Public health it study report
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Dr. Pankaj Gupta presented on health information and innovation in India. He discussed how current public health IT systems are siloed and not integrated. He proposed creating a National E-Health Authority to define a national e-health architecture with standards and interoperability. This would include state health information exchanges, a national health information network, and use of telemedicine and mHealth to support disease management and health outcomes. The goal is to move from isolated systems to an integrated approach that supports data-driven decision making across health programs and levels of care.
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Public health it study report
- 1. CONFIDENTIAL AND PROPRIETARY TO THE PARTIES IN DISCUSSION. Contact: Dr Pankaj Gupta Partner, Taurus Glocal Consulting Independent Consultant, NHSRC. Member ICT Sub-Group of Healthcare SIC under PMO GOI. Dr_pankajgupta@yahoo.com drgupta@taurusglocal.com Website: www.taurusglocal.com Blog: http://www.healthcareitstrategy.blogspot.com/ LinkedIn: http://www.linkedin.com/in/drpankajgupta
- 2. • India has been very ingenious in finding workarounds but we have lost it along the way to modernization • Organizations not designed ‘ground up’ for innovation will not be creative. Innovation can be extraordinarily disruptive. • Culture of innovation has to be nurtured in the country. • Must work with all stakeholders to select and deploy innovative improvements that measurably improve service quality and provides truly ‘out of the box’ thinking to the country. 2010-2020 DECLARED AS DECADE OF INNOVATION I N N O V A T I O N I S A C U L T U R E N O T A S T R A T E G Y
- 3. NATIONAL INNOVATION COUNCIL [NINC] CREATED TO PROMOTE INNOVATION IN THE COUNTRY Transformative Leadership Next Practices Process Innovation Incremental Improvements Existing Operational ModelsObsolete Resilience Business as Usual Short Term Gains Long Term Success
- 4. ICT SUBGROUP OF HEALTH SECTOR INNOVATION COUNCIL IS PART OF NINC
- 5. Next Practices Where we want to be Where we are today Quantum Leap in Planning Paradigm Work backwards from where we want to be, to develop the Execution Plan to get there, not the reverse NEXT PRACTICES - INNOVATION
- 6. o Process: o Consultation with program officers o Review of the literature on Public Health ICT o Study of innovations in Health care ICT o Functional Specifications of Public Health IT Systems o Study of IT systems for Tele- medicine o Study of Hospital Information Systems o Mandate: o To document various ICT innovations in healthcare o To identify drivers of innovation o To understand failures & successes and reasons associated o Prepare & promote sustainable ‘eco system’ for ICT innovations in healthcare CURRENT INNOVATION IN HEALTH ICT Systems Studied NRHM-RCH National Program Specific innovations National HMIS Web Portal NACO- Strategic Information Management System DHIS 2.0 Integrated Disease Surveillance Project (IDSP) MCTS- Tracking System National Malaria Control Program -NAMMIS State Specific innovations Other Innovations Gujarat- eMAMTA, Tripura Tele-ophthalmology application Tamil Nadu- State HMIS (TCS) Kerala Tele-oncology application Andhra Pradesh – Historical HMIS Development
- 7. ALL PUBLIC HEALTH IT SYSTEMS ARE IN SILOS Nutrition Block Facility MCTS – Reprod. & Child Health System at National Level NACO National Disease Program Hospital Informati on Systems, EMR State Health Program s e.g. EMRI, eMamta, HMIS, DHIS Birth & Deaths Private Sector MOHFW District Admin State HQ Directorates e.g. Malaria, IDSP, NACO IDSP National Disease Program Malaria National Disease Program RNTCP National Disease Program Web portal – Reprod. & Child Health System at National Level o Programs/ directorates/ states have their own IT solutions for program reporting needs. o Silos - All systems functioning in silos and doesn’t help in integrated decision making. o Standards lacking – Architecture, I/O Data standards, Disease and Service codes, Interoperability standards. o Design issues- Developed as Application for single purpose not as products o Capacity building - change management is limited o Process transformation - business process reengineering not done
- 8. PROPOSED NATIONAL E-HEALTH AUTHORITY TO DEFINE THE NATIONAL E-HEALTH ARCHITECTURE E-Health Architecture: Key features Information exchanges [HIE], State & National. Registries and UID Set of Standards Flexible Data Input Flexible Data Output Online and offline modes Integration across systems Single System for field workers Multi modal connectivity Data privacy and security ICT for quality of care Capacity Building Procurement standardization
