Shahid Akhter, editor, ETHealthworld spoke to R Raghavan, Former GM, GIC of India and also Founder CEO of IIB to know more about the need for a unique thirteen digit id, ROHINI, which could be supportive in identification of hospitals and also help in promoting medical tourism in India. Edited excerpts:
Hospital identification: The need
We have hospitals in various segments in health care industry in India. Firstly, is obviously the government run hospitals, both at the primary level, health care level, then your secondary level, at district headquarter hospitals, and thirdly you have a specialist like AIIMS etc. Secondly, you have corporate run kind of chain of hospitals like Apollo Indraprastha and also medium -sized hospitals like for example, the Ganga Ram Hospital in Delhi. You also have super-speciality hospitals in India like the cancer institutes, TB institutes etc. No one has an exact number on number of hospitals in the country basically because the regulatory system for infrastructure framework for hospital upto an establishment is scattered between the central government and the various state governments. Each state government has its own law because health is still a concurrent subject.
With the reserve what happens is, there is no single better ways from where we can locate all of the city as to which hospital is located in which place. So, this leads to not only confusion in the minds of the general patient public those who seek health care but when it comes to the back of its requirements like analytics or even control of certain diseases like endemics and epidemics, it leads to a huge yawning gap .Therefore, the lack of a single, National health registry of hospitals on the road is a huge deterrent to the analytics of the country.The problem of the health insurance companies can also be added to it as they basically recur proper documentation from patients which are normally supplied by what are called as the third party administrators who are the link between the hospitals providing treatment and the insurance companies who finally pick up the bill .
Those capturing data also create a lot of distortions so with the result what happens is in the Insurance Information Bureau, it has a very robust data base, dating on health insurance claims, dating from 2005 onwards, But all that huge volume of data base cannot be constructively utilized for analytics for a simple reason that the data input is coming in a deficient way. This is exactly where some kind of identification of hospitals on a unique basis was meant as necessary. The comparable example is perhaps the IFSC code for the banks, today if you want to send money from one bank to another bank, between the banks electronically or from one individual to another individual in another bank, you use the simple IFSC code, from the particular branch from where the money goes and also for the particular branch which receives the money on bare from the payee.
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That kind of absence of a single code was the biggest nightmare of any analytics to be carried of and more importantly this is also a great detriment for fraud detection and fraud control as far as insurance claims are concerned. So, there is Ram Chandra hospital which can be perhaps in one location, let say in Dhaula kuan but since there is a fraud detriment in Ram Chandra Hospital, they can change their name to Chandra Ram Hospital and continue in the same location in the same building, so this was again great handicap for the insurance company thus,unfortunately in health insurance, insurers are not making money.They are paying more than 152-180 rupees as claims and out of these 180, may be 30-40 rupees is because of fraud only, so the purpose of having a National Registry is to insure the information linkage between various stakeholders in the health care industry.
Source: ET HealthWorld
