The Health Department’s ambitious e-health project has managed to complete a tumultuous pilot phase with “significant achievements” on one side and much valuable lessons learnt on the other.
However, scaling up of the project across the State could remain a far-fetched dream, as the financial investment it entails is huge and the technical challenges immense, it is feared.
The ₹96-crore project envisages the development of an electronic demographic data base, electronic health records (EHRs) of a population and end-to-end automation of all government hospitals. With less than ₹30 crore Central funds remaining to be secured, finding funds to sustain the project in the long term is a challenge that the Health Department will have to face head on.
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“We have demonstrated through the pilot that the project has immense potential and is eminently doable. But it will take at least four to five years to stabilise and we will have to continue the verification and rectification process,” said Additional Chief Secretary (Health) Rajeev Sadanandan.
Started in 2013, the project ran into rough weather after questions were raised about the quality and competency of the software acquired for the project and could get off its feet only by the end of 2015.
It was initially started in 11 hospitals in Thiruvananthapuram district, and scaled up to seven districts by 2018. But the State has barely managed to complete the pilot, thanks to a huge mismatch between the scope of the project as envisaged by the Health Department and the reach of the software.
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Patient management was a priority and at present, the OP module, which includes digitisation of hospital registrations and a queue management system, seems to be working well. It has eased crowding at Thiruvananthapuram Medical College, one of the pilot sites.
The other modules — IP module, labs, pharmacy and imageology — are still being incorporated and the process could take time.
In Peroorkada district hospital where e-health was formally launched by the Chief Minister, the project never really took off. Efforts are on to revive it there.
“Re-organising the health system on a digital platform is expected to ease processes, not complicate it. Wherever the domain needs are not recognised by the implementers, it will evoke little user-interest. Doctors were very receptive initially, but they gave up when the system responses failed them, especially when they had to deal with hundreds of distressed patients at a time,” a senior Health official said.
“The software could not accommodate the complexities of our domain requirements beyond the level of primary health centres and had to be reconfigured over and over. Though it has taken more time than we expected, the pilot phase has been a huge learning experience. We will assimilate our lessons, improve the software and go forward,” said C. Jayan, joint director, e-health.
On the public health side, the demographic data of some 1.25 crore population, captured by field-level health workers, have been uploaded into the central data base. Scaling up the project across districts would require more intense planning, further software tweaking and a steady flow of copious amount of funds, anywhere from ₹250 crore upwards.
“The Kerala Infrastructure Investment Fund Board (KIIFB) could be a funding option but we will make a move only after we stabilise the project,” said Mr. Sadanandan.