India has a long way to go to make use of its success in information technology for healthcare for its 1.2 billion population.
Despite promises by the government to introduce computerisation for maintaining medical records, the situation is dismal. The country does not even have standardisation in common medical terminologies.
“Our medical terms and names of medicines differ from location to location. For example, the technical term for heart attack is myocardial infarction. But it is called heart attack or even attacked heart by doctors. Similarly, medicines are prescribed instead of the salts they contain. So we cannot maintain a proper record of medical history of patients,” said Sushil K Meher, computer faculty, AIIMS.
“Without the data, we cannot analyse the health situation in India,” he said at a conference on medical informatics organised by AIIMS’ computer faculty. Recently, the health ministry had announced that public hospitals in Delhi will get electronic medical records, where information of every patient will be digitised and made available to every hospital.
The ministry plans to start the process with Safdarjung Hospital, Ram Manohar Lohia Hospital and Lady Hardinge Hospital. Doctors, paramedics and representatives of companies involved in promoting IT-based healthcare attended the conference.
It had sessions on tele-medicines, through which doctors prescribe medicine on phone. The concept of ‘mobile health’, through which patients can get information about diseases on cellphones, were also discussed. Using the internet for healthcare was another highlight of the meeting.
“India has a ratio of one doctor per 1,700 people. Unless we move extensively to information technology, the gap in health services cannot be filled,” said Meher. Doctors slammed the government for not spending even 3 per cent of the Gross National Product maintenence of health services.
According to doctors, work overload and lack of good training facilities for nurses and paramedical staff pose a hindrance in using computers for maintaining patients’ medical records.
“Our chain-management programme is not in place. The government should provide guidelines to share details of treatment of a patient among doctors in case the patient chooses to change the doctor. This will make the system transparent,” added Meher.
Linked to UID
Dr Sanjay Bedi, member of web-based learning committee of the Medical Council of India, said the government is considering using Unique Identification Number (UID) to maintain medical records.
“It was not part of the original proposal, but the government plans to link healthcare with the UID project,” said Dr Bedi.
It is a tough call for India to maintain a unified medical record of every citizen due to the sheer number of the population. Also, the country has a shifting population. Lakhs of labourers have bad fingerprints due to the nature of their work.
“Once UID cards are given to all, which will take five years, healthcare can become a part of the project,” said Dr S K Biswas, deputy director, Indian Council of Medical Research. However, he said the quality of healthcare must improve first before adopting IT.
He said it is important to have computerised medical records because patients, especially from lower income groups who come to government hospitals, usually do not bring old prescription cards. Only Taiwan and Hong Kong have centralised database of medical records.
“The US also does not have a national database because of medico-legal and security issues. It will be easier for anyone to access all information about a person. In the US, individual hospitals maintain the data. I suggest we follow the same method in India as well,” said Dr Biswas.