January 2012

Standardise Nomenclature of Medical Information

Col Sanjay Patole, Head IT, Army R&R Hospital, believesthat HL7 version 3.0 can be a potential solution for creating medicalinformation database


Improper data and non-availability of medical informationoften results in extraordinary hardship for many serving exservicepersonnel, whose records get lost, and who are unableto get their benefits processed in a timely fashion.

We need a different approach in the healthcare domain. Theproblem is that a modern information system does not exist in allhospitals. Many sections of the industry uses ICD 10, which has10,000 terms. HL 7 already uses a Reference Information Model(RIM), which includes ICD 10, SONMED (Systematised Nomenclaturein Medicine) and has every clinical term included in it.

The Department of Defence (DOD) is working with theDepartment of Veterans Affairs (VA) in USA to create a newelectronic-health record (EHR) system, which will have healthcareinformation on veterans from the time they enter militaryservice. The Joint Virtual Lifetime Record will standardise theway the agencies share electronic medical information. In ourcase we have to focus more on patient centricity than on institutionalcentricity. If we look at the IT budget, only 2 percentis spent on Health IT. The Indian army is planning a hospitalsystem that will have 30,000 beds and 4-5 million dependentpersonnel. This is in line with what the US Veteran Society has.


GAO Report, US DOD – Department of Defence reports thelack of an integrated system perpetuated the reliance on paper-based records, leading DOD to pursue a comprehensiveelectronic healthcare record. HL7 version 3.0 is a system thatcan deliver the solution to us. Its called the medical logicalmodule (MLM) that can effectively work to integrate servicesin an organisation. We need something in our country whichgives us a certified EHR that we can use and the data will beupdated automatically

IT is the Future

Dr Akash Rajpal, MD & CEO, EKO Health Management Consultants,aims to deliver affordable healthcare by improving patient awareness


EKO Health Management Consultants facilitates discountsfor patients who are in the uninsured or unsecuredsegments and who have diabetes or hyper tensionor lie under the 50 plus age group.

Use of Hospital Management Software is becoming essentialin hospitals, as it contributes to faster turnaround timesand reduces paperwork. RFID, bar coders and even use ofmobile phones for remote patient monitoring is a trend. All postings when done in software automatically adjusts central/sub stores accountability, reorders can be placed as appropriate,re-order levels can be set depending on usage trends andhigh risk alerts can be popped up. Central monitoring systemis conducive for better patient safety. Blood samples can bequickly transported from vacuum chutes to lab for quick communicationand transcription. No matter how sophisticatedthe technology is or how good the software is or it can storeyour information till eternity, if it reduces the productivity, it is a complete failure.

The computer canstore standard nursingcare plans in a formatdetermined by the institution,to be used bynurses as the basis for developing individualised client care plan. Nurses notes can be entered quickly by choosing statements,appropriate for a particular client from multiple preprogrammedchoices. Computer is a useful tool in Educationbecause it allows an individual self paced learning. ComputedAssisted Instruction (CAI) is a method of eaching that involvesinteraction between the learner and the computer.

The technology cannot replace the human element nor underminethe values that define nursing. On the contrary, I havecome to believe that informatics and technologies would in factsecure the future of the profession. It would hardly be a timewhen IT use would not be considered as an effort and will bepart of routine.

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