Toward an integrated ehealth infrastructure in India

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Toward an integrated e-health infrastructure in
India
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CONTEXT OF DHIS2 USE IN INDIA

• Managed and supported by HISP India since 2000
• Since 2008 DHIS2 is been used as the state
  specific application for intra-district in more
  than 20 states
• NHSRC has HISP India as technical support partner
  for software customization, capacity building,
  data analysis new application development
• Integrated e-Health systems represents the next
  wave of development

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Health System Information Flow
STATE HEAD QUARTER
State Level
Data Given
Feed Back
District TB Department District Malaria
Department District Leprosy Department District
Blindness Control Program Others
District Level
District Head Quarter (DPMU)
Block MOIC
CHC
CHC Level
PHC Level
PHC
PHC MOIC
Sector Level
Health Supervisor
Sub-Centre Level
ANM
ANM Register
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KEY FUNCTIONALITIES IN DHIS2 IN RELATION TO
INTEGRATION

• Represent a data warehouse which combines
  different forms of data (Data types, programs,
  periodicity, etc).
• Based on open standards.
• Integrates with existing systems in states and
  also with national web portal.
• Integrates different kinds of functionalities
  including tabular, graphical spatial.
• Flexible and modular in approach to incorporate
  new demands for integration from state and
  national level.

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FRAMEWORK FOR TECHNICAL INTEGRATION BASED ON
DATA WAREHOUSE APPROACH

• Unified System for
• Reporting
• Dashboard
• Data Validation
• GIS

Malaria
RCH
HIV/AIDS
RNTCP
Others
NLEP
Various Systems in their individual
formants/database
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DHIS 2 INCREMENTALLY BEING ENHANCED TO INCLUDE
Logistics

Drug Management
Hospital information system
Human Resource
Program Management
DHIS 2
Lab Monitoring system
Name based tracking system for ANC and
immunization
Mobile based reporting from sub centers
Finance Management
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Block
GSM Gateway SERVER
Feed-back
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Computerized PHC
PHC
GSM Gateway SERVER
Feed-back
ANM at Subcentre
Mobile Phone
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Health Care Burden
Clinics!
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• Locating/tracking individuals e.g. ANC,
  immunisation
• Activity planning
• Outreaching

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• Hierarchical approach with a village/community
  as an entry point
• Identifcation mechanism Name? Unique ID?...
• Issue of migration

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Integration across Health Program

• Leprosy

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TELEMEDICINE GPS 108
HANDICAP
DLIMS
ICDS
OTHER PROGRAMMES
SCHOOL HEALTH
HMIS
DHIS
CRS UNIQUE ID NO.
HANDICAP
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Challenges in Developing an Integrated e-Health
Architecture

• Building awareness in state about the relevance
  and usefulness of integration e-Health
  Architecture.
• Dealing with the institutional bottlenecks-
  donors, program specific systems, etc.
• The heavy use of proprietary systems which
  impede integration.
• Poor infrastructure, especially internet capacity
  
• Existing users have historically worked in silo
  based systems

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Approaches being adopted to meet the challenges

• Taking even small success stories and telling
  other states
• Getting buy-in at the national level for
  integration by showing them existing success
• Using open source, platform independent and open
  standards for integration.
• Using innovative technologies like mobile phones
  to facilitate integration.
• Using combination of Off-line On-line
  deployment
• Education users about advantages about
  integration

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THANK YOU
NAMASTHE