1. 1
A Report
on
Acceptance of Primary Care EHR by the Doctors
at
dWise Healthcare IT Solutions Pvt. Ltd, Bangalore
Submitted by
Dr.V.Dhanalakshmi,BPT
of
Post-Graduate Diploma Management in Healthcare Information
Technology
PGDM-HIT 2015-17 Batch
As a partial fulfilment of the Summer Training Program requirement
of PGDM-HIT Program
(April 2016 to June 2016)

2. 2
Certificate
This is to certify that Dr. V. DhanaLakshmi. BPT, Registration No IIHMR-
B/PGDM-HIT/2015-17/144, student of Institute of Health Management and
Research, Bangalore has successfully completed her internship project titled
“Acceptance of primary Care Her By the Doctors” in our organization dWise
Healthcare IT solutions Pvt. Ltd. from April-05-2016 to June-05-2016.
Signature of the Industry Mentor

3. 3
Certificate by the Faculty Mentor
This is to certify that Dr.V. DhanaLakshmi BPT, Regn. No. IHMR-B/PGDM-HIT/2015-
17/144 has done the project on “Acceptance of Primary Care EHR by the
Doctors” under the supervision of Dr. Pramod at dWise Healthcare IT solutions Pvt.
Ltd. as a partial fulfilment of the Summer Training Program requirement of PGDM-
HIT Program (2015-17 Batch).
Signature of the Mentor Signature of Dean - Academic and Student Affairs
Dr. R. Sarala (Dr. Usha Manjunath)

4. 4
Acknowledgement
On completion of my Summer Training Project, when I look back on the whole experience
from its very start, I feel humbled. All along I was assured of the presence of Almighty, to
whom goes all the glory, for successful completion of the Project. At the outset, I want to
express my deep gratitude to my guide and mentor Dr. Sarala, Assistant Professor at
IIHMR-Bangalore, for her support and timely guidance in helping me complete the study.
My heartfelt gratitude to my Industry Mentor Dr. Pramod D Jacob and Mr. Ramesh Sharma,
who rendered their valuable advice, precious time, knowledge and experience on the
domain and whose suggestions and guidance have immensely helped me in completion of
this Summer Training Report. I would also like to thank each and every employee of dWise
Healthcare IT Solutions, for their love and support throughout the summer training
programme. Their suggestions and guidance have been of great learning value.
My sincere Thanks to one and all!

5. 5
Table of Contents
Chapters Title Page Number
1. Organization Profile 1-6
2. HMIS 7- 13
3. Implementation 14-21
4. Primary Care HER 22-25

6. 6
Acronyms/Abbreviations
EHR Electronic Health Record
HIT Health Information Technology
ER Emergency Room
ICD International Classification of Diseases
LOINC Logical observation Identifiers Names &Codes
NANDA North American Nursing Diagnosis Association
CDSS Clinical Decision Support System
CPOE Computerized Physician Order Entry
CCR Continuity of Care Record
CCD Continuity of Care Document
CDA Clinical Document Architecture

7. 7
Executive Summary
 This report is compilation of all the assignment that is undertaken during the
Summer Training. The report presents in detail about the Hospital Management
Information System (HMIS) and Implementation Process of dwise Healthcare. In
addition, Primary Care EHR Management Software of dwise is discussed in detail.
As part of summer training, a study was carried out a) to understand the
acceptability of Primary care EHR by doctors (Bangalore) in clinics and reasons for
adoption and non-adoption of it. Interviewed schedule was developed and was
incorporated in the mobile app was used to collect the data from the respondents.
Convenient sampling was adopted to collect the data since; the list of clinics was not
available. Total number of doctors’ interviewed was 100. Findings of the study
revealed that a large number of (80 %) of the doctors are willing to use the primary
care EHR and are already using software. During the interview the doctors were
saying that they like to use the software since it reduces the treatment time, errors,
increase the quality of the treatment and can maintain the patients’ record for long
time and all the information about particular patients can be kept from the time of
birth. Reasons for non-adoption of EHR Software by doctor were a) Senior doctors
who are more than 60 years of age they rejected (1 out of 2) because they said they
are happy and comfort with traditional way of writing on paper b) Consumes time
since need to type the information clicking on respective tabs c) Doctor- patient
Interaction will be hampered/less attention to complaints shared by the patient and
d) Maintaintence of the internet speed is not possible. Other During visit many
clinics are not having proper infrastructure such as computer, internet connectivity
and proper setup of their clinic. Thus, it is recommended that a) Usage of EHR
Software can be increase by providing low internet speed and less set up by
software companies b) If that EHR software is more User-friendly then usage will
be more and c) EHR Software usage can be increase by initiative taken by
Government of India like tax reduction for EHR software using hosp

