Tele-health and Rural Empowerment

1
Tele-health and Rural Empowerment
Prof. CM Pandey Sub Dean and Head Department of
Biostatistics and Health Informatics Sanjay
Gandhi Postgraduate Institute of Medical
Sciences Lucknow-226014, India Email
cmpandey_at_sgpgi.ac.in
2
Presentation Outline

• Health Situation in Amethi and around
• Role IT in Rural Health Care
• Hospital Information Systems and EMR

3
Part 1 Local Health Situation
4
District Sultanpur
5
Sample summary
Reference Period 2004-5
Clusters covered 30
Total households 1216
Total population 9440
Eligible women participated 1150
Pregnancy history 3808
Recently delivered mothers 252
Children 0-35 months 759
6
Village profile
7
Access to health facility
Facilities within 1 km from the village
8
Medical practitioners in village
System of medicine Percent villages having practitioners Percent villages having practitioners Percent villages having practitioners Percent villages having practitioners
System of medicine 1-4 5-8 gt8 None
Allopathic 26.7 3.3 3.3 66.7
Ayurvadic 03.3 0.0 0.0 96.7
Unani 03.3 0.0 0.0 96.7
Homeopathic 20.0 3.3 0.0 76.7
Bone setters 43.3 0.0 0.0 56.7
Others 33.3 16.7 10.0 40.0
9
Housing condition
10
Household facilities
Main source of light Electricity Kerosene or gas Others 64.31 28.20 07.07
Sanitation facility Own flush toilet Own pit toilet Shared toilet (any type) Public toilet (any type) No toilet facility 6.99 0.82 9.21 0.00 82.98
Main cooking fuel LPG/electricity Kerosene Other 12.83 1.81 85.36
Use of iodized salt SC/ST OBC Other 78.31 40.28 83.97
11
Household size and EW
Characteristics Percent Households
Total number of Household 1216
Eligible Women per Household None One Two Three 7.07 57.98 20.48 14.47
Mean eligible women per Household 1.55
Mean size of Household 7.75
12
Age and sex distribution of household population
Female
Male
13
Age at consummation of marriage (Female)
14
Pregnancy outcome
15
Pregnancy outcome by Age
Mothers Age (yrs) Outcome of pregnancy Outcome of pregnancy Outcome of pregnancy Outcome of pregnancy Number of pregnancies
Mothers Age (yrs) Live birth Still birth Spontaneous abortion Induced abortion Number of pregnancies
15-19 20-24 25-29 30-34 35-39 40-44 87.0 89.6 92.0 90.7 93.7 93.3 4.3 2.7 3.0 4.0 2.3 2.5 8.7 7.1 4.6 4.1 3.7 4.0 0.0 0.6 0.4 1.3 0.3 0.2 46 521 962 959 875 445
16
Children born and surviving
Mothers Age group (yrs) Mean children ever born Mean children ever born Mean children ever born Mean children surviving Mean children surviving Mean children surviving No. of women
Mothers Age group (yrs) Male Female Total Male Female Total No. of women
15-19 20-24 25-29 30-34 35-39 40-44 0.28 0.87 1.44 2.20 2.44 2.54 0.28 0.72 1.43 1.89 2.36 2.69 0.57 1.59 2.87 4.08 4.80 5.23 0.27 0.84 1.38 2.06 2.26 2.30 0.27 0.68 1.37 1.76 2.20 2.44 0.54 1.52 2.75 3.82 4.46 4.74 74 293 311 219 172 81
17
Place of delivery
18
Treatment of neonatal morbidity
Percent Neonates
19
Part 2 ICT USE
20
ICT Applications in Rural India
21
e-Chaupal
Source Word Bank
22
Success Stories
23
Digital Health
Some of the known forms of digital health are

• Tele-health Systems
• Therapeutic Diagnostic Devices
• Medication Monitoring Equipment
• Remote Monitoring Devices
• Mobile Health Applications
• Electronic Health Records
• Medical Robotics
• ePrescriptions

24
nLogue -Telemedicine
25
SGPGI Hospital Information System
26
Part 3 HIS
27
Patient Care Process
ILL PATIENTS
Cured
Improved
Unchanged
Accommodation Communication Investigation Treatmen
t Social needs Sanitation Nutrition
Absconded
Expired
TREATED PATIENTS
Medical
Surgical
Others
28
What is HIS ?

