Editorial

ICT ENABLED HOSPITAL OF THE YEAR

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MUNICIPAL CORPORATION OF DELHI

Municipal Corporation of Delhi, has six major hospitals to provide tertiary patient care for the public including Swamy Dayanand Hospital (250 beds), Rajan Babu TB Hospital (1155 beds), Hindu Rao Hospital (980 beds), MVID Hospital (250), Kasturba Hospital (450 beds), and GLM Hospital (97 beds).

The concept behind the HIS system, installed by Wipro Limited (Health Care), is to register the patient once in a life time, issue UHID and connect all hospitals for sharing the patient folder through electronic patient folder. The deployment architecture is decentralised and the product is modular. The database of each hospital has been connected to the central server of MCD through EPF (electronic patient folder), where the details on patient care, lab and radiology reports are available and can be accessed by the treating physician. Wipro HIS also been interfaced with lab equipments, which helps in avoiding re-entering the results in the laboratory system. Results from the equipment are captured and displayed in laboratory module automatically.

Highlights

Connects all the six hospitals catering to the needs of out patient and inpatient functionality within each hospital.

  • Includes patient registration with demographic details, out patient visits, doctors’ appointment scheduling, admissions/bed, transfers/discharges, order entry, laboratory/radiology/cardiology result reporting, operation theatre management, main stores, sub stores, pharmacy, etc.
  • Generation of timely census and other reports with accurate data.
  • Easier inventory management.
  • Generation of stock reports online and auditing of these reports.
  • Provision of browser based electronic patient folder.
  • Implementor: Dr. RC Patnaik, Chief Medical Officer (Health Informatics), MCD
    Website:
    http://www.mcdonline.gov.in/healthdetail.php?id=1

    “HIS helps in better patient care by retrieval of records, reporting system, inventory control, online availability of patient record and generation of statistical reports.”

    ARAVIND EYE CARE SYSTEM

    The integrated hospital management system at Aravind Eye Care System was designed to automate patients enquiry, registration, billing, admission, clinics management, counselling, inpatient admissions, operation theatre notes, laboratory, ward management, and credit services management process. IT has increased the accuracy of the billing, diminution of waiting time, easy retrieval of data for clinical studies and researches, planning, operational management and decision making. Embedded systems for investigations of patients helped to store the findings in the image for reference and also for comparison. For some investigations, it simplified the whole process and patients themselves could undergo test without the help of technicians. In the administrative areas side, accounting software helped to eliminate entire manual work and also preparation of legal documents up to balance sheet and schedules are automated.

    Highlights

    • Simple Message Service: Implemented to communicate with the patients to increase their compliance rate of surgery, follow-up, medications etc.
    • Telemedicine: Aravind applied ICT to provide over 500 tele-consultancies in a day.
    • Eyestalk: Developed for remote consultancy for second opinion using software platform; uses FTP for transferring the medical records between the ophthalmologists.
    • Medical Image Grading and Scoring: Implementation of ADRES (Aravind Diabetic Retinopathy Evaluating) to send images taken by junior level technicians at remote places to diabetologists for review and diagnosis. Wide Area Network has been setup at these camps using leased line to share the data between branches and the central hospital.
    Implementor: Dr. P Namperumalasamy, Chairman, Aravind Eye Care System
    Website: 
    http://www.aravind.org/

    “HMS standardizes processes and improves operational efficiency and performance of the system and staff.”

    KOVAI MEDICAL CENTRE AND HOSPITAL

    Kovai Medical Centre and Hospital (KMCH) is a 500-bed multi-disciplinary super speciality hospital located in Coimbatore. The hospital has more than 50 medical disciplines managed by highly qualified and trained full time medical specialists providing round the clock service. KMCH is recognized by the Tamil Nadu Government and Central Government for providing medical treatment in specialized areas like open heart surgeries, kidney transplants, joint replacements etc. Hospital is also recognized for getting financial assistance for poor people through Prime Minister’s National Relief Fund and Chief Ministers Relief Fund. The hospital provides cashless treatment through all public sector insurance companies and reputed private sector insurance companies. KMCH has implemented the BackBone HIS for automating its operations. The successful outcome of the entire project has been a result of the great job done by its employees.

