The Inside Story of National Health Portal of India

National Health Portal of India has been on our minds for a long time. This is the inside story of working for the national health portal of India which is scheduled for launch on 1st October 2013, almost four years after it first came under consideration. It’s a very optimistic project and a wordle created from the project report showcases that very well.

First, some history and background.

Backed by the National Knowledge Commission, a working group committee sent its Project Report on setting and developing the national health portal for India in August 2010. The NKC proposed to launch the National Health Information Portal which would serve as a comprehensive source on health information in India. The portal plans to serve as a single point of access for consolidated health information, application and resources on the sector and aim to cater to a wide spectrum of users from citizens, to students, healthcare professionals and researchers.

The proposal also aims to create space for other portals, publishers, IT and non IT based interventions. It is envisaged that private enterprises would join the government in creating new tools and services with the help of all the Data to be collected via NHP. This is a humungous task by any standards and the progress on the portal has been understandably slow.

A recent meet at AIIMS organized by HIMSS India and attended by Dr. Suptendra Nath Sarbadhikari, Project Director, Centre for Health Informatics of the National Health Portal cleared the mystery surrounding the progress of National Health Portal. During the meet, a lot of time was spent on stressing the need for Uniform Data Standards to be adopted so that all EHRs across the country (private and public hospitals) can be connected to the national health portal. With the addition of Prof. Indrajit Bhattacharya, the team at the National Health Portal is now well positioned to take this project forward.

The meet highlighted 3 main topics of discussion;

1) Data standards and Interoperability

2) Mobile apps for content distribution

3) Social Media Help desk and social networking activities

In order to accumulate data from various state health departments, government hospitals and private hospitals, we need a common system for entering the health data. The GOI has not yet taken the effort to set up a recommended set of data standards which can be followed by all hospitals and institutes while storing data. Unless data standards to be followed are finalized soon, linking/ merging of diverse sets of healthcare data will be close to impossible in the future.

Mobile apps and device agnostic websites were identified as an important next step in the project. The project objective is also to improve health literacy of the masses in India. One immediate hurdle for the National Health Portal is the need for authentic and high quality content in multiple languages.  At this stage, It is not desirable that NHP spends its efforts and money creating original content for education of consumers and healthcare practitioners.Except for a core team (4 or 5) of graphic artists and subject matter experts to create interactive and visual media on a daily/weekly basis, the task of content creation could very well be outsourced. The NHP team can always validate the content after creation and before it is uploaded to the website. Besides, a lot of content is freely available from international sources like Centre For Disease Control (CDC) and World Health Organization which can be hot-linked on the portal. Professional content curation and dissemination via mobile apps will play a huge role in providing content for the National Health Portal.

Another important consideration at the NHP meet was the creation of a Social Media Helpdesk for the portal. Social Networking is the new fact of our connected lives today and the NHP plans to make full use of existing platforms like Facebook and Twitter to further its agenda. Social Networking would also be utilized via various health Forums planned on the portal. Social Media will be a key component of the content distribution strategy.

The National Health Portal will always be a work in motion. You, too, can have a say in how that happens. We have created a Facebook page for this project. You can join us on Facebook to share your views/suggestions as well as Tweet us your suggestions by using the hashtag #nhportal.  We will make sure all tweets and comments are forwarded to the right authorities.

This update has also been shared on India Health Network website.

Why Doctors Love To Hate Electronic Health Records

Doctors love to hate electronic health records. Over the years, many surveys have tried to pinpoint the physicians who are more likely to be satisfied by their EHRs. Surveys have found that those in primary care or Internal medicine are generally more satisfied with their EHRs than their colleagues in Oncology or Ophthalmology. Also, solo physicians were the most satisfied and that satisfaction decreased as the practice size grew to 50 physicians. Physicians in 100% productivity-based practices were more satisfied than salaried physicians. 

So what are the top reasons doctors love electronic health records?

1) An electronic record forces documentation of many steps which might be otherwise missed. More thorough documentation of clinical visits leads to less leakage of revenue.

2) In medicine, patient data is the source of all decisions. EHRs make data retrieval easier and thus quality of patient service is enhanced

3) Doctors are no longer tied to their desks and can work from anywhere anytime.

As many doctors will be quick to point out, EHR adoption also comes with a lot of pain-points.