8. 8
Chapter I
Profile of the Organisation: dwise Healthcare Solutions
1.1 History of the Organisation
dwise Healthcare Solutions as Healthcare Domain Experts with a collective experience of
more than 100 Man years in the areas of Healthcare IT Software Development with
expertise in Cloud Engineering, Big Data & Analytics and Mobility solutions. They operate
with dedicated focus on EHR Technology Framework and have experience in developing
and deploying Healthcare IT products in highly competitive International Markets. They
developed a Cloud based Ambulatory EHR Solution for Primary Care and a complete
Inpatient EHR solution for Hospitals, for the US Healthcare industry, which received
“Meaningful Use (MU)” Stages 1 & 2 Certification. They also developed other Cloud based
products for the US Healthcare market such as a Financial Management Solution, a
Physician Credentialing Platform and a Geriatric Care Management product. Their products
are built on modern technology, comply with International and Indian EHR (Electronic
Health Records) standards. They have innovative company finding success and satisfaction
in being able to work closely with our clients in areas that are critical to their success. They
strive to support customers with best practices in Healthcare Management through the
domain & technology expertise and mature Healthcare IT Software Solutions. Their
solutions focus on customer delight. They are very nimble footed when it comes to speed of
implementation and they take great pride in being a thinking organization. They see each
engagement as an opportunity to collaborate with their clients and ensure maximum
return on their investment.
Vision
Lifetrenz was set up with the vision to become the leading provider of innovative and
economical Healthcare IT Solutions to help healthcare providers deliver safer healthcare
while bringing down the overall cost. Our Vision is to become the No.1 EHR Solution
provider in India by 2018.

9. 9
Mission
Constantly upgrade the technology and capabilities to address the evolving needs of the
Healthcare IT market by deploying best of breed technologies, people and domain
expertise aimed at enhancing the operational excellence of Healthcare organizations on the
LifetrenzPlatform.
1.2. What They Do
dwise build IT solutions that enable healthcare providers deliver safer healthcare,
economically, so as to make quality healthcare more affordable for people across all socio -
economic strata. The service, delivered as pay-per-user service, from public cloud platform
enables healthcare providers of all sizes and segments to consume these services as they
need. dwise service sits on top of an extensive and evolving knowledge base of information
and tools that enable the users of the service to improve the safety, quality and speed of
their work. Any professional person or organization in healthcare wishing to streamline
their practice and align their work to International Standards and best practices will find
that Lifetrenz makes this journey painless. Though there are many local and regional
players in this segment, it is largely fragmented and looked at more from an operations
perspective and not so much from the clinical delivery of care perspective. Lifetrenzturns
the table around to look at the whole solution from a patient centric perspective and makes
it possible to capture, store and retrieve patient clinical data using EHR standards. The EHR
Technology Framework of Lifetrenz is built on Open Source Technologies incorporating
features like scalability, exceptional all round security and minimal set-up and go-live
requirements, blending best of functionality with user-friendliness.
1.3. Location of the Company
dWise Healthcare is located only in Bangalore .

