New Delhi: The government is facing serious challenges in its efforts to adopt an electronic health records (EHR) system—a sweeping digital database of every Indian’s medical record that can be accessed by doctors and hospitals—that is aimed at transforming healthcare in the country.
These challenges range from infrastructure creation, policy and regulations, standards and interoperability to research and development.
A latest review report prepared by the ministry of electronics and information technology (MeitY) titled Adoption of Electronic Health Records: A Roadmap for India has revealed how the country lacks the basic requirements to implement the system.
Government officials reviewed documents and reports from various concerned government agencies, such as the MeitY, the health ministry and NITI Aayog as well as reports from other countries such as Canada, Germany and the US where such a digital health records of citizens are in place.
Reports published by organizations such as the Healthcare Information and Management Systems Society (HIMSS), an America non-profit dedicated to improving healthcare through the use of information technology and management systems, were also included. India has a mixed system of healthcare consisting of a large number of hospitals run by the central and state governments as well as the private sector. The report found that, in general, the level of use of information and communication technology (ICT) in healthcare in India is lower than in other countries.
When it comes to basic infrastructure, the report highlighted that government hospitals and dispensaries have very little ICT infrastructure. Only some major public hospitals, such as the All India Institute of Medical Sciences (AIIMS) and the Postgraduate Institute of Medical Education and Research (PGIMER), have computers and connectivity. “The number of public healthcare facilities is quite large in the country; therefore, a large investment in hardware and software is required. To reduce expenses, it is necessary to use open source software systems, mobile devices, and the cloud computing environment," Sunil Kumar Srivastava, senior director at the department of electronics and information technology, MeitY, said.
“However the government is working towards adoption of ICT in public hospitals; even in private hospitals the EHRs are rarely being exchanged between hospitals. The EHRs remain in the same hospital and are referenced when the patient visits again. There is no authentic report on the number of patients whose EHRs have been stored so far," he said.
With more than 75% of outpatients and more than 60% of inpatients in India being treated in private healthcare facilities, the report said that it is necessary for the government to bring these establishments on-board for using EHR. In view of the size of the country, there is a need to take a Free and Open Source Software (FOSS) approach to make good quality software available to hospitals and individual practitioners. In FOSS, the software code is made freely accessible and can be modified by anyone. If it is in the FOSS domain, even local entrepreneurs can provide technical support. Currently, the Hospital Information System (HIS) software is used in India.
“Though India has progressed well in the adoption of ICT in other sectors, such as banking, railway reservation, etc., and has an established IT industry, it has not yet utilized the potential of ICT in the healthcare sector," said Srivastava.
“In public healthcare institutions, the usage of ICT is limited to billing and registration. The private sector has a limited form of electronic medical records (EMR) but it has not yet started the exchange of health information to improve quality of care," he said.