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Micro Health Centre (µHC) Cloud enabled Healthcare Infrastructure

28 Apr

In India the healthcare delivery at the village level is constrained by lack of healthcare infrastructure, lack of doctors, lack of supply-chain and lack of appropriate monitoring of the existing healthcare infrastructure.

Most of the poor people living in remote areas are not able to access formal health care and many of them consult untrained local ‘private practitioners’ incase of any illness. Nearly one million Indians die every year due to inadequate healthcare facilities and 700 million people have no access to specialist care. About 75% of health care infrastructure, medical manpower and other health resources are concentrated in the cities or towns where only 27% of the population resides. There is a dual burden of disease with the rise in communicable and non-communicable diseases. There is shortage of human resources, poorly trained providers, poor quality of care, lack of drugs, equipment and ineffective referral systems. These are responsible for the lack of progress in reducing maternal mortality and in providing basic reproductive and maternal health services and act as a barrier for achieving millennium development goals. Recognizing this need to strengthen the Indian healthcare delivery system led to the conceptualization of the cloud enabled healthcare infrastructure – The Micro Health Centre.

This innovative and visionary affordable health care infrastructure can be rapidly rolled out to provide basic healthcare along with Tele-video medical consultation technology. It consists of a standard shipping container converted to a Micro Health Centre, that is connected to specialized medical personnel through Internet, to bring much needed preliminary healthcare to those in need. The first deployment will be in rural Haryana.

The objective is to equip the Micro Health Centre with basic diagnostic equipments that can be operated by paramedics or interns, along with specialist medical personnel providing expert interventions through remote medical consultation. It has a network connectivity varying from 256 KBPA (via satellite) to 2 MBPS (via leased line). Furthermore it can be easily transported to remote rural areas as all supply-chains such as trucks, trains, roadways etc are aligned to handling shipping containers. The Micro Health Centre has been designed to provide healthcare, health education as well as medicines, thereby providing the basic health facilities to inaccessible areas.

 

Micro Health Centre structure

 The solution helps in mitigating the following issues:

 

Identified Healthcare Issue Conceptualized solution
Lack of Doctors and specialists • Remote tele-health consultation
Absenteeism of assigned doctors • Cloud enabled biometric monitoring
Lack of Healthcare Infrastructure, no electricity • Rapidly deployable health infrastructure
Non Functioning medical equipment • Equipments integrated with Health Cloud
Inability to rapidly deploy and then maintain the

healthcare infrastructure

• Self sustainable infrastructure
Trained manpower to run the medical equipment • Interns/ para medical personnel can operate with

training in Tele-health services

No proper medical records • Centralized medical records

Easily deployable in remote areas

 

Key features:

  • Self contained medical solution that can be rapidly deployed and is usable from day one. Requires minimum skilled resources at site and only requires diesel to make it functional.
  • Satellite connectivity and built in electricity
  • Tele health services to provide basic healthcare and specialist medical care
  • Innovative and affordable health care infrastructure
  • Rapid roll out
  • Easy transportation to remote rural areas as all supply-chains such as trucks, trains, roadways etc are aligned to handling shipping containers.

 

 

Micro Health centre Functionalities

 

 Benefits:

•   Increasing the reach of healthcare

•   Affordable healthcare solution

•   Providing high quality care.

•   Provides primary healthcare

•   Remote medical consultation services

 

Cloud Enabled Micro Health Centre

 

The Micro Health Centre is able to leverage the revolutionary effect of cloud computing for Tele-health services, addressing the shortage of healthcare personnel in remote areas. The above diagram demonstrates the cloud computing functionality at µHC. The healthcare delivery at the Micro Health Centre can be monitored through the health cloud connectivity, thereby providing highly efficient and quality healthcare

The µHC- Health cloud advantage:

1.  Cloud computing for Tele-health is advantageous for remote consultations via video-conferencing; it can save the time and money spent by the patient.

2.  Real-time devices like tele-ECG at the µHC can transmit data to remote locations for instant analysis. Data is stored and forwarded to several sites at once or accumulated for further analysis at a later time.

3.  Patient registration, appointment scheduling and monitoring can all be performed

4.  Healthcare management and patient education are effectively handled by the µHC Health cloud, giving more complete care to the patient.