    Highlights

    • Paperless Patient Ordering System: The pharmacy, lab requests, supplies, surgical issues etc., are all done within BackBone thereby completely eliminating paperwork.
    • Text Messaging: Text messages are used in communicating vital information such as lab results, insurance pre-authorization and amount authorized etc.
    • Information Kiosk: A very simple to use touch screen kiosk in the hospital’s lobby providing information on patient details, bill details, certain test results and for general information and non-patients, etc. Another feature offered by the kiosk is a patient self-registration.
    • Supplier Portal: This is a mechanism to generate purchase orders directly through the system for wholesalers and retailers.
    Implementor: UK Ananthapadmanabhan, President, KMCH
    Website:
    http://www.kmchonline.com/index.php

    “Installation of BackBone at KMCH not only improved patient experience, but also reduced administrative work.”

    SIR GANGA RAM HOSPITAL

    Five years ago, Sir Ganga Ram Hospital implemented an internationally acclaimed software (TrakCare) from TrakHealth (now InterSystems, USA). Implementation has been turbulent, largely because of large volumes of transactions at every location, which has necessitated the development of unique workflows very different from those originally configured in the software and the tremendous flexibility of the software has aided all this. The software allows tight integration between patient registrations, admissions, billing, discharges, ordering, prescription, pharmacy, laboratories, imaging, stock indenting, purchase, receiving, stores and finance modules. This has lead to better patient management and inventory and cost controls.

    Highlights

    Integration of laboratory machines with the HIS.

  • The electronic medical records module allows patient data to be always available to doctors.
  • The pharmacy management system includes ordering of medication from the wards, with patient allergy alerts and drug to drug interaction warnings, intelligent drug substitution in the pharmacy from existing stock, inventory controls and MIS reports.
  • Patient billing is automated so that the bill is always updated and available at all times.
  • Tight integration between various activities relating to stock have resulted in a tighter inventory control as well as smaller inventory holding.
  • The volume of MIS data generated by the business intelligence tools has improved management decision making.
  • Implementor: Dr. Karanvir Singh, Head-Medical Informatics, Sir Ganga Ram Hospital
    Website: 
    http://www.sgrh.com/

    “Installation of TrakCare at SGRH has led to better patient management and inventory and cost controls.”

    ARTEMIS HEALTH INSTITUTE

    Artemis Health Institute is 500 bed state of the art multi-speciality hospital, focused on delivering world class healthcare with its state of the art facilities, spread across India. The first Artemis Health Institute, located in Gurgaon in the National Capital Region, is operational since July 2007. Artemis Health Sciences is promoted by Apollo Tyres Group, which is India’s largest tyre company and is highly regarded for its professional management.

    The hospital has an HIS (hospital integration system) in place that caters to the front office operations like IP, OP, ER, pharmacy, billing etc. However, the back office operations like procurement, accounts payable, accounts receivables, etc. were not there in the HIS. Hence SAP was implemented to meet the functional requirement of finance, procurement and management reporting. However, implementing SAP is a challenge which becomes even more complicated when integration with another heterogeneous system (HIS in this case) is required. There was a need to ensure that both HIS and SAP talk to each other seamlessly.

    Highlights

    • Implementation of international patients module is difficult as country and patient specific needs have to be met within the same HIS package and also in SAP.
    • Pushing the data from HIS to SAP, is one step and confirmation of delivery to SAP is the next step. Confirmation of posting of this information into SAP is another step and finally marking this record as an already read record and to stop it from getting pushed again is the most important step.
    • Here there are a lot of technical aspects involved like maintaining the sequence of records, maintaining the check of duplicate records, maintaining flag for read and unread records, maintaining the flag and log of erroneous records.
    • With HIS and SAP seamlessly integrated, there is a single point of data entry and duplicacy is avoided.
    • Also MRP (Material Requirement Planning) in SAP is done based on the inventory position in the HIS pharmacy locations.
    Implementor: Dr. Kushagra Katariya, Chief Exective Officer, Artemis Health Institute
    Website:
    http://www.artemishospital.in/

    “At Artemis Health Institute, integration of HIS and SAP has resulted in efficiently managing front as well as back office operations.”