• A hospital information system (HIS), also called
  clinical information system (CIS) is a
  comprehensive, integrated information system
  usually designed to manage the administrative,
  financial and clinical aspects of a hospital.
  This encompasses paper-based information
  processing as well as data processing machines

29
Data Source and Linkages
Central Registration Admission
Wards
OPD
Discharge Billing
Hospital Information System
Public Relation Enquiry
Operation Theater
Labs Radiology
Patients Records

• BACK OFFICE
• Stores, Purchase
• Establishment
• Finance
• Planning
• Security

30
Scope of HIS

• As an area of medical informatics the aim of any
  HIS is to achieve the best possible support for
  patient care and administration by electronic
  data processing.
• It can be composed of variety of sub-systems in
  medical specialties (e.g. Laboratory Information
  System, Radiology Information System).
• CISs are sometimes separated from HISs and
  former concentrate on patient- and clinical
  state- related data (electronic patient record)
  whereas the latter focuses on management issues
  of the hospital.

31
HIS Modules

1. Registration
2. Enquiry
3. Appointments
4. Out-Patient Mgt
5. Investigations
6. Billing-Accounts
7. Operation Theatre
8. Blood Bank

1. In-Patient Mgt
2. CSSD Mgt
3. Diet Kitchen
4. Bio-Medical Eng
5. Central Stores
6. Pharmacy Mgt
7. Medical Records
8. Master Mgt

32
HIS New features

• Web based system
• Online Registration
• Online appointment
• Online Reports
• e Banking
• Integration with PACS
• Smart card
• Biometrics

33
HIS Design Issues

• Centralized or distributed database
• Data Security and confidentiality
• Data capturing technology
• Data exchange standards
• Local vs Global access

34
Centralized Database
Computer Based Patient Record (CPR)
USERS
35
Distributed Database
Pharmacy System
Patient Pharmacy Data
LAB System
Patient Lab Data
NETWORK SERVER
Other Departmental Systems
Intradepartmental (e.g. Lab Users)
Patient Financial Data
Computer based Patient Record (CPR)
Billing System
USERS
36
Data Security and Confidentiality
37
Type of data in patient care

• Alpha Numeric
• Static Image
• Dynamic Image
• Voice

38
Data Capturing Technologies

• Key Board Entry
• Mouse and GUI
• OCR and ICR
• Light Pen and touch screens
• Voice Recognition System
• Equipment Interface

39
Data Exchange Standards
Data Exchange Vocabulary Standards Communication
Network Protocols

• ICD 10 Disease and Condition
• International Statistical Classification of
  Diseases and Injuries by WHO
• HIPAA Procedures and Insurance
• HIPAA stands for Health Insurance Portability
  and Accountability Act which was framed by the
  Dept of Health and Human Services USA and was
  passed by US Federal Congress in 1996. The
  guidelines were implemented in April, 2003

40
Data Exchange Standards

• HL7 Equipment interface
• HL7 or "Health Level Seven" is the standard
  language for the electronic interchange of
  clinical, financial, and administrative
  information between health care oriented computer
  systems. In other words, HL7 acts as the standard
  for interoperability of health information
  technology
• DICOM Image compatibility
• DICOM stands for "Digital Imaging and
  Communication in Medicine" is a document that
  defines a method of communication for the various
  equipment of digital medical imaging
  devices/software (modalities). This standard is
  now in use by the majority of medical imaging
  hardware manufacturers.

41
Thank You