5.  Medical equipment integration with the health cloud such as with stethoscope, glucometer and equipments to monitor vitals to aid in remote consultations.

Thus it dramatically increases the reach of healthcare, bridging the Indian healthcare need gap.

 

REFERENCES:

 

1. John TJ. et al, 2011. Continuing challenge of infectious diseases in India. Lancet 15;377(9761):252-69.

2. Patel V, 2011. Chronic diseases and injuries in India. Lancet. 2011 Jan 29;377(9763):413-28.

3.Haines, A. et al, 2004. Can the millennium development goals be attained? BMJ. 2004; 329(7462): 394–397.

4.Travis, P. et al, 2004. Overcoming health-systems constraints to achieve the Millennium Development Goals. Lancet 2004; 364: 900–06.

5.Bhandari L. et al, 2007. Health Infrastructure in Rural India, India infrastructure report – 2007, 3inetwork, oxford publication, India. (Available at:  3inetwork.org/reports/IIR2007/11-Health.pdf)

6. Healthcare in India, Emerging market report 2007, Price Waterhouse Coopers. (Available at: http://www.pwc.com/en_GX/gx/healthcare/pdf/emerging-market-report-hc-in-india.pdf).

7. Krishnan A, 2010. Evaluation of computerized health management information system for primary health care in rural India. BMC Health Services Research 2010, 10:310

8. Siriginidi SR, 2009. Achieving millennium development goals: Role of ICTS innovations in India. Telematics and Informatics, 26(2):127-143.

9.Wang X. et al, 2010. Application of cloud computing in the health information system. In: Proceedings of the2010 International Conference on Computer Application and System Modeling (ICCASM). New York, NY: IEEE; 2010

  1. Technology firms and health care: heads in the cloud: digitising America’s health records could be a huge business. Will it? The Economist (US) 2011; 399(8727):63.
  2. Wootton R, 1997. The possible use of telemedicine in developing countries. J Telemed Telecare; 3(1):23-6.

About the Author:

Dr. Jaijit Bhattacharya
Adjunct Professor, Department of Management Studies
IIT – Delhi

Director, South Asia, Global Government Affairs,

HP India Sales Pvt. Ltd

email: jbhattacharya@iitd.ac.in

Bio: Dr. Bhattacharya is Adjunct Professor at IIT Delhi, and Vice President of Institute of Open Technology and Applications (IOTA), Government of West Bengal. Dr. Bhattacharya advises governments on e-governance strategies. Dr. Bhattacharya has developed business models and strategies for leading companies in the IT, media and computer hardware industries. He is the author/co-author of four books on e-Governance including the first book on e-Governance in India, ‘Government On-line – Opportunities and Challenges’.

Co- Author:

Ms. Ritu Ghosh
Research Associate
IIT – DELHI

Specialist – Education Health Environment, Global Government Affairs,

HP India Sales Pvt. Ltd
Email ID: ritug054@gmail.com 

Bio: Ms. Ritu Ghosh is a research associate with Indian Institute of Technology, Delhi and has set up the Centre for Excellence in e-Governance at IIT Delhi campus with an objective to carry research activities and showcase the latest technology initiatives and innovation to the government. She is an ICT public policy expert with over 13 years of experience. She has been driving initiatives for the adoption of ICT as the transformation tool in emerging and developed economies.

Co- Author:

Dr. Anjali Nanda, B.D.S

Social Systems Specialist,

Hewlett Packard – India, Gurgaon

E-mail: anjalinanda0503@gmail.com

Bio: Dr. Anjali Nanda is a dental surgeon with rich clinical experience in both rural settings and urban areas in India. She has been a part of research projects involving urban poor and has a good understanding of their healthcare needs and the healthcare delivery process.

Information Technology Orientation For Starting Hospital Administrators

3 May

Information technology and computer science tools are definitely the most rapidly growing segment of the world ecosystem. The development in the sector permeates every human activity; social, economic, cultural, religious, political, professional, personal and healthcare. Information technology has radically altered the way many people work and think. Information Technology has made a significant difference to the Quality and Standards of Life. Learning some of the common IT application an individual can carry out any activity of your work life simpler and easier.

