Health Management and Information System (HMIS)
HMIS envisages empowering health services at grass root level by strengthening the health data collection and information system using hand held devices. A centralized server used for storing the collected data in a central database and its analysis using statistical methods. This will serve as an input to health planning and decision making at higher levels of the Directorate of Health Services (DHS). Digitized name based data is maintained at PHCs/CHCs level. The data at PHCs/CHCs is digitally updated from the data on the handheld devices. This also enables automated generation of the work plan based on the demographic data entered by the health workers. The use of hand helds has also been explored for management of childhood diseases and other health awareness programs. HMIS application is capable of larger information synthesis, processing and dissemination. HMIS can be integrated with telemedicine system for consultation and treatment.
The system has following modules:
1. Demographic Module
2. Family Welfare Module
3. Antenatal Care Module
4. Post natal care Module for Mother and Child
5. Immunization Module
6. Communicable/Non Communicable Disease / ORT Diseases
7. Malaria/RNTCP/Blindness Control
8. Death Module with causes of death
9. Immigrant/Emigration Module
10. Vector Study Module
11. Community Education Module
12. Stock management Module
13. Workplan for Health worker
14. Reports supporting NRHM formats
15. Alerts, reminders for family welfare, immunization and High Risk Pregnancies
16. Different reports at subcentres, PHCs/CHCs/BPHCs and DHS level including graphical reports.
1. Web based system which provides timely data flow from health worker to Directorate of Health Services.
2. Mobile/Handheld devices are used for data collection ensuring accurate, relevant and up-to-date data flow to the higher authorities for decision making.
3. It stores collected health data in a central database server which could serve as a health information database.
4. Reduce the data redundancy using centralize data repository method.
5. It has the facility of name based follow up of Antenatal and Postnatal Care, Family Welfare, Child Immunization, Communicable and Non Communicable diseases etc
6. It is also useful for work plan and alerts for health workers/ASHA workers for the early identification and timely referral of high risk Ante Natal cases.
7. The reports generation is based on standard as well as customizable formats including graphical reports.
8. The system can be used for other purposes like different national programs like Malaria Control Program, TB Control Program, Communicable and Non Communicable disease Control Program, Immunization, Antenatal and Post Natal care Program, Family Planning Program and Population Survey, researches, census, surveys etc.
9. Security constraints are used for the data confidentiality.
Benefits of the system
a) Empowers field level health workers with hand held systems for data entry and retrieval, and thereby improving their health care delivery activities.
b) Accurate, relevant and up-to-date information for health officials on health related activities which improve decision making, planning and service delivery.
c) Reduce the data entry by eliminating duplication of data.
d) Easy maintenance of data at various levels.
e) Authenticated data collection and verification.
f) Data Collection using Handhelds increases the efficiency of health status monitoring and speed at which disease outbreaks can be handled
g) Provides schedule to health worker for services (Ante Natal Care, Post natal Care, Immunization, Family Welfare, Communicable and Non-Communicable diseases, etc) to be rendered in each habitation during a month.
h) Early identification and timely referral of high risk ante natal cases.
i) The system provides improved quality and a wide coverage of health care services.
j) It reduces infant mortality rates by improving immunization rate.
k) Reduces the burden of manual record keeping by staff at the field and higher levels.
The system is deployed at 20 locations (15 PHCs/ 3 BPHCs/ 2 CHCs) of Tirur Taluk, Mallapuram, Kerala. The total beneficiaries under this deployment are 7.8 lakhs population.
Rural Telemedicine System: Sehat Saathi - Portable Model of Primary Healthcare Delivery
Sehat Saathi is a rural telemedicine system that can be used to extend medical care to patients in the remote parts of the country. The model provides front end contact through a suitably trained non-medical person, back end support from doctors, pathologists and other health specialist for diagnosis and treatment. It has Interface Builder Kit for doctors by which doctor can change the interface to the patient as per requirement.
The components of the telemedicine system include: Patient Database management; Interaction between doctor and patient; Medical data acquisition such as ECG, eye images, heart and lung sounds etc.; Software for doctors for data management, display, diagnosis and interaction (ECG, Cardiac Auscultation etc.)
