State Mission Mode Projects – Health

Department Initiatives

9/9/2011 1

Anju Sharma, IAS

Mission Director

(NRHM)

State Consultation Workshop on

E-Governance, Gujarat

9th September, 2011

E-Governance @ IT Initiatives Department Health & FW , Gujarat

ACCOUNTABILITY TRANSPARENCY RESPONSIVENESS DECISION MAKING

• Department’s Website •Drugs License •Telemedicine •RIMS (Routine

immunization Monitoring System)

• Hospitals Website •Medical Education

Admission committee

•EMRI 108 (Emergency

Management &

Research Institute)

•BADEA

(Birth & Death Entry

Application & Reporting System)

• Medical Colleges

Website

•DLIMS (Drug

Logistics Information

& Management System)

•GPS Mobile Van

Monitoring System•HMIS (Hospital

Management

Information System)

•IWDMS (Integrated

Workflow and Document

Management System)

•Intra-FDCA

application (Food and

Drug Control Administration)

•IDSP (Integrated

diseases surveillance project)

•E-Mamta (Mother

and Child Tracking

System)

•IFMS (Integrated

Finance Management System)

9/9/2011 2

Mission Mode projects

• E-Mamta : Mother & Child Tracking System

An IT based management tool to plan, deliver and

monitor quality MCH services, track drop outs and

ensure complete service delivery through Work Plans,

analysis of performance and message alerts, thereby

reducing IMR/MMR

• HMIS(Hospital Management Information System)

A total hospital & patient care management solution to

provide better care to patients through patient record

system & IT based hospital services

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E- mamta(Mother & Child Tracking System)

http://e-Mamta.gujarat.gov.in

9/9/2011 4

plan deliver

monitor

• Aims at ensuring servicedelivery to every individual withspecial focus on mother andchildren

• Plans the service deliverythrough system generatedWork Plans on the basis ofbeneficiary information

• Service delivery is monitoredto generate further work plansand analyze status of servicedelivery & quality of service

NAME BASED TRACKING : RATIONALE

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I. District Family Health survey : Data entry of all the individuals of Gujarat

(covering the entire rural, urban slum and slum like population)

II. Verification, cross verification and validation of the data- physical

verification and sample cross check.

III. Registration of mother and child : System generated unique health ID for

every mother & child.

IV. Tracking of services through denominator based Monthly Work Plans

and follow up of the left outs.

V. Detailed analytical charts on the dashboard to determine service delivery

status

VI. Online health record/ Immunisation card/ growth chart/Hb. Charts/ weight

charts

VII. SMS alerts to beneficiaries/ service providers

VIII. Communication platform for health personnel

IX. Details of various incentives paid to all cadres of health workers

individual records for the benefits of JSY, BSY and CY schemes6

SALIENT FEATURES 0F PROJECT

9/9/2011 7

E-Mamta: Process

District Family Health Survey

Mother and Child registration

MonthlyWorkplan for

grass root level workers

Service delivery and left out tracking; SMS to Pregnant woman & children families for

due services

INFORMATION EMPOWERED FHW

THROUGH WORKPLANS

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Online Records SMS to

Beneficiary and

In department

Efficient Stock

Management

Incentive details

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Time and Manpower Saved Real Time and Better Analysis of Data for

each facility; Charts and Reports at Click

of button9/9/2011 10

COVERAGE E-Mamta

26 Districts,

8 Corporations,

All Villages of

Gujarat

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PROGRESS SO FAR

started since May 2010

No. of families entered 94 lakh

No. of members entered 4.71 crore

No. of PW registered 13.7 lakh

Infant registered 10.3 lakh

Children(1-6 yrs)

Registered

10.0 lakh

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• Unique ID based online family health data base covering the entire

rural, urban slum and slum like population.

• 100% tracking for complete health services, specially maternal &

child health services.

• Reduction in the work of field level health workers as they have

not to prepare reports and keep various records

• Improved inventory management and financial management of the

health programmes.

• Capturing data in case of migration .

• Better data analysis for preparation of Block/District health action

plans and State PIPs with realistic/accurate denominators.

• Basis for ICDS, Primary education, ration card, Adolescent health,

school health etc.

• Better reporting of Maternal & Infant deaths

BENEFITS

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• Comprehensive service delivery

• Reduced IMR, MMR and TFR

• Universal coverage of immunization

• Reduction in anemia and malnutrition

POTENTIAL OUTCOMES OF E-MAMTA

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Problem faced StepsInfrastructure In place with Gujarat state wide network

connection and computers at each 1099 PHC,

292 CHC, 26DH, 26SDH

Training of Manpower Data entry operators in place at each 1099

PHC, 292 CHC, 26DH, 26SDH, through funding

of SRHM; were provided extensive training in

various phases, manpower provided to NIC.

Mammoth Online data

entry

Financial incentives & outsourcing for data entry

Day to day handholding 24 x7 Helpdesk

Resistance of out reach

workers ,mindset

SATCOM trainings and regional workshops,

Intensive training & sensitization.

Motivation & ownership Awards to performers, bi-way communication

inculcating their suggestions on regular basis

Technical up gradation Regular meetings with NIC Gujarat officials &

guidance for constant improvement and up

gradation9/9/2011 15

INNOVATIVE FEATURES

• Modular design to expand the application into a multiple service

delivery network for the entire health system including nutrition

& disease control, stock management, payment modules

• Not just a postmortem of historical data but dynamic

management tool to support service delivery

• Monthly Work Plans introduced for the first time as delivery

schedules & left out lists.

