Consider this: When a child is born, its name immediately gets registered
with the birth registration authorities through a unique ID-which also
automatically generates an immunization schedule for the baby. What’s more,
every morning the software alerts the health authorities about the list of
children in the area whose immunization is due. The result: a 100% immunization
In addition, the same health ID can be used to maintain an online health
record of the person throughout its life, no matter wherever he goes. The
compiled database is then corroborated at the district health office, where it
is mapped with the help of the GIS system of the area. This healthcare tracking
mechanism can help generate real-time data and many problems can be nipped out
in its early stages, increasing the economic productivity of the individuals.
Noting the potential impact of advances in ICT on healthcare, the World
Health Assembly has recently adopted a resolution on eHealth: "The
resolution urges member states to endeavor to reach communities, including
vulnerable groups, with eHealth services, and requests the WHO Director General
to continue the expansion of mechanisms such as the Health Academy, which
promote health awareness and healthy lifestyles through eLearning."
The Indian government has taken many initiatives in this direction but it’s
still a long way off. Unfortunately, the current thrust is on high-cost
initiatives, not on more effective ones. In this scenario, the district health
information system can be an important tool for reaching the common man, though
in the light of the WHO resolution a roadmap is yet to be worked out.
Computerization of birth and death records: The entire population of a
district needs to be indexed, with each member given a health number or a file
number in the form of his name and his/her father’s name. This will help in
identifying an individual with regard to his/her health parameters, including
immunization records, and disease patterns. Though many state governments,
especially the Delhi government, have started computerizing the birth records,
but it’s being done in a standalone manner. The citizen IDs so generated need
to be linked to the health records.
Computer literacy among doctors: For this, special tailor-made computer
courses for doctors should be designed. Unfortunately, though Medical Council of
India has proposed computerization of medical records in its code of ethics, it
has failed to enforce its proposal. Moreover, computers still do not constitute
the essential equipment for inspections by the council.
ICT infrastructure: Though many state governments have started providing
computers at hospitals, it would of no use in the absence of personnel to run
these computers. In addition, proper medical software is still a far cry. To
pool all the health information from private and government hospitals, all the
computers of these healthcenters have to be interlinked, with the central node
at district headquarters. Thankfully, some new technology like health-related
smart cards and RFID is on its way.
Feeding daily OPD/patient data: This includes their health index number and
their diagnosis. Disease registries have come up as public repositories of
health data like www.canceratlasindia.org, which is an important repository for
cancer patients’ data.
Interpretation of data: Based on this complete information, the district
health authorities can track any epidemic or any other health irregularity that
may erupt at any one localized spot in the district. Many softwares are now
freely available for this purpose, like Epiinfo and Epimap, downloadable from http://www.cdc.gov/epiinfo.
Finally, increasing crunch on healthcare resources can be met only by
extensive use of IT. In addition, infections diseases can only be tracked by
instantaneous evaluation of data. Then, what holds us?
Dr Sanjay Bedi is the editor-in-chief of Indian Journal of Medical
Informatic, and associate professor at SGRD Institute of Medical Sciences,