The pilot deployment of Sehat Saathi (ophthalmology module) telemedicine software has been done at Primary Health Centre (PHC) Chaubepur (Kanpur) in collaboration with Ministry of Health and Family Welfare. An expert eye treatment provided to more than 700 patients over a period of 6 months. The technology of Sehat Saathi (Ophthalmology module) system is being transfer to M/s Sobha Renaissance Information Technology (SRIT), a global IT solution company and Venu Eye Institute and Research Centre (its six remote locations in UP, Haryana and Utterakhand).
e-Dhanwanthari – Web-based Health Care Delivery System through Telemedicine using ICT:
The project focuses on development and implementation of model for taking telemedicine for addressing primary healthcare in a sustainable way. The telemedicine centers of the project are identified as suggested by Department of Health and Family Welfare, Government of Kerala. The overall architecture consists of 4 Telemedicine Specialty Centers (Medical College Hospital-Thiruvananthapuram, Medical College Hospital-Kozhikode, Sree Chitra Tirunal Institute of Medical Sciences and Technology-Thiruvananthapuram, Regional Cancer Center-Thiruvananthapuram), 8 Telemedicine remote Centers and Data center at Thiruvananthapuram.
The specialty centers and remote hospitals are connected to the KSWAN with Wi-Fi technology. The doctors at Specialty Hospitals and patient at the PHCs can communicate using the videoconferencing facility supported by this network. The specialty hospitals and the PHCs are accessing the data center resource using Wi-Fi connectivity. e-Dhanwanthari web based telemedicine software is developed under this project, the details as follows:
Types of eDhanwanthari applications
1. e-Dhanvantahri Centralized (eDh C) is a web based application with centralized storage of patient Electronic Medical Record (EMR)
2. eDhanvantahri Distributed (eDh D) is a web based application with centralized and distributed storage of EMR clinic, thereby detecting diseases earlier and saving life.
3. Avoiding unwanted crowd at specialty hospitals
4. To provide super specialty health care to the common man at the most affordable cost. Avoid unwanted travel to specialist hospital there by saving time and money for the travel
5. To enable discussion about medical cases among specialists of the super specialty hospitals and between junior and senior doctors.
6. Training for the medical and paramedical staff through the Telemedicine network.
7. Low cost, replicable Telemedicine system
Freely replicable and easily configurable software
Centralized Storage of Electronic Medical Record (EMR) with unique patient ID for each patient.
Creation, centralized storage, retrieval, editing and updating of EMR.
Patient Record elements include Medical Images, Investigation Reports, Audio and Video clips of reports in addition to demographics and other clinical data.
Patient data accessible through unique patient ID and social security Number.
Text, Audio/Video Chat facility.
Tele Pathology, Tele Radiology, Tele ECG and Tele Education services.
Image processing features like Contrast, Brightness, Zoom Control rotate, Annotations etc
Interface with Clinical devices like digital microscope, X Ray Film scanner etc.
Supports International code of Disease (ICD 10).
DICOM Image viewer.
Fixing of appointment.
Scheduling of doctors.
Various types of Reports.
W3C (World Wide Web Consortium) Complaints
Patient data made secure through SSL (Secured Socket Layer)
The Specialty hospital which is having their patients living in distance can host the e-Dhanwanthari Centralized application in an Internet (May be any other connectivity V-SAT, ISDN etc.) server and the patient can directly access the application and create his EMR (individually or with the help of a Remote hospital doctor) then ask for the consultation by paying the consultation fee. The specialist doctor in the specialty hospital can review the EMR and record his opinion, Advices, Treatment procedures, medications and follow-up details in the e-Dhanwanthari application. Immediately or later the patient can view the expert doctor advices (individually or with the help of Remote hospital doctor) and get the treatment from the local remote hospital. Video conferencing can be used for live consultation
Mobile Telemedicine application
The Specialty hospital can setup a Telemedicine server in mobile Telemedicine van and another one server in hospital with e-Dhanvantahri Distributed applications and any type of Networks like V-SAT, ISDN, and Internet etc between the hospital and mobile unit. A junior doctor and nurses can travel in the mobile van to the remote villages and create the EMR of the patient, and then they can provide the treatment to the patient in the mobile unit itself. In case of a requirement of advice from a specialist doctor in the hospital then the remote mobile Telemedicine unit doctor / administrator can upload the patient EMR to the hospital’s server and request for Expert consultation. In case the junior doctor in the remote mobile Telemedicine unit himself treated the patient without requesting the expert opinion he / administrator can synchronize (make available all the patients EMR which are newly created in the remote mobile van) with the hospital server. This type of Telemedicine applications can reduce the network usage costs and avoid the traveling of the patient. Video conferencing can be used for live consultation.