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1.4. Service Providedby the Organization
dwise mainly provides HMIS software and EHR & Clinical Information System (CIS) which
address the Clinical, Operational, Financial and Administrative workflows of a Hospital.Itis
a patient centric & standards compliant Hospital Management System, that is highly
configurable to provide automated, end to end, streamlined integration of various
processes in hospital like Outpatient Management, Inpatient Management,Operations,
Billing/Finance,Pharmacy,Lab,Radiology etc., in accordance with the workflows of hospital.
Lifetrenz HIS is a user friendly, and it can be and deployed in a short time. The key
differentiator between other solutions and dwise solution is it is a Patient Centric World
Class Solution, compliant to International/ Indian EHR & WHO Standards, such as ICD-10,
SNOMED-CT, LOINC, UMLS, Rx Norm, NANDA, NIC, NOC, DICOM, bringing down the cost of
delivery of healthcare without compromising on quality of car

11. 11
1.5.Organizational Structure
1.2 Importance ofITin Healthcare
Health IT (health information technology) is the area of IT involving the design,
development, creation, use and maintenance of information systems for the healthcare
industry. Automated and interoperable healthcare information systems are expected to
improve medical care, lower costs, increase efficiency, reduce error and improve patient
satisfaction, while also optimizing reimbursement for ambulatory and inpatient healthcare
providers
Electronic Health Record(EHR) is one such technology that can transform delivery of healthcare by
ensuring safer and better quality of care forpatients.
EHR
Electronic Health Record (EHR) is defined as a systematic collection of electronic health
information aboutindividual patients or populations. It is a record in digital format that is

12. 12
generated by one or more encounters over a period of time at differenthealthcare providers and
therefore it’s often referred to as a longitudinalrecord- rather than information from a single
visit to a doctor or hospital. It is capableof being shared across different healthcare settings.
Such records include a wholerange of data in comprehensive or summary form,including
patient demographics,medical history, progress notes, problems,medications and
allergies,immunisationstatus, laboratory test results, radiology images & reports, vital signs,
personal statuslike age, height, weight etc. Its purpose can be understood as a complete record
ofpatient encounters that allows the automation and streamlining of the workflow inhealth care
settings and increases safety through evidence based decision support,quality management,
and outcomes reporting.
Benefits of EHR
It helps the physicians to provide quality care.EHRs provide financial, clinical and administrative/
operational benefits toproviders. Few of the ways EHRs can help improve care are:
Access by Multiple Health Providers: Because it can be accessed by logging onto a computer,
EHR "travels" from doctor's office to doctor's office. This can be helpful in an urgent setting. If
someone isunconscious and cannot tell an emergency room doctor about an allergy to certain
medications, the ERdoctor will know from looking at that person's EHR. EHRs also make it easier
for primary doctor tocoordinate with any specialists he or she might refer. Everything they need to
know about a person'shealth is right at their fingertips.
No morehandwriting mishaps: The drawbacks to handwritten health records go beyond hard-to-
readhandwriting. When doctors and nurses take notes, they're more likely to abbreviate to save
time, andthere's always a risk they'll forget what they meant or that someone else looking at the
chart won'tunderstand the abbreviation and have to find out what it means. EHR software helps
clinicians be bothdetailed and fast by providing a series of prompts and dropdown menus to click
through.
Efficiency: When information is kept together in one central file, it helps doctors avoid ordering
testthat another doctor has already ordered. Eg: If a person consults a primary care physician
because of a knee hurt and if he or she orders an X-rayand then refers to an orthopaedic expert for

13. 13
treatment, that expert can also see the same X-ray. Then, if physical therapy is needed, the therapist
can see it too — along with both doctor's notes and thespecialist's notes.
Education: Being able to see one's own medical files helps the patients take part in own health
care.Apatient can view test results, keep track of things like blood glucose level, if the person is
diabetic or lungfunction for asthma patients, review the medical team's instructions, and even
check for errors.
Security: There's always the chance that paper records can get lost or misfiled or somehow
damaged.For example, paper medical records for thousands of patients were destroyed by
Hurricane Katrina in2005 in the US. There's less chance of this happening with electronic records.
Indian EHR Standards
EHR systems are built on published standards and this ensures that data is captured compliant
tostandards and makes them inter-operable or sharable among different healthcare organisations.
At
National level patient data becomes available to governments to do various kinds of analytics on
thepopulation health.The Ministry of Health, Govt of India, had set up a committee to finalise
standards for Electronic HealthRecords (EHR) in India and this committee submitted its final
recommendations to the Govt in April2013. These standards have been approved by MOH & FW,
Govt of India in August 2013 to be adoptedby Healthcare providers and hospitals providing
primary, secondary or tertiary care in India. Lifetrenzsolutions are the only solution available in the
country as on date that are fully compliant to thesestandards.
ComponentsofEHR
The various components or major parts a good EHR must have are:
Administrative system components
 Clinical Decision Support System (CDSS)
 Computerized physician order entry(CPOE)
 Clinical Documentation
 Laboratory,Radiology,Pharmacy system components
 Health information exchange