• E-mobile facility- SMS alerts & communication platform

provided through network of about 30,000 CUGs to service

providers including ASHAs & mobile numbers of beneficiaries

• De centralized outsourcing for data entry in the initial stage

• 24x7 helpdesk for constant handholding & support as well as

verification

• Registration through call centre based information captured

• UID compatibility9/9/2011 16

• Recognized by Ministry of Health & Family Welfare, GoI as the best

Mother & Child tracking models available & replicated in all the states with

the support of MD, NRHM Gujarat & NIC Gujarat.

• Training provided to all State Technical & Administrative teams in

Ahmedabad in 5 batches.

• Source code provided to all the state wings of NIC and central division of

NIC for National replication as MCTS. on national server @

nrhm.mcts.nic.in

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KNOWLEDGE SHARING: E-MAMTA REPLICATED AT NATIONAL LEVEL

• Ms. Anju Sharma IAS, Mission Director NRHM Gujarat presenting E-

Mamta at NRHM National Review at Bhopal, July 2010

9/9/2011 18

NATIONAL ROLL-OUT

E-World award 2011 for Improving Maternal

Health; care delivery through innovative use

of technology9/9/2011 19

Hospital Management

Information System (HMIS)

9/9/2011 20

INTRODUCTION

• A unique IT based Hospital Management System

connecting 6 Medical Colleges and 24 District

Hospitals

• 30 different modules through support Hospital

Services & patient care.

• Developed on .NET framework, data base on SQL

2005

• Works on Intranet (GSWAN ) connectivity & a

dedicated server

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22

Patient Care Services

• Registration

• Wards

• Pharmacy

• Billing

• Patient Education

• Information Kiosk

• Nursing Care

Clinical Services

• Clinical/EMR

(Gynecology,

Ophthalmic,

Orthopedic, ENT, Gastro

Medicine, General

Medicine, Nephrology,

Pediatric, Surgery,

Urology, Skin etc…)

• Laboratory

(Pathology,

Microbiology, Bio

Chemistry, Radiology)

• Blood Bank

• Imaging

Hospital Admin

• Hospital Admin

• Human Resource

• Payroll

• Financial Accounting

• Stores/Inventory

• Purchase

• Complaints &

Redresses

• Transportation

• MIS Reports

• EIS Reports

Ancillary Services

• National Programs

• Linen Management

• Equipment Maintenance

• Resource Scheduling

• Special Camp & Training

• Bio Medical Waste

• Application Security

• Rogi Kalyan Samiti

(RKS)

• National Accreditation

Board for Hospitals &

Healthcare (NABH)

Modules available in HMIS (30)

HMIS is end-to-end solution for Hospital which offers

flexibility to choose various modules as per the hospital

specific need

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SALIENT FEATURES HMIS

• Easy Customization available at each level of Hospital

• Configurable as per hospital needs

• Comprehensive Electronic Medical Record

• Exhaustive and Flexible reporting functionality to generate

user specific reports

• Good Graphical User Interface(GUI), User Friendly

• Integrated, which reduces the work load of other departments

• Reliable, Scalable & Secure

• Real Time Reporting Nature

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PROJECT STATUS

• Total Hospital connected

• 6 major Hospitals (Medical College)

• 24 Minor Hospitals

• HMIS module usage in the state 71.33%

• OPD Registration more than 146.08 lakhs

• IPD Registration more than 17.77 lakhs

• Plan to extend this in 2 Dental Colleges and 2 Mental Hospitals

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Project Status…

Bhuj

Jamnagar

Khambhaliya

Porbandar

Junagadh

Bhavnagar

Surendranagar

Jamnabai

Gandhinagar

Himmatnagar

Patan

Palanpur

Rajkot PKG

Amreli

PDU, Rajkot

Palitana

Valsad

Navsari

Dang

Surat

Bharuch

Rajpipla

SSG, Baroda

Petlad

Godhara

Nadiad

Sola

Mahesana

Dahod

Gotri, Baroda

1st Site Live 26-Jun-06

Major/Teaching Hospitals 6

Minor/Non-Teaching Hospitals

24

To be implement in 2 Dental, 2 Mental & 1 Medical Collage

till 2nd September, 2011

Total Registration 1,63,85,849

OPD 1,46,08,276

IPD 17,77,573

Total Operations 3,19,606

Total Lab Tests 38,05,322

Trained Users 13,0219/9/2011 25

PROBLEMS FACED -HMIS

• Availability of Network and Hardware- supported through

Government of Gujarat & NRHM funds

• Trained manpower- Training & Sensitization of the staff &

AHAs

• Resistance from users- Interactive Communication &

Problem Solving

• Dependence on the Private Technology Provider.

9/9/2011 26

INNOVATIVE METHODS OF

OVERCOMING CHALLENGES -HMIS

• Strengthening of GSWAN and Availability of Servers

at Local Level

• Dedicated Server

• System Manager at Each Hospital

• Ready to Use Templates for doctors to reduce

Diagnosis Error and Patient Checking Time.

• Easy transfer of employee payroll from 5th to 6th

Pay Commission.

• Easy Patient/Doctor Tracking with the help of

Information Kiosk (useful for relatives).

9/9/2011 27

KNOWLEDGE SHARING

• Templates prepared by doctors can be useful

for interns and other doctors too.

• Readily available DO’s and DONT’s for

various diseases and conditions.

• Information Kiosk helping patients for

Doctor’s availability, Services offered,

Certificates offered, Other basic details about

the hospital.

• Diagnosis as per ICD 10 and Deaths

recorded as per MCCD standard which helps

in demographic study.

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Expectation from DST, GoG

and Department of IT, GoI

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Connectivity Support

• Strengthening of GSWAN and Internet connectivity

• GSWAN connectivity till the village Level

Hardware support

• Handheld devices with printer needed for Real Time

Entry

Technology Support

• Integration of various database

• UID Integration support.

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ISSUES

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