Affordable Mobile Telemedicine Facility:
The objective of the project is to develop a model for affordable mobile telemedicine system for primary healthcare. A mobile tele-clinical van with necessary medical equipments goes in a predefined schedule to the rural areas (20 villages in Cherthala taluk). The mobile telemedicine van is having a basic set of medical diagnostic equipments, a Doctor, Nurses, Lab technicians and Driver cum Attendant. A Telemedicine room is in the specialty hospital i.e. KVM Hospital, Cherthala.
The wireless connectivity (WLL by BSNL) is provisioned between the van at specified locations and the Specialty Hospital for connecting the patents to the doctors at the hospital. The design and development of the mobile van completed. The mobile van is running in 20 locations in the Cherthala taluk covering more than five lakhs population. The speciality treatment provided to more than 1500 patient and EMR for the same in available for managing data and further action.
Affordable health care management system for remote health Centres
A new dimension
The telemedicine terminal adds a new dimension to remote diagnosis and patient care. It supports voice, video based communication over broadband IP connections while supporting a broad range of medical devices.
Reduces the cost of healthcare
Patients need to visit nearby health centres only for follow on consultations. Specialist consultation made available through video conferencing.
Seamless Integration of Patient Information and Records
A variety of Medical information from devices such as Ultrasound scanners, ECG Machines, Digital Stethoscopes, Digital Microscope etc can be accessed either directly or through the Hospital Network and used for remote consultation.
The terminal includes productivity applications such as DICOM Image viewer, Standard image editors, scanner interface and an embedded browser which can run browser enabled applications.
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Communication protocols supported
- Video : H.264
- Audio : G.711
- CIF Video format (352 x 288) upto 25fps
- QCIF Video (176 x 144) upto 25fps
- Composite input – RCA Jack
- S-Video input jack
- Composite output – RCA Jack
- VGA output (1280 x 720)
- Stereo Output for external speaker
- Built in speaker with 500mw power
- H.264 based video conferencing
- Text Chat
- Secure File Transfer
- Built in web browser
- SANE/TWAIN complain scanners
Built in Applications
- Image viewer (JPEG, TIFF)
- Text editor
- 80 GB Local Hard disk
- SD Card
- Ethernet (DSL, Cable broadband)
- 4 USB input ports
- 1 RS232 Serial port
- QWERTY 101 Key Keyboards
• Patients need not repeatedly travel to the Speciality Hospital for follow on consultations.
• Doctor at Remote Health Centre can consult with specialist doctor through video conferencing.
• Specialist doctor can access Patients records on telemedicine terminal.
• Specialist doctor can see and talk to Patient at remote centre
• Specialist doctor can give diagnosis and prescriptions through text to remote centre.
Digital Health at Every Door Step – Using Wireless Communication Network
The project aims to develop affordable biomedical and public healthcare diagnostic devices for rural healthcare. In this project, front end interfaces for the targeted equipment will be developed where the signals from equipment interfaces will be multiplexed and encoded into a synchronized stream. These wireless integrated biomedical devices are useful in the mobile telemedicine system for providing treatment to the patients in the rural areas. The biomedical equipments are integrated using wireless technology.
The project addresses the issues of bandwidth constrained compression, standards-compliant formatting and integrated multimedia transmission etc. The above diagram illustrates the overall schematic of telemedicine solution. The system has several major components including:
a) Telemedicine Exchange Server - Server side software architecture to process, interpret, aggregate and present information.
b) A local command site (mobile vehicle) for field coordination.
c) Cellular/Satellite/Wireless links for real time communication between local and remote sites.
d) Patient sensors (a temperature, Blood Pressure, pulse-oximetry sensors) for patient vital sign monitoring.
e) A wireless infrastructure for real-time data transport between Patient Sensors and local command sites.
The field trial of wireless network and telemedicine system has been done at Ettimadai Campus (Tamil Nadu)
Adaptive Automatic Insulin Pump
The objective of the project is to develop affordable automatic insulin pump based on MEMS (micro-electro-mechanical systems) mechanism and a biosensor for estimating blood glucose level. It is useful for development of affordable drug delivery system. The software logic of the pump is useful for computing drug dosage for automated injection through coupling of the biosensor to MEMS (micro-electro-mechanical systems). The design of insulin pump and biosensor for blood glucose measurement has been done and the development of the same is in progress