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Chapter II
Hospital Management Information System (HMIS) and
Implementation Process of dwise Healthcare
Section1: HMIS Modules
The HMIS Software consists of following Modules
2.1. Outpatient
It covers all the process like Patient Registration, Appointment Management, Billing,
Physician consultation Prescription for Medications, Laboratory Investigations, Radiology
tests and other OP services and their billing and patient check outs.
Out Patient (OP) Registration
This is very user-friendly and quick, thus removing a major bottleneck in a hospital’s OP
operations resulting in immense saving of valuable time for the patients. .
OP Registration has 3 main features
i) Quick Registration
A patient can be registered quickly in Lifetrenz using a Minimum Data Set with just Name,
Age and Gender. This ensures reduced registration time and avoids long and annoying
Queues at the Registration Counter. This also helps when registering a patient over a
telephone call (telephonic request for an appointment) or from the patient portal. A quick
registration can be converted to a full registration at any point in time.
ii) Avoids Duplicate Registrations
While registering a patient, the system automatically checks for possible duplicate records
for the same patient and help avoid duplicate registrations. This also ensures that a lifetime

15. 15
EHR is uniquely maintained for each patient; although, in case of duplication of patient
records, there is a feature available in Lifetrenz to merge.
iii) Unique Lifetime Master Patient Index (MPI)
It provides a unique, Patient ID for lifetime for each patient registered in the system. This
helps identify a patient uniquely, not only at the registering hospital but also across
multiple hospitals & clinics within the same group, avoiding duplication of records and
enabling care givers and patient’s seamless access across all hospitals/ clinics within the
chain, making the system a true EHR as opposed to an EMR. This unique MPI can be linked
to the UID (Aadhar Card) making it compliant with Indian EHR standards approved by GOI.
OP Appointment
OP appointment is done by front desk executive. Besides, Physicians also can give
appointments for the chain of clinics he is working. This module consists of the following
sub-modules such as i) Physician' Appointment across the same chain and ii) Re-scheduling
of Physicians appointments and iii) Re-scheduling of Physicians appointments
i) Physician Level Appointment
It consists of different type of appointments such as token based, fixed time slot based or
variable time based, at individual physician level. This means based on individual
physician's preference and patient load, the hospital can choose a flexible type of
appointment type that best meets the business objectives.
ii) Physician' Appointment across the same chain
For physicians practicing across different hospitals & clinics in the same chain, this
application allows appointments to be created at any of the hospital or Clinic within the
group, where the physician has practicing rights. This combined with seamless access to

16. 16
patient EHR from any of the location, brings in a different paradigm in patient convenience
and care delivery.
iii) Re-scheduling of Physicians appointments
It has the provision for bulk re-scheduling of any Physicians' appointments.For example, in
case of non-availability of a physician for a specific time period, all the appointments
scheduled for that period of practice by the physician can be rescheduled to another date
or a different physician.
OP Billing
It captures all the charges for services delivered to the patient.it includes consultations
charges , lab , Radiology , minor procedures and physiotherapy etc. here op billing system
is designed to accurately bill for all the services, taking inputs from the charge masters
created in hospital management solutions.
OP Consultation
This Process covers all the steps in an Out-Patient encounter with the Physician in a
Hospital.The Out-Patient Consultation process takes over the patient, after patient
registration. The Patient from appointment to Check-out. This involves processes such as -
Patient Pre-consultation with a Nurse or a Doctor's Assistant (Junior Consultant) before the
actual consultation with the Doctor, Doctor's consultation (History, Examination, Diagnosis
& Orders/ Plan of Management), Electronic Prescriptions for Medications, Lab & Radiology
services and other orders and fulfilment of all the e-Prescribed orders. All the processes are
captured and the billing is done automatically. The OP consultation process culminates
either in the Patient Check-out or admission as an In-Patient.