    Dr. LH HIRANANDANI HOSPITAL

    The ICT at Dr. LH Hiranandani hospital results in maximum patient safety and satisfaction and staff satisfaction. The in-house development of hospital management system (HMS) was to have the source code for dynamic changes over a period of time as per operational requirements.

    The HMS is an operation friendly system which has resulted in reducing the waiting time for patients. The laboratory software interfaces with all equipments for automated data integration, and little or no manual intervention for minimum error. The lab reports can also be viewed online through a secure login that ensures confidentiality. To ensure hat the lab parameters are performing optimally, software for lab for QC checks has also been installed. Even the radiology images can be viewed by nursing staff and doctors through secured login during patient care in OPD and IPD.

    Highlights

    • Dedicated OPD appointments module.
    • Hundred percent integrated online Standard Operating Procedures (SOP).
    • In house developed research software.
    • Management Information System (MIS) helps management in taking marketing decision and helps the concerned authorities to associate or dissociate with doctors based on their performance.
    • Strong inventory management modules in HMS to block excess indents, and enabling ROL.
    • Live telecast of OT procedures to auditorium and even at far off locations for knowledge sharing.
    • Electronic discharge summary and a printed copy given to the patients.
    Implementor: Dr. Sujit Chatterjee, Chief Executive Officer, Dr. LH Hiranandani Hospital
    Website:
    http://www.hiranandanihospital.org/

    “The ICT at Dr. LH Hiranandani hospital complies with various NABH and international accreditation requirements.”

    DRUG LOGISTICS INFORMATION AND
    MANAGEMENT SYSTEM

    The Drug Logistics Information and Management System (DLIMS) handles procurement, storage and distribution of medicines, drugs, injectables, surgical goods and medical equipments and distributes them to medical colleges, district and taluka hospitals, community health centres and municipal corporations (435 direct demanding offices). All activities of indenting, procurement, receipt dispatch, billing etc. are integrated in a single database, which helps maintain accuracy and integrity of data throughout the process. The system improves efficiency and effectiveness of the drug logistics and warehousing process by automated online indenting, monitoring of requirements versus availability of various processes. The existing modules include: indenting, purchase order processing, special programme monitoring, store issuable monitoring, store receivables monitoring, stock monitoring, bill payment and rate contract monitoring.

    Highlights

    • Centralised data base has increased accuracy, as all activities are inter-related and use the same data base.
    • As suppliers are also a part of the system, it is a very good example of Government to Business (GtoB) extension of e-governance and this has also enhanced transparency.
    • System is hosted in central server of NIC hence data disaster, backup etc. are all taken care by NIC’s technical resources.
    • Management of drug procurement and supply improved due to continuous online monitoring.
    • As the system is online and all concerned employees and officers use the system at their own.
    Implementor: Central Medical Stores Organization, Gandhinagar, Gujarat
    Website:
    www.gujhealth.gov.in/cmso_initiative.htm

    “Installation of DLIMS has helped in developing a different work culture with enhanced computer literacy leading to human  resource development.”

    HOSPITAL MANAGEMENT INFORMATION SYSTEM

    The state Government’s vision for HMIS is to allow general hospitals to provide efficient and quality health services to build trust and confidence  in the hearts of the citizens. The HMIS is a web-enabled system, which practically supports any time-anywhere access by the users. However, the user access has been controlled through GSWAN and role-based access has been imposed in order to protect security of patient records. The HMIS has been envisaged to not only help the administrators to have better monitoring and control over the functioning of hospitals across the state using decision support indicators and management tools, but also assist doctors and medical staff in improving health services with readily available patient data, work flow enabled less-paper processes and parameterised alarms and triggers during patient treatment cycle.

