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Sanjay
Gandhi Postgraduate Institute (SGPGI), Lucknow
and C-DAC have been involved in a stimulating
exercise for the last 3 years to develop a Hospital
Information System (HIS). SGPGI is a young tertiary
care super specialty hospital which started
in 1987 and became fully functional in the early
1990s. It has always been a forward thinking
Institution having established itself as a purely
super specialty center, a model that did not
exist elsewhere in the country. The Institution
also had started many specialties which did
not exist in other centers and its teaching
- training programs had many novel aspects.
Being a new institution, it had the advantage
of not being bound down by established cultures.
In this scenario, it was not surprising that
SGPGI should think in terms of total computerization
of its patient care facilities. The preliminary
discussions had started in the early years of
the institute. However, the Institute seriously
started to look at the various available options
in 1995 and realized that ready made packages
available at the time were not suitable for
the needs of an Indian public sector hospital.
Added to that SGPGI did not offer its services
free and needed to have a strong billing package.
In 1996, a memorandum of understanding was signed
with C-DAC to jointly develop a HIS package
for the local needs.
After
extensive interactions between the C-DAC programmers
and the end users at SGPGI, an FRS was developed
consisting of 14 modules which were to cover
the various aspects related to patient care.
The C-DAC programmers, by and large young and
enthusiastic new comers, had never visited a
hospital. The end user had even less idea as
to what computerization held in store. After
many hiccups the first module, for patient registration,
was deployed in June 1998 and outpatient functions
were made online in August 1998.
SGPGI
took a conscious decision that computerization
would not involve additional manpower but would
be implemented by retraining the existing personnel.
This did in some measure add to the delays in
implementation but the final outcome was gratifying.
A large number of our staff - registration clerks,
billing clerks, nurses, technicians and others
- learnt to use the modules, sometimes with
reluctance and sometimes with enthusiasm!! The
doctors were by and large enthusiastic. The
other functions were also gradually brought
online and to-day we can say without hesitation
that we are the only totally computerized hospital
in the country. We have over 200 nodes linked
to the central server and from admission to
discharge all patient related activities are
online.
We
have not reached this stage without some hiccups
along the way. There were occasions when a function
was made online and the system gave problems,
forcing us to opt for temporary manual solutions.
The constant interaction between the core team
at SGPGI and the C-DAC team provided these solutions.
Since neither side had any previous experience
of such a software, many of the original ideas
had to be modified. But we learnt as we went
along and C-DAC was responsive to the need for
modifications. In fact, many of the software
team came to know all about how hospitals function.
And some of us learnt a little about software!
So,
the final product is almost complete. The SGPGI
patient is a happier person, since there are
no lost files, no misplaced reports, appointments
are streamlined and billing is hassle free.
The hospital has benefited in myriad ways and
the staff feel happy to be working in such a
environment. It has also thrown up new challenges
- an online system has to be up and running
24 hours a day, all around the year; the data
volume are enormous and have to be managed!!!
The rapidly changing technology makes it imperative
that we think of where we can improve further
for the benefit of the patient and the doctor.
Should we go in for picture archival systems?
What about smart cards? Are these cost effective?
These are issues we need to address especially
in the context of our country.
Finally,
SGPGI is proud to have a functioning HIS which
has improved the quality of the patient care.
The process of its development and implementation
has been a wonderful experience for all those
connected with it. Our association with C-DAC
through out the process has been one of partners
and we hope that the association will continue
in the years ahead.
Dr.
(Mrs.) Sita Naik
Prof. & Head Dept. of Immunology, SGPGI
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