There is a rising awareness about the need for better healthcare in India. The demand for healthcare is growing with the increasing affordability of Indian middle class, a new breed of patients have emerged with enhanced expectations for better quality of healthcare, both patients and doctors exposed to international healthcare setting demand more, number of insurance players playing a key role, net savvy population, more number of independent hospitals have made the healthcare market more competent and complex.

Over the years, technology has touched a new zenith and now it is not constrained to developed countries. Developing countries such as India have kept pace with the world in modern technology. Healthcare professionals can no longer disregard the application of information technology to healthcare because they are key elements for competing in complex healthcare competition.

The major component that can give an edge in terms of patient care and effective decision making is IT support. Today’s corporate hospitals compete on the basis of the technology with investment in it being the major benchmark.

Technology in healthcare has brought better therapeutic & diagnostics delivery of services,  integration to various components of large healthcare providing entity, very similar to that of any other sector like manufacturing and banking sectors. Healthcare IT has huge potential in India as the hospital are emerging, growing up and healthcare workers want to upgrade.

When a fresh post graduate with medical and non medical background entering in the market searching for a job in the healthcare administration side with little or no knowledge on IT, he has to be a part of  following job codes

Job code 1 He joins an ongoing cooperate hospitals that has an established IT infrastructure, enterprise wide software and a well integrated system. The hospitals have already invested heavily on IT applications and using them successfully, the expectations from a fresher to perform in the new setting are high. To deal with this situation the fresher should be oriented with basic operational domain knowledge as well as trained by application specialist.

Job code 2  When a fresh post graduate joins a hospital from the scratch (for a new hospital which is in the inception/ setting up stage). The fresh post graduate has to plan, coordinate, budget, execute, install, and train the employees, built an entire IT system for a new hospital for which he should have a sound knowledge of IT application in his post graduation as a core subject.

Job code 3 When a fresh post graduate joins a consultancy and suppose the consultancy is working on an IT project for an established hospital or a new hospital. The fresh post graduate has to work with IT vendors and make a decision regarding the IT infrastructure. He has to plan, budget, execute, install, and train the employees built an entire IT plan for a new hospital and act as a facilitator, catalyst as a change agent

Job code 4 When a fresh post graduate has mobilized enough funds to start his own hospital as the owner he has to make a  tough decision regarding  IT infrastructure .He  should know his budget, requirement and growth prospect .He can plan the entire schedule by himself or take the help of  IT consultant

Job code 5 This is the toughest of all the jobs codes, you are working with existing software and reported some modifications either want to add new features or replace it you have been assigned this duty to select , administer , execute, train, budget the entire program( he has to act as a change agent, motivate the staff and convince the management ). It is very risky. The individual may have little or no knowledge of new technology and application. The success of the project depends up on you which involves time, money and efforts.

What Are The Software Options?

As a fresh post graduate who is in the future going to be an administrator should understand few basic principals about IT software either to go for (Build software vs. Buy software) or (Make decision vs. Buy decision). This is the most important and curtail of all the decision of IT infrastructure.

If it is Make decision then it is development of software in house which follows SDLC (System Development Life Cycle)

If it is Buy decision then checking out your hospital requirements, listing out various vendors who supply readymade software product on contract basesevaluate their features, select the best from the available, install the software, train the employees with application specialist, have a backend support with vendor.

 

Basic Check List Elements

Check list 1    The first responsibility that the administrator has is to ensure is that the software which is being used has an End-User-Licensing-Agreement. It should not be pirated one

Check list 2 The administrator should instruct the IT manager to have all the detailed about hardware, software, number of computers, date of manufacturing, their warranty period, when was the annual maintenance contract renewal (AMC), when is it to be renewed and so on. This all should be maintained as a hard and soft copy.

Check list 3 The administrator should instruct the IT manager to have total control over the network, support your system with a good firewall which scans each piece of data that goes out or comes in, a good antivirus with daily updates with Malware and spam mail options, a sound multi-level authorisation to ensure what data is viewed only by authorised personal. Site-blocker software should be installed which blocks illegal browsing sites.

Check list 4 A sound backup and recovery program is very important. (Offsite backup is preferred).