- 9. STATE HEALTH INFORMATION EXCHANGE – PROPOSED ARCHITECTURE Block1 Block2 Facility1 Facility2 Facility3 District Admin State HQ Reprod. & Child Health at National Level Hospital Informati on Systems, EMR Reports National Disease Program s e.g. Malaria, IDSP, NACO State Health Program s e.g. EMRI, HMIS, DHIS Nutrition Birth & Deaths Private Sector As per Privileges Facility1 Facility2 Facility3 Private Sector MOHFW Reprod.& Child Health Directorates e.g. Malaria, IDSP, NACO Data Warehouse Disease Registry Provider Registry Patient Registry [UID] Facility Registry Document Registry Service Registry Most states have a paper based system that collects aggregate data which is converted to electronic form only at District level
- 10. STATE HEALTH INFORMATION EXCHANGE – PROPOSED ARCHITECTURE Nutrition Block1 Block2 Facility1 Facility2 Facility3 Reprod. & Child Health at National Level District Admin State HQ National Disease Program s e.g. Malaria, IDSP, NACO Hospital Informati on Systems, EMR Reports State Health Program s e.g. EMRI, eMamta, HMIS, DHIS Birth & Deaths Private Sector As per Privileges Facility1 Facility2 Facility3 State1 Health Information Exchange Portal Block1 Block2 Facility2 Facility3 Reprod. & Child Health at National Level Hospital Informati on Systems, EMR National Disease Program s e.g. Malaria, IDSP, NACO State Health Program s e.g. EMRI, HMIS, DHIS Nutrition Birth & Deaths Private Sector Facility1 Facility2 Facility3 Private Sector MOHFW Reprod.& Child Health Directorates e.g. Malaria, IDSP, NACO Payers Patient Private and Govt. E.g. RSBY, JSY Data Warehouse Disease Registry Provider Registry Patient Registry [UID] Payment Registry Facility Registry Service Registry Document Registry Some states have built capacity to collect patient-based data thru broadband and mobile from the facility level
- 11. PROPOSED NATIONAL HEALTH INFORMATION NETWORK State2 Health Information Exchange State1 Health Information Exchange Portal Portal Nutrition Private Sector Block1 Block2 Facility1 Facility2 Facility3 Block1 Block2 Facility1 Facility2 Facility3 Reprod. & Child Health at National Level MOHFW District Admin State HQ National Disease Program s e.g. Malaria, IDSP, NACO Hospital Informati on Systems, EMR Reprod. & Child Health at National Level Hospital Informati on Systems, EMR Reprod.& Child Health Directorates e.g. Malaria, IDSP, NACO Indicators Indicators Reports Reports National Disease Program s e.g. Malaria, IDSP, NACO State Health Program s e.g. EMRI, eMamta, HMIS, DHIS State Health Program s e.g. EMRI, HMIS, DHIS Birth & Deaths Private Sector Nutrition Birth & Deaths Private Sector As per Privileges As per Privileges Facility1 Facility2 Facility3Facility1 Facility2 Facility3 National Health Information Network Payers Patient Private and Govt. E.g. RSBY, JSY Data Warehouse Disease Registry State Registry Indicator Registry Payment Registry Patient Registry [UID] Service Registry
- 12. State2 Health Information Exchange State1 Health Information Exchange Portal Portal Portal Nutrition Private Sector Block1 Block2 Facility1 Facility2 Facility3 Block1 Block2 Facility1 Facility2 Facility3 Reprod. & Child Health at National Level MOHFW District Admin State HQ National Disease Program s e.g. Malaria, IDSP, NACO Hospital Informati on Systems, EMR Reprod. & Child Health at National Level Hospital Informati on Systems, EMR Reprod.& Child Health Directorates e.g. Malaria, IDSP, NACO Indicators Indicators Reports Reports National Disease Program s e.g. Malaria, IDSP, NACO State Health Program s e.g. EMRI, eMamta, HMIS, DHIS State Health Program s e.g. EMRI, HMIS, DHIS Birth & Deaths Private Sector Nutrition Birth & Deaths Private Sector As per Privileges As per Privileges Facility1 Facility2 Facility3Facility1 Facility2 Facility3 National Health Information Network Payers Patient Reports As per Privileges Private and Govt. E.g. RSBY, JSY PROPOSED NATIONAL E-HEALTH ARCHITECTURE
- 13. Hospital Pharmacy Telemedicine Patient Lab/ Rad Payers Health Information Exchange for Disease Management E-HEALTH ARCHITECTURE WILL ENABLE M-HEALTH AND TELEMEDICINE FOR DISEASE MANAGEMENT Ambulance
- 14. HEALTH INFORMATION SYSTEMS PILLAR SUPPORTS HEALTH OUTCOMES Report of Planning Commission’ Steering committee on Health has dedicated chapter 3 for HIS
- 15. THANKS Contact: Dr Pankaj Gupta Partner, Taurus Glocal Consulting Independent Consultant, NHSRC. Member ICT Sub-Group of Healthcare SIC under PMO GOI. Dr_pankajgupta@yahoo.com drgupta@taurusglocal.com Website: www.taurusglocal.com Blog: http://www.healthcareitstrategy.blogspot.com/ LinkedIn: http://www.linkedin.com/in/drpankajgupta