17. 17
OP Check-out Process
At the end of an Out-Patient visit, if the patient is advised a follow up at a later date, an
appointment can be created for the next visit, either directly by the physician or the
appointment desk.
2.2 IP Admission
IP admission process,an integral part of the ADT_ admission, discharge&Transferprocess of
the hospital. This process can also take e-admissions directly from out- patient
consultation(or) Emergency Room(or)Day Care, which enhances the efficiency of hospitals
operations
Inpatient-Nursing
IP nursing module aims to ensure easy adoption and usability by nurses with high work
load. Studies have shown a good electronic clinical documentation systems can save as
much as 24% of a nurse’s time, which can be productively used for patient care.
IP Physician Process: Appointments for follow-up patients is done by the physician.
Surgery Management
Scheduling and managing surgeries are critical tasks in a Hospital. Operation theatres and
associated activates are the nerve centre of hospital and performing the task of
savinghundreds of lives.

18. 18
Patient Transfer
During the process of IP encounter,many occasions arises where in a patient is required to
be transferred from one patient care location to another. It is important to track the location
of the patient at any given time and facilitates through the patient transfer feature, which is
part of the Admission discharge and Transfer(ADT) module. It also records any change in
room /bed or level of care which is important from the billing perspective so that correctand
accurate charges are made in patient’s bill.
Patient Discharge
It is a key activity in an In- patient management at any hospital. It’s an important factor.
This contributes to the patient satisfaction and operational efficiency of the hospital.
2.3 Emergency Room (ER)/ Day Care
The emergency room Being a fast dynamic , transient and high turnover
clinicalenvironment which needs quick registration, Triage and tracking of patients, speedy
andeasy input of data and orders ,high usage of protocols ,provision to handle Medico
legalcases and continuum of care, if patient is admitted to IP.
2.4 Traiage
EfficientTriage system enhances the efficiency and quality of care being delivered in the ER
department. It has in-built triage systems to assess the condition of the patients and decide
the course of the emergency care that needs to be delivered.According to this ‘transfer’ of the
patient done can be done from one department to another department and also admission
can be done in IC
2.5 Follow up
Follow up appointment is done by the physician and Front desk executives. It is designed for
delivering quality care quickly and without errors. It provides reliable andhigh quality patient
care.

19. 19
2.6 Discharge
ER/Day care module has all process from admission, Triage followed by clinicalassessment,
follow-up & ultimately the patient discharge process. At the end of ER/Daycare visit, the
patient may check out and back home or may be admitted to IP or may betransferred to
another healthcare facility. Lifetrenz has complete workflows to handle thescenarios.
Section2: ImplementationProcess ofHMIS
Implementation of HMIS consists of the following process:
1. Collection of Information from the hospitals
2. Mapping the requirements with the products
3. Realize the gaps
4. Configure: implementation team configure the things
5. Developing the team
6. On-site implementation
1. Collection of information from hospital (requirement gathering)
Information on the needs and requirements for both clinical and non-clinical are
collected from the hospitals. Clinicalinformation consists of details related to doctors,
treatment, and access for the doctor, construction assessment form, etc. Non-clinical
information consists of billing, dashboard management, finance management, charge
master management etc.Example: Few hospitalsrequire software for revenue
management whereas few don’t want. Therefore, it is vital to understand their needs in
detail.
2. Mapping the requirements with the products
Needs and requirements gathered from the hospital is compared with the existing
default software of dwise.
3. Realize the gaps
If any gaps found, it is informed to the developing team to develop the requirements.
They build the specific features to the requirements. If it is unique they will charge.

