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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
9/9/2011 3
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
9/9/2011 5
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
9/9/2011 8
Online Records SMS to
Beneficiary and
In department
Efficient Stock
Management
Incentive details
9/9/2011 9
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
9/9/2011 11
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
9/9/2011 12
• 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
9/9/2011 13
• Comprehensive service delivery
• Reduced IMR, MMR and TFR
• Universal coverage of immunization
• Reduction in anemia and malnutrition
POTENTIAL OUTCOMES OF E-MAMTA
9/9/2011 14
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
9/9/2011 17
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
9/9/2011 21
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
9/9/2011 22
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
9/9/2011 23
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
9/9/2011 24
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.
9/9/2011 28
Expectation from DST, GoG
and Department of IT, GoI
9/9/2011 29
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.
9/9/2011 30
ISSUES
9/9/2011 31
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9/9/2011 34