Check list 5 Check the various insurance options for IT which include (Insurance for the entire hardware and software installed in the system and even the user is supposed to be insured. (If you are not aware of the insurance policy then hire an insurance broker)

Check list 6 Plan the IT– infrastructure by seeing the existing workload, technology up gradation etc. A definite amount of budget should be allocated to the IT- Manager. A maintenance budget and an operational budget

Check list 7 Regular training programs should be conducted for the new employees, as well as for the existing ones. Eemployee feedback should be taken about IT and evaluated by the administrator and IT manager.

Check list 8 An easy to navigate, light, perfect, interactive website or portal should be maintained by hospital IT-Department. This can be browsed on any browser.  All the employees should possess an Email for any form of internal communication.

Note: The document has not covered the technical details of various elements like firewall, backup, recovery, browser, portal, insurance broker etc

.

Syed Murtuza Hussain Bakshi

Associate Professor

Department Of Hospital Management

Owaisi Hospital and Research Center

murtuza_in21@yahoo.commurtuzain21@gmail.com

Mobile: – 09948662135

Quality of health information on the internet – Indian Students Perspective

2 May
Authors:

Dr Birpreet, Dr Amarjeet Singh, Dr Manoj Kumar

Bhojia Dental College and Hospital,

Budh, Distt. Solan, Himachal Pradesh, India

E mail: docbirpreet@gmail.com

Learnings from Japan: National Health IT Networks are required

26 Apr

The past few days have involved almost all of us praying for Japan which was ravaged by a severe earthquake and tsunami. Japan’s most powerful earthquake in 140 years struck the north-east coast on March 11th 2011, triggering a massive tsunami leaving behind many homeless and stranded. (Information and Situation Report from WHO)

As we continue praying for hope in Japan, we are also learning all we can about how disasters can impact the way we live and seek to improve. Sadly, Japan now faces severe logistical problems and with the latest news on the mishap at a nuclear reactor, the situation only seems to be getting worse. While Japanese officials have more pressing issues on their hands, a problem that will arise as time progresses will be that those left alive may find themselves without their medical records. Natural disasters wipe out everything — including paper medical records as well as computer and communication networks.

In this time of national crisis, it would have certainly been helpful for Japan to have a robust Healthcare IT network in place. A collaborative one where it is easy to share data, which is securely backed up redundantly in multiple locations that would leverage geographical diversity as a means of countering nature’s unpredictability: Geographical Division Multiplexing if you please.

While Japan does have a Healthcare IT strategy setup, with benefits and stimulus funds, it is relatively new and yet to mature. Health data digitization and Electronic Record Keeping is still in its infancy. Japan does not boast of large scale Electronic Medical Record coverage.

Wouldn’t any country ride out disasters better with health data sharing in place? This should be taken as a wakeup call as well as a learning lesson by all nations which haven’t yet devoted time and money to setting up Nationwide Health IT Infrastructures.

India for one must be looking at learning from this.  Having a Nationwide Health IT Strategy should be treated as important as a Tsunami Alerting System (TAS). Purists will argue that a Nationwide Health IT System is not intended for alerting and helping contain situations like the TAS. And they are not completely wrong.

In many cases it has been observed that long term benefits are eventually forgotten. Instead, this concept of “Long Term benefits” must be replaced with Pre-planned Goals which must be “Sought” on maturity of a model.  Now, any system can provide a set of benefits directly on implementation, and an additional set when it has matured.

Similarly, the use case of using a Nationwide Health IT System for predicting and alerting requires a certain amount of usage at first.  A sophisticated and mature Nationwide Healthcare Network built using technology can identify the emergence of possible pandemics. Trends in symptoms can help identify risk areas, and collaborative diagnosis can help is sharing treatment plans and improving them.One must understand that if maturity of a network is required for additional goals and since that takes time, one must seek to implement early.

Links of Interest
WHO Page on Environmental Health in Emergencies
WHO page on Myths and Realities in Disaster Situations

Date: 26-04 2011

Author: Nrip Nihalani

About: Director, Plus91 Technologies (www.plus91.in). Healthcare IT and EMR company based out of Pune, India

You can read more of Nrip’s Articles at: wirelysis.blogspot.com

Medico legal and patient safety through information dissemination

15 Feb

Date: 15th Feb 2011

Author: Aditya Patkar

About: Marketing Head, Plus91 Technologies (www.plus91.in)

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