1 1 medical education & drugs department government of maharashtra
TRANSCRIPT
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Medical Education & Drugs
Department
Government of Maharashtra
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Implementation of Healthcare & Academics
Management & Information System in
Government Medical Colleges & its Attached hospitals in Maharashtra
HMIS Project
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ObjectiveImplementation of e-Governance policy decision of the
State Government in Government Medical College &
its attached Hospitals in Maharashtra
Improvement in Delivery of Health Care and Medical
Education by using powerful HMIS Software of
International standard and Quality Hardware
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Project Scope
Hospital + Medical College
Hospital
Central Server-NASIK
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Benefits• Unique Health ID• EMR Electronic Medical Record • Time Saving• International Standards• Better Utilization of Available Resources• Avoidance of Pilferages• Business Intelligence Reports• Instant Availability of Administrative
Data Savings Clinical Trials & Research
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Benefits Institute & Government
All Institutes Interconnectivity, Centralized Data ,UniformityInventory Management - Prevention of Pilferages Availability & analysis of Administrative Data Generation of income through Clinical
Trials and Research
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Innovative Model
• Build Own Operate & Refresh (BOOR) Model
• Service Contract
• No Upfront Payment to the Service Provider
• Monthly Payments linked to the Service Provided as per Service Level Agreements (SLAs)
• Zero Risk to the Government
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Architecture
• Distributed
– LAN – At Each Institute
– WAN – Connecting To Central Data Repository (CSRC)
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Initial Project Cost
• Rs. 180 crore
• Rs. 150 crores - Fixed Charges - From
Plan Budget
• Rs. 30 crores (approx.) - Transaction
Charges - From Hospital PLA - @ Rs.
6.60/Transaction
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Transactions
•OPD Registration
•IPD Registration
•Students Registration
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Expected Changes Registration
Present ScenarioScenario After HMIS
Implementation
New Registration number every time
One single unique Health ID
throughout Life
Long Queues for Registration - New/Old
Reduction in waiting time for Registration as no need to enter the data
again
Registration Counters - OPD/Casualty manned by
GoM
All Registration Counters - manned by Service
provider
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Expected Changes OPD -Doctors Consultation
Present ScenarioNo Computerization
• Doctors unaware of the Waiting Patients
• No availability of Past Record
• No statistical analysis possible for OPD Clinical
Data • Laboratory Investigations
and Prescription of Medicines - on Paper.
• Separate Forms needs to be filled
• Such facility is not available
Scenario After HMIS Implementation
• Computerization in all OPDs• Waiting Patients List
available on Computer screen
• Instant availability of Past Record
• All types of statistical analysis possible on OPD
Data• Investigation & Prescription
of Medicines- e-Prescription • With click of the Mouse - on
Computer• Each Department can
customize the their OPD screens as per their favorite list of Symptoms, Probable Diagnosis, Investigations,
Medicines etc.
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Expected Changes OPD - Doctors Consultation
contd...
Present Scenario Scenario After HMIS Implementation
On Paper
Lab Results are manually carried by the
Patients.
Availability of Bed,
Scheduling for Investigation or
Operation is difficult
as no data of other concerned
departments available in the manual set-
up
Instant availability of the Lab Results
Instant availability of X-Ray, C.T. Scan, MRI, Sonography on the Computer
Time saving for the Departments to handover the Reports and Patients to
carry them
Doctor can access these Reports from any terminal in the Hospital
IPD Admission, Operation scheduling, Special Investigation scheduling -
Possible at OPD
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Possible Generation of IncomeRegistration
AreaPresent Scenario
Possibility
Registration
Rs. 5Rs. 10
(Transaction Charge payable to Service Provider - Rs 6.60)
Validity - 7 Days Validity - 1 Day
No charges from - Prisoners &
Samples for Testing
Charge of Rs. 10 to be introduced
No Charge if attends of referred to other
OPD
Rs 10 to be charged if he wants to attend other OPD
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Possible Generation of IncomePharmacy
Area Present Scenario Possibility
Pharmacy
All Medicines - Free
Actual Charges (may be 5% less than MRP)
BPL - Free - certain Medicines only.