20. 20
4. Configure
Implementationteam configures the requirements in the software and thereafter starts
onsite implementation.During on-site implementation, training is provided to the staffs
for their respective fields of operation/work.
Approximately, it takes 1 week to on-site implementation of the software and training
the staffs. However, the time depends upon the bed size of the hospital.
Work flow
After implementation of the software, to support the hospital in-case of any problems,
support team from dwise is allocated to fix the tickets. Approximately, support is provided
to the hospitals for 2-5 days.
RequirementGathering
Map the Requirements with the products
Realize the gaps
Developing Team
Onsite Implementation
Training (hand holding, elbow support)

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Chapter III
Primary Care EHR Management
3.1 Primary Care EHR Management Software
Electronic Medical Records Software is a program that helps to convert and store the
medical record of a patient into a digital format. The information is usually places or stored
in a database that is accessible from anywhere via a secure network by authorized
personnel. Electronic Medical Records (EMR), or Electronic Health Records (EHR) contains
important data about the patient such as lab results, blood tests, inoculations, prescriptions
etc,. This app is mainly designed for doctors who are giving primary healthcare in clinics.
How to use the Practice Management of EHR for Doctors
 First registration needs to be done with doctors’ portal. There is no fee for
registration
 Then user name and pass word is send to Gmail account
 Can open the link through using the id and password
It consists of 8 modules. They are:
1. Appointment
2. Nursing
3. Consultant
4. Medical records
5. Reports
6. Alerts
7. Live chats
8. Social Tools
Alerts, Live Chart, Social Tools are under development.

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3.1.1 Appointment
Time scheduling will be available according to the doctors’ available timings and dates.It
consists of ‘new appointment’ and ‘confirmed appointments’ and ‘billing’. It also has the
option to ‘reschedule’ the appointment, ‘cancellation’ of the appointment.
Different colour coding is used for indicating the ‘status of appointment’ such as Available
-Green, Scheduled - Red, Elapsed – Purple, and Holiday - Ash Colour.
Image 3.1.1 Appointment
3.1.2 Nursing
In this module appointments list will appear, the nurse had to select the patient who needs
to be assessed and then click the tab ‘continue’ and start assessing the patient. Assessment
format includesa) subjective, b) objective, c) Diagnosis/assessment andd) plan
order(SOAP) to assess the patients. Home Screen of the app contains patient name, reason
for visit, appointment time, phone no, age etc.

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Image 3.1.2 Nursing module
a) Subjective (history) analysis consists of the following tabs
 Patient complaint
 History of present illness
 Past diagnosis
 Past procedure
 Patient allergy
 Family history
 History - Birth, Nutritional, Hearing and Phototherapy
 Life style history (diet, tobacco,sleep pattern, physical and occupation,Alcohol and
travel)
b) Objective Assessment (Examination)
In objective assessment clinical findings of the patient and patient clinical alert are not
active in nursing module. The objective assessment consists of the following tabs:
 Vitals

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 Growth chart
 General examination
c) Diagnosis: Diagnosis/Assessment is not active in the nursing module
d) Orders (PLAN)
It consists of home / active medication, medication, Lab, Radiology, Procedures, Other
orders (patient advice, diet advice, speech order, Immunization, Occupational therapy,
speech orders).
3.1.3 Consultation
In this module appointments list will appear, the nurse had to select the patient who needs
to be assessed and then click the tab ‘continue’ and start assessing the patient. Assessment
format includesa) subjective, b) objective, c) Diagnosis/assessment andd) plan
order(SOAP) to assess the patients. Home Screen of the app contains patient name, reason
for visit, appointment time, phone no, age etc.
Image3.1.3 Consultant Module

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a) Subjective (history) analysis consists of the following tabs
 Patient complaint
 History of present illness
 Past diagnosis
 Past procedure
 Patient allergy
 Family history
 History - Birth, Nutritional, Hearing and Phototherapy
 Life style history (diet, tobacco,sleep pattern, physical and occupation,Alcohol and
travel)
Image3.1.3 consultant Module
b) Objective Assessment (Examination)
In objective assessment clinical findings of the patient and patient clinical alert are not
active in nursing module. The objective assessment consists of the following tabs:
 Vitals
 Growth chart
 General examination
 Clinical Findings
 Patient clinical Alert

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c) DiagnosisAssessment
It consists of ‘Current Diagnosis’ and ‘Active diagnoses’.
d) Orders (PLAN)
It consists of home / active medication, Medication, Lab, Radiology, Procedures,Other
orders (patient advice, diet advice, speech order, occupational therapy, Immunization,
Occupational therapy, speech orders).
3.1.4 Medical Records
It consists of all patient related information like Name of the Patient, Master Personnel
Index (MPI),Gender, Phone No, Age, and ViewRecord Option. With the help of ‘View
Record’ the physician can access the complete record of the patient.
Image 3.1.4 Medical Records
3.1.5 Reports
Reports consists of a) Dashboard (How many new visits, how many old patients), b) Slot
utilization,c) Demographics Report, d) Billing Report.
a) Dash Board
In Dash board the physician or management can view the number of new and old patients.

