December 2014

Tamil Nadu Health System at Crossroads

MS Shanmugham, Project Director, Tamil Nadu Health Systems

MS Shanmugham, Project Director, Tamil
Nadu Health Systems

The need of the hour is to frequently implement the technological innovations, which make the life of the medical personnel in the hospital better and help him deliver the best of care, says MS Shanmugham, Project Director, Tamil Nadu Health Systems.


Healthcare system in India, especially medical technology needs to reach to next level of performance. At the same time it has to be patient friendly. Technology interface will play a key role in reducing the human intervention in delivery of healthcare services, which is essentially the need of the hour.

IT initiatives in Tamil Nadu

Tamilnadu, like many other states across the country, is facing the perennial problem of acute shortage of nurses and other para-medical staff in general. This is prent across all hospitals and is a major roadblock. To add to this, consider the ever increasing load of out-patient and in-patients in the government institutions. The need of the hour is to frequently implement technological innovations, which make the life of the medical personnel in the hospital better and help him deliver the best of care to his patients.


The Tamil Nadu Health System is a World Bank funded project primarily looking at some key areas like of communicable diseases, mother and child healthcare, Healthcare Information Management Systems (HIMS), tribal health, integrated bio-medical waste management and general activities to take healthcare for all in the state.

As an initiative to promote use of technology at the last mile and ensure data collection is faster and more accurate, we have given laptops to the village health nurses who are given the responsibility to carry the data with them for surveys and for them to collect data at the household level in real time. We have also supported them with Internet facility via issue of a datacard to connect each laptop and transmit it to the head office. This has eased the work process, facilitated speedier data flow and better management of the programme or project.

“We have created a dynamic framework under the PPP model that facilitates the partnership for benefit of patients at the end of the day”

Innovations are centric to transformations. Unfortunately, the Government does have a dedicated healthcare R&D agency to assist the Department on many fronts. Thus we look up to leading technology companies from across the world and in India. We have created a dynamic framework under the PPP model that facilitates the partnership for benefit of patients at the end of the day. For example we have allowed our health insurance scheme companies or agencies which are implementing new technologies like ECP. This is a procedure to be done for heart patients who are not fit for heart surgery and via media of video, they can put up the entire system, put the technology and put in our hospitals. Since it is a listed procedure, the insurance will pay the company for the patients.


Today the HMIS is one of the major innovation that our state is implementing. In this we have computerized all the state government hospitals at the district level and the taluka level. So any patient who comes at the hospital need not queue up in line to get the outpatient (OP) sheet manually written. The patient just needs to furnish his details to the operator and a computer printed OP slip will be given. A unique will be registered in his name and he has to carry the slip to the doctor. He will type the PIN number and the patient details will come. The prescription is also paperless as the doctors type the prescription and comment on the computer and then the prescription will go to the pharmacy using Intranet. He will give then prescribeddrugs to the patient. This process he can do even on a repeat visit wherein the patient just needs to give his PIN number and all the details of patients will be available to the doctor at the click of a button. This is just one aspect of Outpatient management system (OPS), there are many features such as Lab Management System, HR, vehicles, equipments and many more components that are put on automation using this model.

The second initiative that has been taken by the state government is that of computerizing the tertiary care institution and medical colleges of all the 20 government colleges and 264 government hospitals. The doctor can take the entire health records that are now easily available identified by the PIN number of patients to understand the healthcare scenario of the state. This has made the life of a patient easy and good system for medical records to the administration to make policy decisions. These are some of the steps taken by the government at our level to make the life of our patients better and help us deliver better healthcare facilities to them. Apart from that there are umpteen number of departments and directorates starting from drug control to medical education that comes close to 21 or more. So this data collation at the state level for policy intervention is important. Otherwise to browse through piles of files and data and understand the crux of the problem takes many days even months to act upon. Also they are aggregatable and acting in silos and this was not allowing us to take a holistic view of things in the department thus we have created a state heath data resource centre. That is a central repository of data, which will integrate on a common platform all policy decisions can be taken. There is data dis-integration and there is chaos in critical situation and is prevailing in many states also. From the medical point of view the efforts needs to come from the medical fraternity which the government would be happy to take. This will make the system participatory and help in the success of the project.

The governments are willing to take any new innovation, technology or advancement so long as it is cost effective and improved the quality of care for the patient, eases our load on manpower we are willing to take it up. We are becoming hub and are also offering huge opportunities in the domestic market too. So the healthcare innovations should increase and every government is willing to take.

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