he healthcare industry in India faces several challenges, ranging from infrastructure and access to healthcare services to regulatory issues and affordability. Some of the key challenges include: Infrastructure and Resource Constraints: India's healthcare infrastructure is often inadequate, especially in rural areas. There is a shortage of hospitals, clinics, beds, medical professionals, and essential medical equipment. This imbalance between demand and supply leads to overcrowding in healthcare facilities and compromises the quality of care. Accessibility and Geographic Disparities: Accessibility to healthcare services varies significantly across different regions of India. Rural areas often lack basic healthcare facilities, forcing people to travel long distances for treatment. This geographic disparity exacerbates healthcare inequalities, with urban populations having better access to healthcare compared to rural populations. Affordability and Financial Barriers: Healthcare costs in India can be prohibitively expensive for many people, particularly those from low-income backgrounds. Out-of-pocket expenditure on healthcare is high, pushing many families into poverty. Lack of comprehensive health insurance coverage further exacerbates financial barriers to accessing quality healthcare services.

1. Dr. Rashmi Nasra
Quality & Operations Head
Sohana, A Superspeciality Hospital, Mohali
Healthcare- Scope & Challenges
Medical records - Scope & Challenges

4. Sectors In Healthcare
• Human Resource
• Health Operations
• Health Finance
• Health I T
• Health Infra
• Health Insurance – Govt and
Pvt.
• Health Device
Manufacturing
• Pharmaceuticals
• Biotechnology
• Healthcare equipment &
Services – BME, Surgical and
Non Surgical

6. 2023-2024
The Indian Healthcare industry continued its healthy growth
in 2023 and reached a value of USD 372 bn/ 30973.87 driven
by both private sector and government.
The Indian healthcare industry is expected to reach a
valuation of USD 132 billion by 2023 growing at a CAGR of
16-17%. The sector needs to be more cohesive, with many
small and medium-sized startups.
The digital transformation of India's healthcare industry has
the potential to accelerate tenfold, from $2.7 billion in 2022
to approximately $37 billion by 2030, a report by Boston
Consulting Group (BCG) and B Capital said.

16. Trends after COVID19
1. Telemedicine
2. Artificial Intelligence
3. Remote Patient Monitoring
4. Robotic Surgery-DA Vinci
5. 3dPrinting

17. Healthcare Record Keeping
Dr. Rashmi Nasra

18. Health records = information
Information is a vital asset
It facilitates the provision of healthcare to individuals but is also key to the
efficient management of services and resources.
It plays a key part in:
clinical governance,
service planning and
performance management.
Thus ,it’s essential that information is effectively managed and that
appropriate policies, procedures, protocols and guidelines (PPPGs) and
organizational structures provide a robust governance framework.

19. What is a healthcare record.
It is an essential part of care allowing communication between
healthcare professionals which demonstrates that the practitioner’s
duty of care has been fulfilled.
The healthcare record refers to all information collected, processed
and held in both manual and electronic formats pertaining to the
service user and their care.
It includes demographics, unique identification, clinical data, images,
investigations, samples, correspondence and communications
relating to the service user and his/her care.

20. Record /(Information) has most value when it is accurate, up to date
and accessible when it is needed.
An effective records management service ensures that:
• information is properly managed,
• is available whenever and wherever there is a justified need
for that information,
• in whatever medium it is required and
• which is compliant with the relevant legislation.

22. Healthcare Records Management
Healthcare records management is the systematic and consistent
control of all healthcare records throughout their lifecycle:
systematic procedure - records are managed in a planned and
methodical way.
consistent - records of the same kind are managed in the same way.
Whether electronic or paper, the management of the record should
be consistent.

23. Consistency over time - managing records is always vital whether
resources are adequate or scarce.
Control - organizations need to control how records are produced,
received, organized, registered, stored, retrieved, retained, destroyed
or permanently preserved.
All records - this includes all documents, active and inactive, formal
and informal, regardless of the medium in which they are held.

24. Various forms of records.
a. service user healthcare records (electronic or paper based,
including those concerning all specialties).
b. emergency department, birth, death, minor operations and other
related registers.
c. x-ray and imaging reports, output and images.
d. photographs, slides, and other images.
e. microform (i.e. microfiche/microfilm).
f. audio and video tapes, cassettes, CD-ROM etc.
g. computerized records & scanned records.

25. Problems in records management in Hospitals
• Absence of clarity e.g. the meaning of 'Had a good day'
and ‘slept well’ is not clear.
• Failure to record action taken when a problem is
identified, e.g. 'is suffering increasing pain' then no
record of action taken.
• Missing information, e.g. administration of a drug not
documented. (MEDICATION ERROR)
• Spelling mistakes, e.g. error in name resulting in wrong
diagnosis.(LEGIBLE WRITINGPRESCRIPTION AND
TRANSCRIPTION)
• Inaccurate records, e.g. changing a dressing or giving
medication, when in fact the patient had not received the
recorded treatment. (DISCREPENCY)

27. Electronic Health Records.
is a digital format or documentation of an individual’s medical history
that is maintained by health care providers or health institutions.
It includes information on patient’s demographics progress notes,
medication problems, vital signs, past history, diagnostic results and
vaccination.

