Mumbai: Picture a government hospital and the stereotypical image that springs to mind is sloppily maintained infrastructure, wards overflowing with patients and missing doctors.
But Maharashtra is attempting an ambitious Rs180 crore, eight-year, networking and automation project to transform its hospitals.
The project, initiated in January, involves 19 key government hospitals and 14 associated medical colleges across the state. Hewlett Packard India Ltd and L&T
Infotech Ltd are leading the effort, which will start with a pilot site at the Sir JJ Hospital here and one of the largest referral hospitals in the state.
Come November, all medical records at the hospital will be maintained digitally and all administrative functions such as procurement of medicines and other consumables ,will be automated. If successful, the pilot will then be extended to the other large hospitals across the state.
The government hopes that leveraging the power of technology will better patient care and result in cost savings for the state government by reducing pilferage and enabling lower cost sourcing of supplies.
Having statewide IT infrastructure also has ramifications on public health. “The government can keep a track of disease outbreaks as well as know the status of epidemics across the state,” says K. Gopinath, a director at HP. Adds Vishal Bali, CEO of the privately owned Wockhardt Hospitals Ltd: “The information system project envisaged by the Maharashtra government is an ideal one as it takes into account both the needs of patient care delivery as well as administrative functions.”
Bali points out that the plan goes well beyond anything that is envisioned elsewhere in India. Wockhardt started the process of implementing a similar project three years ago and is still improvising the system. “Any health care information system requires constant refinement. There are many stakeholders—doctors, nurses, administrative personnel—and it has to deliver to each of these stakeholders,” he says. Wockhardt has invested more than Rs12 crore in its information systems so far.
Even as the Maharashtra pilot gets going, IBM Global Services India Pvt. Ltd too has bid for similar government health- care projects in Karnataka and Tamil Nadu. And other states, including Punjab, West Bengal and Goa, are proposing to do the same.
Vibhawari Dani, dean of Indira Gandhi Medical College and Mayo General Hospital in Nagpur, is enthused about the potential for collaboration between her 566-bed hospital with other major government referral hospitals in Maharashtra. “Having IT systems in place will not just help us treat more patients because we will not waste time in duplicating tests and examinations, but it will also mean that we will be a lot more efficient in terms of managing the information that is generated,” she says. This government hospital has more than 1,500 out-patients every day and almost 30,000 in-patients every year.
Dr Dani may be aiming high at not having to make patients undergo the same tests twice when they are referred by a smaller hospital to a larger one, but most patients would be happy if they just got their reports on time and without mix ups. “A patient at a government hospital anywhere in Maharashtra should be able to access medical treatment at another government hospital in the state without having to carry his case papers along,” says HP’s Gopinath.
Having an efficient information system in place “will make seeking medical care simpler for the patients. If deployed and used well in hospitals, it will streamline patient registration, scheduling of appointments and patient checks, which will reduce waiting time and treat more patients, and bring efficiency”, says Mohammed Hussain Naseem, a vice-president of health care at IBM.
First off the block to experience the difference will be patients at the Sir JJ Hospital. “The scope of the pilot project is to develop a system to create and maintain electronic medical records and automate administrative functions,” says Manoj Menon, a project manager at HP. “The immediate benefit that the hospital will accrue will be streamlining of procurement, reduced wastage (by centralizing procurement and distributed supplies across the networked hospitals) and reduction in waiting time for patients,” he adds. Some even hope that medical errors may be minimized.
With more than 30,000 in-patients treated every year and more than 500,000 out-patients every year, Sir JJ Hospital is a challenging test case for the proposed system as well as hospital staff. With massive volumes of medical data being generated daily, maintaining and managing the database of all patient-related information in a central electronic format won’t be easy. Especially, accessing history, results of tests or even digital images and records across the network of hospitals will mean putting in place a high-speed, properly backed-up telecom network that will also need its own power backup, given the frequent power outages now being experienced in the state.
Government officials admit that projects involving digitization of medical records are difficult to implement. The success of this eight-year project will hinge on many factors, the most critical one being getting people in the hospitals to adapt to the system.
“Doctors at government hospitals have to deal with so many patients that they might not have enough time to feed all the data into the systems. Training the doctors, nurses and administrative staff to use information technology routinely will be a challenging task,” says a senior government official who is involved with the project, but who cannot be named because of policy reasons. “Telecom bandwith being available too is an issue, but we hope that by the time the hospitals are networked, this will have ceased to matter,” says another state government official who too declined to be named.