    Highlights

    • Benefits to citizens: efficient health services due to digitized health  records, electronic patient data, organized record keeping and referral services, hospital related and health promotion, reduced per visit time, standardized charges.
    • Benefits for doctors and healthcare staff: increased efficiency due to easy access to electronic EMR, templatised treatment recording cycle and ICD10 codification support, parameterised SMS alerts for patients, recording observations, reduced time-to-serve patients, building knowledge-base for research & development support and keeping track of and manage bio-medical waste as per FDA guidelines.
    • Benefits to state administrators and medical superintendents: getting real time data, getting state-wide holistic view of hospitals, monitoring pre-defined health indicators, decision support, management information system comprising of status update reporting, monitoring effectiveness of national programs and identifying areas of improvements and comparing data using state wide reports.
    Implementor: Commissionerate of Health, Medical Service and Medical Education; Gandhinagar, Gujarat
    Website: 
    www.epch.com

    “HMIS has established centralized helpdesk in health department, which helps in providing immediate solutions for resembling queries”.

    AAROGYASRI HEALTHCARE TRUST

    In order to improve access of people, living below the poverty line, to quality medical care, Government initiated a pilot project in May 2004 to partly pay for hospitalisation and treatment from Chief Minister’s Relief Fund (CMRF). However the inability of this scheme to meet the expected needs led to the set up of  Aarogyasri Health Care Trust scheme.

    As of present, following components of the Scheme are under implementation:

    • Aarogyasri I: for 15 districts and Aarogyasri (I&II combined) for 8 districts through insurance company and funded from medical department budget.
    • Aarogyasri  II: for 15 districts and chief minister’s camp office referrals directly by Trust and funded from CM Relief Fund.

    All BPL ration card holders (white card) are eligible for benefit from the scheme. The total number of diseases covered under both Aarogyasri I and Aarogyasri II schemes is 942. The scheme is implemented online through an IT portal for efficiency, transparency and accountability.

    Highlights

    A list of diseases for coverage under scheme is pre-identified; pre-existing disease load is covered; hospitalization for treatment is a pre-condition.

  • Cashless arrangement with network hospitals.
  • An insurance company undertakes the health insurance and provides risk cover.
  • Scheme provides coverage for meeting expenses of hospitalisation and surgical procedures of beneficiary members.
  • A separate fund is maintained as buffer / corporate floater to take care of expenses that exceed the original sum.
  • Choice of hospital for treatment from among empanelled hospitals is given to patient.
  • All primary health centres (PHCs), which are the first contact point, are provided with Aarogyamitra (health workers).
  • Implementor: Babu A,CEO, Aarogyasri Health Care Trust, HM & FW Department
    Website:
    http://www.aarogyasri.org/ASRI/index.jsp

    “Aarogyasri project is web-based project for which the workflow and design has been developed by Rajiv Aarogyasri Healthcare Trust.”

    HEALTH IT MASTER PLAN

    In April 2008, Ministry of Communication and Information Technology, Egypt (MCIT) laid out the IT Health Master Plan for the Ministry of Health and Population (MoHP) to be implemented jointly with IBM. The project aims at analyzing the current situation of MoHP and identifying its key objectives and future vision, analysing the current situation of Egypt’s health sector vis-�-vis the international trends in the health sector outlining possible gaps and formulating tactical strategies for achieving so. The project has high priority as it concerns the IT strategy for health in Egypt, therefore it was followed up by the minister of communication and information technology, the ministry of health and several other ministers beside the working cooperation team between the two ministries.

