Medical Education & Drugs Department Government of Maharashtra

1. Medical Education & Drugs Department Government of Maharashtra 1

2. Implementation of Healthcare & Academics Management & Information System inGovernment Medical Colleges & its Attached hospitals in Maharashtra HMIS Project

3. Objective • Implementation of e-Governance policy decision of the State Government in Government Medical College & its attached Hospitals in Maharashtra • Improvement in Delivery of Health Care and Medical Education by using powerful HMIS Software of International standard and Quality Hardware

4. Project Scope Central Server-NASIK Hospital + Medical College Hospital

5. Benefits • Unique Health ID • EMR Electronic Medical Record • Time Saving • International Standards • Better Utilization of Available Resources • Avoidance of Pilferages • Business Intelligence Reports • Instant Availability of Administrative Data Savings Clinical Trials & Research

6. Benefits Institute & Government • All Institutes Interconnectivity, Centralized Data ,Uniformity • Inventory Management - Prevention of Pilferages • Availability & analysis of Administrative Data • Generation of income through Clinical Trials and Research

7. Innovative Model Build Own Operate & Refresh (BOOR) Model Service Contract No Upfront Payment to the Service Provider Monthly Payments linked to the Service Provided as per Service Level Agreements (SLAs) Zero Risk to the Government

8. Architecture • Distributed • LAN – At Each Institute • WAN – Connecting To Central Data Repository (CSRC)

9. Initial Project Cost • Rs. 180 crore • Rs. 150 crores - Fixed Charges - From Plan Budget • Rs. 30 crores (approx.) - Transaction Charges - From Hospital PLA - @ Rs. 6.60/Transaction

10. Transactions OPD Registration IPD Registration Students Registration

11. Expected Changes Registration

12. Present Scenario No Computerization Doctors unaware of the Waiting Patients No availability of Past Record No statistical analysis possible for OPD Clinical Data Laboratory Investigations and Prescription of Medicines - on Paper. Separate Forms needs to be filled Such facility is not available Scenario After HMIS Implementation Computerization in all OPDs Waiting Patients List available on Computer screen Instant availability of Past Record All types of statistical analysis possible on OPD Data Investigation & Prescription of Medicines- e-Prescription With click of the Mouse - on Computer Each Department can customize the their OPD screens as per their favorite list of Symptoms, Probable Diagnosis, Investigations, Medicines etc. Expected Changes OPD -Doctors Consultation

13. Expected Changes OPD - Doctors Consultation contd...

14. Possible Generation of IncomeRegistration

15. Possible Generation of IncomePharmacy

16. Possible Income GenerationAdvertisement • Charging for using the HMIS Data for any analytical purpose (to authorized persons only) as per the prevailing policy for the use of the Data • Advertisement: • On the back side of the OPD Number Card • On the computer screen - scrolling/pop up advertisement • In the Waiting Area • On Medicine Packets • At any other possible area

17. Possible Generation of IncomeClinical Trials/Contract Research • India - Preferred destination for outsourcing due to: • Largest pool of variety of patients. • Specialty Hospital Beds - 7 Lakh • 269 Medical Colleges. • Low cost - 50-60% cheaper than in US • English speaking personnel

18. Present Status Pilot Phase – at Grant Medical College & Sir JJ Hospital Complete Pune, Nagpur & Aurangabad - Ready for Trial St. George, G.T. & Cama – Implementation started

19. Project Governance Steering Committee Project Coordinator State Level Project Implementation Committee Project Implementation Committee (PIC) at Each Location

20. Challenges Customization Mindset of the Users Old Equipments Top Down Governance Old Infrastructure Lack of Flexibility & Freedom in Implementation

21. Challenges • Use of the HMIS Data for Analysis and Policy Making • Legal Issues in relation to EMR confidentiality • RTI Act • OLD Equipments - like X-Ray, Biochemistry Machines not compatible to HMIS • Data Entry into the system

22. Challenges Complexity of the Processes Multiple GR – Sometimes Conflicting

23. Increase in Project Cost Learning from the Pilot Phase Less No of Nodes/Terminal (Computer) Cabinet Approved Additional Rs. 93 crore for receiving the services for the Nodes & Printers for 19 Institutes for 7 years (Feb 09)

24. Timelines • 27th Feb 09 - Cabinet Approved for Additional 93 crores for Nodes • Nov 2010 - Implementation of Roll-Out Locations

25. Ray of Hope No State Government in India has done what GOM has done Its Matter of Time and Benefits are assured

26. International ScenarioUSA • US President Obama's big idea: Digital health records: Computerize all Health Records Within Five Years. • Only about 8% of the US 5,000 hospitals and 17% of its 8 Lakh Physicians currently use the kind of Common Computerized Record-keeping Systems that Obama envisions for the Whole Nation. • Expected Cost at least $75 Billion to $100 Billion (Rs.1.5 - 2 Lakh crores) over the Ten Years they think the Hospitals would need to Implement. • On February 17, 2009 President Obama Signed the Stimulus Bill into Law.  In the Bill, Obama allocated • $19 Billion Dollars (Rs. 38,000 Thousand Crore) to Electronic Health Records program.

27. Stakeholder State Government Larsen & Toubro Limited - Technical Advisor Hewlett Packard - HP - Prime Contractor Amrita Technologies - HMIS Software Provider

28. For the details contactDr. Sanjay Bijwe M.D.Officer on Special DutyMedical Education & Drugs Mantralaya Mumbai -400032 Tel.91-22-22828715Mobile:91-9821138798 Thank You Nivedita Golatkar Special Project Officer Department of Information technology Mantralaya Mumbai-400032 Mobile:9323293206