29. Benefits of EHR
Medical errors
EHR enables patients’ safety by eliminating medical error through
illegible handwriting by physicians. Medical documentation in EHR
appears to be clear and legible and thus reduces legal implications.
Fewer forms to fill out during a visit.
Fewer repetitive questions – regarding past medical history.
Alert system ensure proper dosage and drugs are administered.

30. Improves patients quality of life.
EHR assist in better disease management and client education.
It also enhances communication among healthcare providers.
When patient are educated and healthcare providers work collaboratively b
patient outcome is achieved.

31. Practices to ensure good record keeping.
When a healthcare record has been closed, no further documents
(from that date forward) should be added.
All documents received for filing should bear the appropriate record
number of the healthcare record in which it is to be filed.
Paper clips and pins should be removed from documentation before
filing, as these can damage the paper and if rusted can be a health
hazard.

32. • Healthcare record covers should provide adequate protection for
the documentation contained within and should be replaced if
they become torn or damaged.
• Healthcare records should not contain any loose documentation.
• Avoid duplication of documentation — only one copy of each
document should be filed unless notes have been made on a copy
before the original was issued.

33. Healthcare records should not start with a document referring to
another document that is not in the healthcare record (copy from
previous volume if necessary).
Everyone has a responsibility to ensure that all documentation is filed
in the correct order in the appropriate healthcare record.
The staff member who initiates a document is responsible for filing it,
or ensuring that it is filed.

34. Disadvantages
Technical matters (uncertain quality, functionality, ease of use, lack of
integration) with other applications.
Financial matters - particularly applicable to non-publicly funded
health service systems (initial costs for hardware and software,
maintenance, upgrades, replacement)
Resources issues - training and re-training
Resistance by potential users - implied changes in working practices.
Certification, security, ethical matters; privacy and confidentiality
issues.
Incompatible with other systems.

35. EHR in India
Government of India intends to introduce a uniform system for maintenance of
Electronic Medical Records / Electronic Health Records (EMR / EHR ) by the
Hospitals and healthcare providers in the country.
An Expert committee was set up to develop EMR / EHR Standards for adoption /
implementation in the country. Draft EMR / EHR Standards were hosted on the
website of the Ministry soliciting comments from the stakeholders and general
public.
After due consideration of the recommendation of the Committee and the
comments received thereon, the 'Electronic Health Record Standards for India'
have been finalized and approved by the Ministry of Health and Family Welfare,
Government of India.

36. National Health Portal-Gateway to authentic health
information for all.
The Ministry of Health and Family Welfare, Government of India has set up the
National Health Portal in pursuance to the decisions of the National Knowledge
Commission, to provide healthcare related information to the citizens of India and
to serve as a single point of access for consolidated health information.
The National Institute of Health and Family Welfare (NIHFW) has established Centre
for Health Informatics to be the secretariat for managing the activities of the
National Health Portal.

37. Information security act
No generally accepted set of security standards or general
requirements for protecting health information existed in the health
care industry.
At the same time, new technologies were evolving, and the health
care industry began to move away from paper processes and rely
more heavily on the use of electronic information systems to pay
claims, answer eligibility questions, provide health information and
conduct a host of other administrative and clinically based functions.

38. Bioinformatics

39. WHAT?
Bioinformatics is an interdisciplinary field that develops methods and
software tools for understanding biological data.
combination of biologists ,statisticians and computer scientists.
Because of this collaboration researchers began to understand the
genes associated with certain diseases in a better way.
It involves managing, analyzing and interpreting information from
biological structures.

40. Relation with EHR
Genetic testing is expected to play a critical role in patient care in the near future.
genetic and genomic information will play an increasingly important role in health in
the future
EHRs have become increasingly essential to managing the wealth of existing clinical
information that now includes genetic information extracted from the patient
genome.
EHR is capable of changing health care in the future by transforming the way
physicians use genomic information in the practice of medicine

41. Case Study
A woman enters the emergency room with
stomach pain. She undergoes a CT scan
and is diagnosed with an abdominal aortic
aneurysm, a weakening in the wall of the
aorta which causes it to stretch and bulge
(this is very similar to what led to John
Ritter's death). The physicians inform her
that the only way to fix the problem is
surgically, and that the chances of survival
are about 50/50.

42. They also inform her that time is of the essence, and that
should the aneurysm burst, she would be dead in a few
short minutes. The woman is an erotic dancer; she
worries that the surgery will leave a scar that will
negatively affect her work; therefore, she refuses any
surgical treatment. Even after much pressuring from the
physicians, she adamantly refuses surgery. Feeling that
the woman is not in her correct state of mind and
knowing that time is of the essence , the surgeons
decide to perform the procedure without consent. They
anesthetize her and surgically repair the aneurysm. She
survives, and sues the hospital for millions of dollars.

43. Case Study
• You are a general practitioner and a mother comes
into your office with her child who is complaining of
flu-like symptoms. Upon entering the room, you ask
the boy to remove his shirt and you notice a pattern
of very distinct bruises on the boy's torso. You ask
the mother where the bruises came from, and she
tells you that they are from a procedure

44. • she performed on him known as "cao gio," which
is also known as "coining." The procedure
involves rubbing warm oils or gels on a person's
skin with a coin or other flat metal object. The
mother explains that cao gio is used to raise out
bad blood, and improve circulation and healing.
When you touch the boy's back with your
stethoscope, he winces in pain from the bruises.
You debate whether or not you should call Child
Protective Services and report the mother