    Highlights

    • MOH Business Vision
    • MOH IT Vision
    • MOH IT Implications
    • MOH Business Current State Assessment
    • MOH IT Situational Analysis
    • MOH Future State CBM
    • MOH Gap Report
    • MOH Strategic Initiatives & Study Areas – Sample Projects Prioritization
    • MOH IT Governance Model 10- MOH IT Governance Model
    • MOH Project Governance Model
    • MOH Information Model
    • MOH Conceptual Architecture.
    Implementor: The Ministry of Health and Ministry of
    Communication and Information Technology, Egypt
    Website: 
    http://www.mcit.gov.eg/ProjectDetails.aspx?id=LwoZAzlgsAg=&type=ICT%20for%20Health

    “Health IT Master Plan has been developed keeping in mind the Egyptian health system and regulatory framework.”

    TRIPURA VISION CENTRE,
    TELE-OPHTHALMOLOGY PROJECT

    The tele-ophthalmology project is an initiative of the Department of Health aimed at offering primary and preventive eye care services to rural citizens of Tripura adopting advances in medical sciences, bio-medical engineering and its convergence with information and communication technology. Poised with the challenges of inadequate medical facilities and limited eye care specialists in the rural areas, this initiative has overcome all geographical, economic, social barriers earlier faced by the rural citizens and has helped them in obtaining quality eye care services from vision centres located at their doorsteps. The project serves a rural population size of 26,48,074 people in remote areas spread across 40 blocks of 4 districts in the state of Tripura. All patients visiting the vision centre are completely examined by an ophthalmic assistant and the medical record is uploaded electronically for doctor’s live tele-consultation from the IGM base Hospital in Agartala. Audio/Video conferencing tools seamlessly integrate with the medical information system in facilitating the quality consultation process.

    Highlights

    • Comprehensive model for providing eye care in a decentralized manner, located at all 40 block offices of the state.
    • Patients are examined by ophthalmic assistants and the medical record is uploaded electronically for doctor’s live tele-consultation from the IGM base Hospital in Agartala.
    • Audio/visual conferencing tools are integrated with the medical information system.
    • Network support system of private peer to peer VPN with redundant TSWAN connectivity is established for exchange of information.
    Implementor: Dr. Sukumar Deb, Department of Health, Govt of
    Tripura
    Website: 
    http://ittripura.nic.in/Vision/TVC_About.pdf

    “The application of ICT tools not only takes the eye care services to remote locations but also enables measuring the quality and effectiveness of the service offered.”

    TAMIL NADU HEALTH SYSTEMS PROJECT

    The HMIS project was envisaged by the health department of Tamil Nadu as part of the ongoing World Bank project for IT enablement of the hospitals. The project was conceptualized to provide critical health data across the health chain for quick and timely intervention by the health directorates. The project includes the development and implementation of hospital automation of secondary care institutions across the state and a state wide health IT network for reporting on a uniform reporting platform. All the critical parameters are captured at the end user level and made available real time across the health chain for decision making. The Tamil Nadu Health Systems Project (TNHSP) has been set up to implement the World Bank aided project including the HMIS project under the TN Health Department.

    Highlights

    • In a short period of six months, 30 hospitals have gone live with the online system.
    • All respective end users are expected to use the system with NO data entry support.
    • All registration, stores, pharmacy, wards, lab, doctors’ out patient processes are fully online.
    • The doctors are directly entering diagnosis, ordering lab tests and giving prescriptions online for all out patients.
    • The HMIS reporting system covering clinical, program and administrative modules provides for immediate online access to the health administrators at state level on various critical data sets.
    • The HMIS project brought in the services of various agencies to provide a state of art solution,
    • Provided data centre support and critical connectivity to the hospitals across the state.
    Implementor: Department of Health and Family Welfare,
    Government of Tamil Nadu
    Website: 
    http://www.tnhsp.org/

    “The online system records show over 10,000 patient registrations, around 2000 lab investigations, and 8000 prescriptions being entered daily.”

    National Network for Citizen Health Treatment by the Government

    The National Network for Citizen Health Treatment by the Government is a project for cooperation between the Ministry of Communi

 

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