There are huge gaps in healthcare facilities in India. It is even worse when it comes to rural areas. There are shortages of doctors, nurses and hospital beds. The skewed ratios of Doctor:Patient (1:1,700); Nurse:Patient (1:1,100); and, Number of Hospital Beds:Citizens (1:10,000) with a population of 1.3 billion is a big burden on the government to provide healthcare. Adding to it is, the huge rural-urban divide in terms of availability, accessibility and affordability of care. Maharashtra decided to invest in it to leverage the power of information technology (IT) as a quick solution to mitigate some of the issues associated with this mammoth problem. The government-run institutions—Grant Government Medical College & Sir JJ Group of Hospitals—partnered with Hewlett Packard (now Hewlett Packard Enterprise) to implement Healthcare Management Information System (HMIS) project to address these problems.
Healthcare system in India faces multiple challenges. It ranges from patient convenience to quality of service and administrative costs. The major challenges are listed below:
- Waiting in queues for registration.
- Huge patient waiting time that sometime runs into days for those seeking appointments with specialists.
- Misplaced medical records/reports.
- Decision on treatment plan dependent on the arrival of reports.
- Medication error because of manual process.
- Mismatch of Patient Samples.
- Administration and Record Keeping.
The HMIS is designed to give the clinicians access to the patient database from anywhere in the hospital through a unique User ID and Password. The HMIS is provided to all users in all departments spread across large acres of land. Secondly, the lab equipments are interfaced with the HMIS system, which directly posts the results online through a unique ID for each sample, for the clinicians to decide on the line of treatment. All the patient data including their diagnostic reports are stored in the data center created in the hospital. The radiology and lab equipment are interfaced with the HMIS application. The scans and reports are uploaded as soon as they are ready so that a clinician can view these on his system in the operation theatre or in ward. This has drastically improved the delivery of healthcare services especially in case of an emergency.
The new system has led to significant reduction in patient-waiting time and time required for registration and enhanced transparency. During the manual registration being done by hospital clerks only 3 to 4 registration counters were available but after introducing HMIS system, the number of counters increased to 16 depending on the volume of patients.
The average waiting time at counters has reduced to about 7 minutes from about 55 minutes before. Thus, the waiting time at registration counters has reduced by nearly 90 per cent. Each patient is allocated with a queue number, which is available for the clinicians at their workstations. This helps in a big way in managing the patient queue in a particular department in an orderly fashion. This has resulted in increased revenue collection. Implementation of HMIS has been able to clog the pilferage in a big way, which normally is evident in a government organisation.