to leverage or harness the power of cloud.

What are the futuristic plans in terms of expansion or investment in technology enabled services?
Our core IT system are managed and built in-house. We have adopted a 4th generation on-premise software that runs our operations and it keeps on evolving in terms of upgrading to a better database versions. We are working with Microsoft and our partner organizations to revamp our platform modernization as this is going to be our major focus in the coming years.

How do you see the impact of cyber threats in the healthcare sector? How secure is your healthcare institution?
As of today, whatever we run is purely accessible only within the enterprise network, but that is possibly one measure of protection that we have since the software is built and maintained by us. Our ability to spot any potential trap doors are also higher, specially when we are building this new modern application for our IT system. We build security by design, as many-a-times what happens is software is brought or built and then security comes as an after-thought that usually resolves in exposing weak areas. Security is not a one time project and cannot be relied only on security assessments.

In the last couple of years we have done security programmes within the organization, making sure it has our baseline in place and then adding on to subsequent layers of security that we have to take care. But, yes the threat is there and threat has always been there, the thing is that when some of it manifests then there is a larger narrative around it. Therefore, no software is perfect and all software do come with some element of risk in it. The question is, we will have to keep a continuous eye on it and address it as early as possible. Security is not one department’s responsibility, it’s everybody’s responsibility.

While technology can help in reducing costs for providing healthcare services, we see that the healthcare cost is very high in India. Please share your thoughts?
Now there are various levels at which medical technology exists. I would like to make a distinction – there is information technology and then there is medical technology. Few years ago, possibly of doing MRI was very difficult even it was expensive because you had only few places where you could actually do an MRI. Today, by the virtue of technology being more affordable more and more centres are able to make it available. First is the question of availability then is the question of affordability. Now, when mobile phones came into existence they were expensive. More use of technology, automatically brings down the costing further and further.

We talk about telemedicine – here I would say ‘cloud’ has been a real blessing. If I had to put an expensive software, buy my own hardware the initial cost would itself pinch my pocket; but with cloud there are so many things I can do with a pay-as- you-go model. If I have more and more people subscribing to the services I am offering, I don’t have to do an upfront investment. So the cost will automatically get offset. If the same question was there before the cloud era, probably the cost would have to be passed until the critical threshold/ critical mass was achieved. But today, there is very good possibility, and this is what all the cloud providers are talking about – its’ consumption economics. These open source technologies have made it possible for companies to think about big data.

Earlier it was only meant for select few who could afford that kind of money, today it’s not the case. The ability to process large amount of data, today I would still say the real data explosion has not happened. Once internet of things really comes in and that wave hits is then we will see the real data explosion and that point it will be humanly impossible to work with the data, it has to be machine driven. That’s when we will see the value provided for the price is pretty high. People have taken humble steps, they have taken four or five pair machines and created a cluster and installed big data engine out there and processed information, and they actually been able to do wonders!

Is there any real, significant difference in the role of a CIO or CTO in the healthcare sector?
That is an interesting question. Needless to say that these roles in today’s world totally overlap. But, if I were to kind of split hair, I would say the role of a CTO has come into resurgence because information security, which was possibly an add-on role has become big enough to warrant a separate role to be put in place. So that would be a person not talking about information security, and not take on ISO stand – saying here is a list of standards that we shall follow, rather to look at information security objectively, as to what does it really mean for a business and what is the impact of data breach on the business and what can we do about it, address it.

CIO is more actually being able to articulate the value of technology introduction in the difference it is making in business process and outcomes. It can be either monetary return or on technology investment or it can be return in terms of value. CTO would probably look at – what’s happening out there, is there a possible case for us to bring the technology, how can I sample something, how to do a little proof-of-concept on what will work and will not work, the overall technology fitments. There is lot of overlap but there is also some element of individual framework to it.