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Image 3.1.5 a) Dash Board
b) Slot Utilization
This screen contains date, regular slot timings, waiting lists,elapsed slots, and completed
slots.
Image3.15 b) Slot Utilization
C) Demographics Report
In these complete details of the patient such asName of the Patient, Age, Gender, MPI No,
Aadhar No , Phone No, Email No.etc. is available.

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Image3.1.5 c) Demographic Report
d)Billing Report
In billing report, the following information will appear viz., bill no/item no, total
billamount, any concessions, payment mode.
Image3.1.5 d)Billing Report

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Chapter IV
Acceptability, Reasons for Adoption & Non-Adoption of Primary care
EHR among Doctors
4.1 Objectives of the Study
 To understand the acceptability of Primary care EHR by doctors in clinics
 To identify the reasons for adoption and non-adoption of Primary care EHR by
doctors in clinics
4.2 Methodology
Study Area:Bangalore
Tools of Data collection
Interviewed schedule was developed and was incorporated in the mobile app was used to
collect the data from the respondents.
Sampling
Convenient sampling was adopted to collect the data since; the list of clinics was not
available.
Sample Size
Total number of doctors’ interviewed was100
4.3 Findings of the Study
4.3.1 Acceptability of Primary care EHR by doctors in clinics

30. 30
A large number of (80%) of the doctors are willing to use the primary care EHR andare
already using software. During the interview the doctors were saying that they like to use
the software since itreduces thetreatmenttime, errors, increase the quality of the treatment
and can maintain the patients’ record for long time and all the information about particular
patients can be kept from the time of birth.
4.3.2 Reasons for adoption of EHR Software by doctor
 Can save time, space and money
 It is effective in reducing the possibility of human errors such as misspellings,
illegible handwriting and differing terminologies. This helps to standardizethe
patients’ health records.
 It eliminates the possibility of losing important information about the patient.
 Digital storage of important data can be kept forever without the risk of losing it and
preserve previous information that could be useful in the future treatment of the
patient.
 EHR Soft wear can help make health care cost-efficient by consolidating all the data
in one place. Paper records are generally located in different places and older
records may be stored in a locked room or even away from the office. EMR offers a
systematic approach. It allows you to easily access of the necessary data with a
computer. This also allows easier referral to specialists since complete medical
history of the patient is available.
 Increases patient profitability and serve up to 80 % on labs and up to 40% on
medical and office supplies, phone services and more.

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 It empowers the patient to take control over their health and improve outcomes
with an advanced patient portal that allows patients to engage with and become an
active part of their health care.
 Operation can be streamlined with a cloud based virtual officeassistant that shaves
hours of administrative tasks off each day.
 After Government of India guidelines, primary EHR is used by the primary doctors
working in small clinics as well as small hospitals.
S. No No. of. Doctors visited Acceptance of doctors /
already using HER
Not -interested
1 100 80 20
Reasons for non-adoption of EHR Software by doctor
 Senior doctors who are more than 60 years of age they rejected (1out of 2) because
they said they are happy and comfort with traditional way of writing on paper.
 Consumes time since need to type the information clicking on respective tabs
 Doctor- patient Interactionwill be hampered/less attention to complaints shared by
the patient
 Maintaintence of the internet speed is not possible
Infrastructure
 For the better EHR implementation healthcare infrastructure plays an important
role . During visit many clinics are not having proper infrastructure such as
computer.

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 There is no internet connectivity in clinic as internet connection required for
software implementation.
 The clinics don’t have proper setup of their clinic
Recommendations
 Usage of EHR Software can be increase by providing low internet speed and less set
up by software companies.
 If that EHR software is more User-friendly then usage will be more.
 EHR Software usage can be increase by initiative taken by Government of India like
tax reduction for EHR software using hospitals.