1) There is no guaranteed improvement in productivity. In fact, there could be a loss of productivity in the short term.

2) Some EHRs are badly designed and require too many steps/ clicks for relatively simple documentation procedure, for eg. CPOE.. Sometimes, important data maybe difficult to find.

3) The omnipresent computer monitor and keyboard is not a very likeable third party in the examination room. It is an obstacle to one-to-one relationship building between doctors and patients.

Nevertheless, electronic health records are used widely and are here to stay. Insights into the reasons some EHRs are preferred over others can be an important advantage for many companies in this multi-billion-dollar industry.
You can read the original AMA article here.

Also see:
-How Poor Health IT Implementation Can Hurt Patients : Electronic health records can improve care, but doctors should also be mindful of some health IT obstacles that can be detrimental to patients.
-How To Ease EHR Frustration : EHRs can slow physicians' practices to a crawl, but evidence suggests they ultimately pay off.

The Top 20 EMR Software Solutions

A very useful infographic provided by Capterra, the website which specializes in comparing business software. This infographic takes a look at the most popular EMR solutions in the market ( eClinicalWorks is number one) and grades them by total number of users, target audience, followers on social media etc.

© 2011 Capterra, Inc.
You can read about their reasoning and data analysis methods here.

Related articles

• Infographic: The 25 Most Important Online Project Management Solutions (readwriteweb.com)
• EHR Adoption To Reach 80% By 2016 (informationweek.com)
• Top 12 Mashable Infographics (mashable.com)

Doing More With EMRs: What Are The Top Reasons For Failure?

Electronic Medical Records hold a lot of promise. When used well, EMRs decrease drug errors, streamline work flow, assist in clinical decisions and allow efficient accounting. At the same time, EMRs chosen without proper thought and assessment can cause long term pains. The really restrictive EMRs won't even let you shift medical data elsewhere and healthcare providers maybe stuck with outdated EMRs soon after buying them.

EMR failures are most often a cause of one or more of the following four reasons

• Technical EMR implementation failures, because of issues with hardware/ software combination or wireless connectivity issues;
• Financial failures, where the expected EMR ROI wasn’t realized, or the costs were significantly more than expected;
• Software incompatibility issues, where the EMR system didn’t interface with an existing medical practice management system; and
• People-related issues, where some physicians or staff members avoid training or simply refuse to use the EMR system. 

Making an EMR work for a healthcare provider needs work before, during and after installation of an EMR system. When choosing an EMR system, Ignore the bells and whistles and Look at the nuts and bolts.

Indian Medical Association Plans Programs to Make Members Tech Savvy

The potential of improving Healthcare quality by proper use of technology is immense.Recent advances in information technology offer clinicians valuable new tools to support the medical management of patients. HIT has the potential to enable a dramatic transformation in the delivery of health care, making it safer, more effective, and more efficient.

The national unit of the Indian Medical Association (IMA) has decided to make its two lakh members across the country, especially senior medical practitioners, more tech savvy. The National vice-president of IMA, Dr Devendra Shirole says,“Short contact programs of four days will be organized at all local branches of the IMA. Doctors will be trained on how to use information technology for the betterment of medical profession and patents’ data collection.” He said the doctors will be also trained on using e-books in their daily practice.

The IMA will launch this project initially in Maharashtra and the inauguration will take place in Mumbai. Groups, formed for research purposes, will use information technology to study diseases and viruses.To undertake this vast project, talks are on with software companies to provide trainings and technical support, as well as help IMA build web pages for the same.

Also See:

• Costs and Benefits of Health Information Technology
• Technoclinics- Upcoming scenario in India

Using EMRs to improve Efficiency : Video

Using Electronic Medical records in managing medical practices provides a number of benefits, especially in smaller practices where it is much easier to introduce. A few of these benefits include efficient and portable patient care management, lesser errors and improved patient safety.

See how one private practice made the change to electronic medical records and hear how the new technology has changed the office's workflow and staffing levels.

Though this video has been created by Intel, it is a generic video describing the benefits of EMRs to physician practices and does NOT sell anything.

Related articles

• Electronic medical record (EMR) - review of pros and cons in Cleveland Clinic medical journal (casesblog.blogspot.com)
• Using the EMR to reduce ventilator associated lung injury (doctorrw.blogspot.com)
• A Family Physician's EMR Experience (thehealthcareblog.com)