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Digital Push for Healthcare Sector

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Jitendra Arora

Jitendra Arora
Director
(eHealth), Ministry of Health and Family Welfare

National e-Health Authority (NeHA) will have a basic aim to guide the adoption of e-Health solutions at various levels and areas in the country, shares Jitendra Arora, Director(eHealth), Ministry of Health and Family Welfare with Elets News Network (ENN)

What is role of technology in Health sector?

Technology can play an important role in overcoming the various challenges faced in Indian health care system, inimproving the efficiency of the healthcare system and also in improving the quality and expanding reach of healthcare services, especially in the context of serving a billion plus population of India.Large scale and sustainable implementation of ICT interventions in healthcare services i.e. eHealth has a significant potential in addressing such challenges.Ministry is making use of ICT to obtain reliable health information and near real-time data for policy making,and ensuring efficient healthcare program& service delivery by rolling out a number of IT systems and applications.

Why is NeHA or a similar body essential?

Every country during the adoption of national eHealth strategy has focused on developing an authority or agency that would take care of key regulatory and promotional issues. It is necessary to maintain the privacy and confidentiality of the patient health records.The National Knowledge Commission (NKC) in 2009 had recommended for establishment of a National Health Information Authority(NHIA), to maintain the flow of information between various health care establishments and provide guidelines in the context of maintenance &use of EHR. Formation of NeHA has been envisaged for regulation, promotion and adoption of eHealth standards and nodal role in eHealth strategies for the country.

What would be the major responsibilities of NeHA?

Roles of the authourity will be in areas of policy & promotion; standards development; legal aspects including regulation (privacy & security of health data), health exchange and capacity building etc. The authority would also guide adoption of eHealth solutions and facilitate its implementation by integrating and harmonising the standards. It will also act as an enforcement agency with suitable mandate and powersand also deal with privacy and security aspects of health data and records.

Digital-PushHow would NeHA be set-up and what is the time frame required?

The organisation proposed to be created through legislation (Act of parliament).The setting up of the authority will require approval of Cabinet and would require a year for set up.

What is the current status of the process for setting up of the authority?

Concept note on setting up of NeHA has been put in public domain for inviting comments and suggestions from various stakeholders. The concept note will be in public domain fora month and thereafter the suggestions received will be duly evaluated for incorporation.It is available on Ministry of Health and Family Welfare(MoHFW) website as well as on MyGov portal. The response obtained so far on the concept note has been quite supportive of the Ministry’s initiative and remarks this as being a critical step in the direction of further strengthening and ensuring standardisation (thus facilitating inter-operability) of the Health IT system in the Country.

What is the Indian Government’s focus on using ICT in Health?

Twelfth Plan document of Government of India recognises health information system as an important pillar of health care system. In the past, National knowledge Commission (NKC)had recommended extensive use ofIT in health care to promote the delivery of efficient health care. It had also recommended to create a nation wide electronic health record (EHR) system.More recently, the Digital India Programme announced covers in its ambit the use of ICT in healthcare for services namely online consultation,online medicine supply, online medical record and pan India exchange of online medical record.

     Current ICT Solutions
Mother and Child Tracking System & Facilitation Centre for efficient delivery of Health care services to expectant mothers and children with an objective of improving IMR, MMR, and morbidity in women and children.
Drug Supply Chain Management Systems- web-based system to improve supply chain of thedrugs, sutures and surgical items have been rolled out in many states.
Health Management InformationSystem to monitor deliveryof services at facility level hasbeen adopted extensively acrossthe country at district, state andnational levels.
Hospital Management Systems have been put in place by many hospitals and health centres,supporting administrative and clinical functions and providing electronic medical records.Some states have rolled out state-wide Hospital Information Systems to cover all public hospitals across the state, thus enabling continuity of care within the state
Integrated Disease Surveillance Programme for disease surveillance with surveillance units at centre, all State/UT head quarters and all 640 districts in the country,connected through IT network.
“Nikshay” for Tuberculosis control programme, to monitor and track services and status relating to screening, diagnosis, treatment and follow-up of Tuberculosis cases.
Human Resource Management Systems for optimising human resource utilisation have been in place.
Telemedicine- Various tele-medicine pilots have also been initiated in many states over the years,some of them on a large scale.
National Health Portal- a citizen portal for health to provide authentic information on health various issues to public and serve as a single point of access for consolidated health information and services has come into operation recently.
Mobile Health solutions -Swasthya Slate, Kilkari, Mobile Academy have demonstrated good health outcomes by strengthening of health frontline workers.
Social Media platform – use of MyGov, Twitter, You Tube etc. for dissemination of information & interaction with citizens.
Source: MoHFW

Why is MoHFW implementing electronic medical record (EMR)/electronic health record (EHR) standards?

The large corporate hospitals and some public sector hospitals have started maintaining EHR of their patients.However, these healthcare systems are highly complex, fragmented and use multiple information technology systems. And, these records are not standardised and when a patient moves from one hospital to another,his electronic health record does notget exchanged. Ministry has decided to implement the EHR for seamless information flow and smooth movement of health records of beneficiaries across the hospitals. The EHR standards after wide consultation with domain experts and with the stake holders were notified by the Government in September 2013.

The response obtained so far on the concept note has been quite supportive of the Ministry’s initiative

What are the advantages of using HR standards?

EHR will ensure rationalisation of treatment and avoidance of duplication of investigations. It will also aid improved clinicians’ decision-making by providing access to patient health record information when they need it.EHR streamlines the clinician’s workflow, cuts delays,plugs gaps in care and helps in reducing medical errors.

What is the status of the present EMR and EHR systems in India?

Currently in India, there are only a few health service providers, both from both public and private sectors,who have EMR / EHR for patients. But these systems mostly are not as per the standards notified by the government and are not inter-operable.

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