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Updated: November 20, 2013 10:11 IST

e-health, a central nervous system for Kerala hospitals

C. Maya
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It is your first visit to a hospital, but the doctor knows your medical history. A Rs.96-crore e-Health initiative will help government hospitals in the State work this magic.

The Health Department is in the final stages of floating a request for proposal for implementing the initiative, first such in India to create electronic medical records of citizens and electronic health records of a population.

The State won the megaproject from the Electronics and Information Technology Department of the Union Ministry of Communication and Information Technology early this year, for developing an electronic demographic database and a hospital automation system. The State government is investing Rs.9 crore in the project, while the Centre will bear the rest.

The project envisages a central data server holding health and demographic data of the population and linked to the HMIS (Health Management Information System) projects of all health institutions in the State, right down to the level of sub-centres.

“We had invited the expression of interest a few months ago and a few companies had applied. We have evaluated the proposals and are in the process of finalising the request for proposal, which has to be cleared by the various subcommittees working on the project and the executive committee,” M. Beena, State Mission Director, National Rural Health Mission, says.


The project will be implemented in the first phase in Thiruvananthapuram. In Phase II, it will be scaled up to include all government health institutions in Kollam, Malappuram, Kasaragod, Alappuzha, Idukki and Ernakulam. The rest of the districts will be included in Phase III.

The Health Department is studying models of electronic medical records and electronic health records used by various health systems and private hospitals.

Senior officials are in discussions to examine the logistic solutions required for floating the dynamic project, as bandwidth availability and last-mile connectivity can be crucial in enabling information flow from various health institutions to the central data server.

Twin arms

The server is one of the two arms of the system. The data will be collected at all levels of interaction within the health system, including the data collected by health field workers, who will be provided handheld devices to record and transmit health information collected from households during their field visits.

The information relating to communicable and non-communicable diseases, maternal and child care and family planning will be constantly updated. The captured data will be integrated to form the State Health Information System database.

The second part of the project envisages end-to-end automation of government hospitals. All government healthcare institution processes will be automated, including all hospital processes from registration, outpatient consultation, inpatient admission and laboratory diagnosis to discharge of the patient.

Apart from easing the administrative processes, the system will store the electronic medical records of all citizens who access the health system, which makes continuity of medical care easier. A clinician attached to any hospital in the health system can access the centralised database or the electronic medical records if he has the patient’s unique id.

Privacy clauses will be incorporated to protect the citizen’s right to confidentiality. Sensitive personal information will be held only by the patient. All healthcare institutions will be connected through the Kerala State Wide Area Network.

“We are talking about seamless information flow from the field to the centralised database and it should be in sync with our other systems, such as the HMIS, IDSP (Integrated Disease Surveillance Project), etc. The volume of data generated and updated will be huge and hence achieving last-mile connectivity will be very crucial. We have to set up the system first before we will look at our options for suitable software and hardware,” K. Ellangovan, Principal Secretary, Health, says.

The Union government has drawn up a format for electronic medical records and electronic health records, fixing the minimum data set that each should have, given the Indian context, he says.

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