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Computerization & EMR implementation in hospitals in developing countries using indigenous solutions Dr Deepak Agrawal Ass...
CASE STUDY (JPNATC) <ul><li>Two buildings (5 floors + 8 floors) </li></ul><ul><li>8 specialties, 175 beds </li></ul><ul><l...
CASE STUDY (JPNATC) <ul><li>Dual network (wired & wireless) </li></ul><ul><li>Computers with internet in all patient areas...
CASE STUDY (JPNATC) <ul><li>NETWORKING </li></ul><ul><li>Wired network (52 nodes) </li></ul><ul><ul><li>6 months </li></ul...
THIN CLIENTS-TCO US $ 1000
Computers <ul><li>110 Thin Clients   US$ 58510 </li></ul><ul><li>6 servers  US$ 28787 </li></ul><ul><li>6 Network laser pr...
SOFTWARE <ul><li>Vista EHR </li></ul><ul><ul><li>Open source (free to download & use!) </li></ul></ul><ul><ul><li>Develope...
Software (Vista EHR) <ul><li>Installation, Customization & support done free of cost by local vendor </li></ul><ul><li>Tot...
PACS <ul><li>7 license GE PACS solution (Centricity®) with 5 year maintenance contract </li></ul><ul><li>Total cost US$ 51...
Computerization Assistance Team & Support <ul><li>(CATS) </li></ul><ul><ul><li>Hardware & Printer issues </li></ul></ul><u...
CATS <ul><li>Data entry operators </li></ul><ul><li>Especially trained for CATS </li></ul><ul><li>Presently 7 CATS personn...
Mobile computing
Current status <ul><li>HIS (Vista EHR)) </li></ul><ul><ul><li>Registration </li></ul></ul><ul><ul><li>ADT (admission, disc...
 
Interfacing of Lab equipment
Current status (PACS) <ul><li>Running on Wi-fi </li></ul><ul><li>CT,MRI & X-ray (Including portable Xray’s) are available ...
PACS @ home
COST BENFIT ANALYSIS <ul><li>FIXED COSTS </li></ul><ul><ul><li>Networking  US$ 17768 </li></ul></ul><ul><ul><li>Hardware  ...
COST BENFIT ANALYSIS <ul><li>Recurring costs/ year </li></ul><ul><ul><li>Software US$ 51060/ year </li></ul></ul><ul><ul><...
COST BENFIT ANALYSIS <ul><li>TOTAL COST of COMPUTERIZATION OVER 1 YEAR </li></ul><ul><li>US$ 174009 </li></ul>
COST BENFIT ANALYSIS <ul><li>Cost Savings </li></ul><ul><li>Annual cost of films at JPNATC (2006-2007) Approx US$153191 </...
COST BENFIT ANALYSIS <ul><li>Total saving in the very 1 st  year of computerization </li></ul><ul><li>US$ 46808! </li></ul>
OTHER BENIFITS <ul><li>Tangible   benefits </li></ul><ul><ul><li>Access to Data </li></ul></ul><ul><ul><li>Electronic pati...
CONCLUSIONS <ul><li>A very high level of computerization is possible in India using non-proprietary technology and methods...
THANK YOU
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Computerisation of hospitals in developing countries

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Computerisation of hospitals in developing countries