Pharmacy Store can be started in all Institute
Profit Margin is 20-200%
JJ ScenarioAbout 8 crore spent on Medicines
OPD -1.5 croreIPD - 6.5 crore
Free MedicinesBMC - only 20 medicines GoM - About 90 medicines
Restriction on Free MedicinesPossibility of saving 40-60% of
spending
Generation of Income from the Pharmacy Store
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Possible Income GenerationAdvertisement
Charging for using the HMIS Data for any analytical purpose (to authorized persons only) as per the prevailing policy for the use of the DataAdvertisement:
On the back side of the OPD Number CardOn the computer screen - scrolling/pop up advertisementIn the Waiting AreaOn Medicine PacketsAt any other possible area
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Possible Generation of Income
Clinical Trials/Contract ResearchIndia - Preferred destination for outsourcing due to:
Largest pool of variety of patients.
Specialty Hospital Beds - 7 Lakh
269 Medical Colleges.
Low cost - 50-60% cheaper than in US
English speaking personnel
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Present Status
• Pilot Phase – at Grant Medical
College & Sir JJ Hospital Complete
• Pune, Nagpur & Aurangabad - Ready
for Trial
• St. George, G.T. & Cama –
Implementation started
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Project Governance
• Steering Committee
• Project Coordinator
• State Level Project
Implementation Committee
• Project Implementation
Committee (PIC) at Each Location
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Challenges• Customization• Mindset of the Users• Old Equipments• Top Down Governance• Old Infrastructure• Lack of Flexibility & Freedom in
Implementation
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Challenges
Use of the HMIS Data for Analysis and Policy MakingLegal Issues in relation to EMR confidentialityRTI ActOLD Equipments - like X-Ray, Biochemistry Machines not compatible to HMISData Entry into the system
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Challenges
• Complexity of the Processes• Multiple GR – Sometimes Conflicting
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Increase in Project Cost
• Learning from the Pilot Phase
• Less No of Nodes/Terminal (Computer)
• Cabinet Approved Additional Rs. 93
crore for receiving the services for the
Nodes & Printers for 19 Institutes for 7
years (Feb 09)
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Timelines• 27th Feb 09 - Cabinet Approved for
Additional 93 crores for Nodes
• Nov 2010 - Implementation of Roll-Out
Locations
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Ray of Hope
• No State Government in India has done what GOM has done
• Its Matter of Time and Benefits are assured
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International ScenarioUSA• US President Obama's big idea: Digital health records:
Computerize all Health Records Within Five Years.
• Only about 8% of the US 5,000 hospitals and 17% of its 8 Lakh Physicians currently use the kind of Common Computerized Record-keeping Systems that Obama envisions for the Whole Nation.
• Expected Cost at least $75 Billion to $100 Billion (Rs.1.5 - 2 Lakh crores) over the Ten Years they think the Hospitals would need to Implement.
• On February 17, 2009 President Obama Signed the Stimulus Bill into Law. In the Bill, Obama allocated
• $19 Billion Dollars (Rs. 38,000 Thousand
Crore) to Electronic Health Records program.
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Stakeholder
State Government
Larsen & Toubro Limited - Technical
Advisor
Hewlett Packard - HP - Prime Contractor
Amrita Technologies - HMIS Software
Provider
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For the details contact
Dr. Sanjay Bijwe M.D.
Officer on Special Duty
Medical Education & Drugs
Mantralaya Mumbai -400032
Tel.91-22-22828715
Mobile:91-9821138798
Thank You
Nivedita GolatkarSpecial Project OfficerDepartment of Information technologyMantralaya Mumbai-400032Mobile:9323293206