  1. 1. Computerization & EMR implementation in hospitals in developing countries using indigenous solutions Dr Deepak Agrawal Assistant Professor, Neurosurgery JPN Apex Trauma centre, All India Institute of Medical Sciences, New Delhi, India A cost benefit analysis
  2. 2. CASE STUDY (JPNATC) <ul><li>Two buildings (5 floors + 8 floors) </li></ul><ul><li>8 specialties, 175 beds </li></ul><ul><li>Till Sep 2006 </li></ul><ul><li>No networking </li></ul><ul><li>No internet </li></ul><ul><li>No PACS </li></ul><ul><li>No HIS/EMR </li></ul>
  3. 3. CASE STUDY (JPNATC) <ul><li>Dual network (wired & wireless) </li></ul><ul><li>Computers with internet in all patient areas </li></ul><ul><li>Server-client architecture with standalone facility </li></ul><ul><li>Thin clients </li></ul><ul><li>PACS </li></ul>
  4. 4. CASE STUDY (JPNATC) <ul><li>NETWORKING </li></ul><ul><li>Wired network (52 nodes) </li></ul><ul><ul><li>6 months </li></ul></ul><ul><ul><li>Cost US$ 15744 </li></ul></ul><ul><li>Wireless network (full campus) </li></ul><ul><ul><li>3 weeks </li></ul></ul><ul><ul><li>Cost US$ 2042 </li></ul></ul><ul><li>Total Networking cost= US$ 17786 </li></ul>
  5. 5. THIN CLIENTS-TCO US $ 1000
  6. 6. Computers <ul><li>110 Thin Clients US$ 58510 </li></ul><ul><li>6 servers US$ 28787 </li></ul><ul><li>6 Network laser printers US$12766 </li></ul><ul><li>Total hardware cost= US$ 100063 </li></ul>
  7. 7. SOFTWARE <ul><li>Vista EHR </li></ul><ul><ul><li>Open source (free to download & use!) </li></ul></ul><ul><ul><li>Developed by US government </li></ul></ul><ul><ul><li>Rated No 1 HIS/EMR software in the world </li></ul></ul><ul><ul><li>Installed in all US Veterans hospitals </li></ul></ul><ul><ul><li>Full enterprise solution </li></ul></ul>
  8. 8. Software (Vista EHR) <ul><li>Installation, Customization & support done free of cost by local vendor </li></ul><ul><li>Total software cost= US$0 </li></ul><ul><li>Mantainence= US$51060/year </li></ul>
  9. 9. PACS <ul><li>7 license GE PACS solution (Centricity®) with 5 year maintenance contract </li></ul><ul><li>Total cost US$ 5100/ year </li></ul>
  10. 10. Computerization Assistance Team & Support <ul><li>(CATS) </li></ul><ul><ul><li>Hardware & Printer issues </li></ul></ul><ul><ul><li>Username & password issues </li></ul></ul><ul><ul><li>Training on HIS & PACS </li></ul></ul><ul><ul><li>Resolution of end-user issues </li></ul></ul>
  11. 11. CATS <ul><li>Data entry operators </li></ul><ul><li>Especially trained for CATS </li></ul><ul><li>Presently 7 CATS personnel </li></ul><ul><ul><li>Neurosurgery, Ortho & Surgery, Emergency medicine </li></ul></ul>
  12. 12. Mobile computing
  13. 13. Current status <ul><li>HIS (Vista EHR)) </li></ul><ul><ul><li>Registration </li></ul></ul><ul><ul><li>ADT (admission, discharge & transfer) </li></ul></ul><ul><ul><li>CPRS (Computerised Pt record system) </li></ul></ul><ul><ul><ul><li>Computerized casualty note, admission note, operation note & discharge summary </li></ul></ul></ul><ul><ul><li>Lab interface functional </li></ul></ul><ul><ul><li>Appointment system </li></ul></ul><ul><ul><li>Full digital archival of all patient records </li></ul></ul>
  14. 15. Interfacing of Lab equipment
  15. 16. Current status (PACS) <ul><li>Running on Wi-fi </li></ul><ul><li>CT,MRI & X-ray (Including portable Xray’s) are available in near-real-time </li></ul><ul><li>Any pts imaging can be seen on any computer (ward, ICU, casualty, OT) </li></ul><ul><li>75% FILMLESS!! </li></ul>
  16. 17. PACS @ home
  17. 18. COST BENFIT ANALYSIS <ul><li>FIXED COSTS </li></ul><ul><ul><li>Networking US$ 17768 </li></ul></ul><ul><ul><li>Hardware US$ 100063 </li></ul></ul><ul><ul><li>TOTAL US$ 117831 </li></ul></ul>
  18. 19. COST BENFIT ANALYSIS <ul><li>Recurring costs/ year </li></ul><ul><ul><li>Software US$ 51060/ year </li></ul></ul><ul><ul><li>PACS US$ 5100/ year </li></ul></ul><ul><ul><li>TOTAL US$ 56160/ year </li></ul></ul>
  19. 20. COST BENFIT ANALYSIS <ul><li>TOTAL COST of COMPUTERIZATION OVER 1 YEAR </li></ul><ul><li>US$ 174009 </li></ul>
  20. 21. COST BENFIT ANALYSIS <ul><li>Cost Savings </li></ul><ul><li>Annual cost of films at JPNATC (2006-2007) Approx US$153191 </li></ul><ul><li>Saving with PACS @ 75% filmless </li></ul><ul><li> US$ 106382/ year </li></ul>
  21. 22. COST BENFIT ANALYSIS <ul><li>Total saving in the very 1 st year of computerization </li></ul><ul><li>US$ 46808! </li></ul>
  22. 23. OTHER BENIFITS <ul><li>Tangible benefits </li></ul><ul><ul><li>Access to Data </li></ul></ul><ul><ul><li>Electronic patient records </li></ul></ul><ul><ul><li>Laboratory Interfacing </li></ul></ul><ul><li>Intangible Benefits </li></ul><ul><ul><li>Improves Efficiency & quality of pt care </li></ul></ul><ul><ul><li>Decreases errors </li></ul></ul><ul><ul><li>Archival of patient data </li></ul></ul>
  23. 24. CONCLUSIONS <ul><li>A very high level of computerization is possible in India using non-proprietary technology and methods </li></ul><ul><li>Can be done very cost-effectively </li></ul><ul><li>Computerization has to be implemented by doctors themselves in order to succeed </li></ul>
  24. 25. THANK YOU

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