Health at your Fingertips

Imagine a breed of mobile phones that keep their owners healthy and well
informed about health related issues. Such a species of mobile phones does exist
in the Kozhikode (formerly Calicut) district of Kerela. Surprised? You might as
well be.

The force behind making these mobiles and thus the citizens healthy is the
Doctors Project, called the Dr SMS project, which was flagged on March 29, 2008.
Kerala Chief Minister VS Achuthandan inaugurated the project on November 07,
2008. Dr A Jayathilak, district collector Kozhikode explains the benefits of
this service. During emergencies, timely attention is more important than
specialized attention given late and Dr SMS will help to find the nearest place
where such facilities are available, he says. This facility is available
round-the-clock.

The sole idea of the project is to enable people to use their mobile phones
to get information on health resources. The service, first of its kind in the
country, provides the users with a comprehensive list of medical facilities
available in their locality like hospitals having expertise in various medical
specialties (cardiology, orthopedics, etc). It can also list out the specialized
doctors in the area, for eg, ENT specialists.

The facility is now fully operational in Kozhikode. To avail the facility all
that the user has to is to send an SMS to a pre-designated number (9446460600).
The contents of the SMS should be the pin-code of the locality where the
doctors, hospitals, etc, need to be located.

The National Informatics Center and the state information technology
department support the project infrastructure. The unique system has been
nominated for the National e-Governance Award 2008-09 in the health sector. The
system can give pointers to blood banks, diagnostic centers, private hospitals,
specialty centers, facilities for surgery and ventilators, and the list of
specialist doctors in the district.

And if all goes well, the facility is soon going to be available across the
state of Kerela.

The Health Beep

According to Dr A Jayathilak, district collector, Kozhikode, The objective
of this project is to provide health facilities information to the public
through SMS services, email alerts and health portals. The postal index number
has been used as the reference point for the SMS service. Based on the PIN Code,
one can get the SMS feeds of the Health facilities available in and around the
mentioned PIN code. The portal also provides a detailed list of health
facilities available in and around the Kozhikode district.

The project has been successful in creating a central repository of health
facilities available in Kozhikode. It was started keeping in mind the massive
usability and the penetration of mobile phones in the city. This service is
mobile phone oriented and that has not only made it extremely popular but also a
useful device in case of emergencies. The fact that it is area-specific and
instantaneous has only assisted its popularity.

Says Jayathilak, The Dr SMS service is a unique attempt in the health sector
through mobile phones. The project proves that mobile telephones are a great
tool to disseminate the benefits of the digital technology, especially
considering that the mobile penetration in Kerala is over 50% and increasing as
compared to around 10% of Internet penetration. Mobile phones are more
affordable compared to broadband and therefore Dr SMS has much greater reach.
Road accident victims can use this facility to reach the hospital without
delay.

The project has been an initiative of Kerela State IT Mission. Kerala State
Information Technology Mission (KSITM) is a society registered under the
Travancore Cochin Literary Scientific and Charitable Societies Registration Act
(Act 12 of 1955). It is an autonomous nodal IT implementation agency for the
Department of Information Technology, Government of Kerala, which provides
managerial support to various initiatives of the department.

The society acts as an interface between the industry and the government and
has been associated with various e-governance projects like IT@SCHOOL, KSWAN,
m-Governance, etc. The Dr SMS project is, like most others, totally funded by
the state government.

Beyond SMS

The Dr SMS project operates at different levels and can be availed across
various media. For instance, if you send a message with your pin-code and your
email ID, then the system automatically generates a detailed email and relays it
to your account.

The project also incorporates a health portal. This portal provides a
Web-based information mechanism enabled via the Geographical Information System
(GIS)-based details on various health-related attributes. The health centers can
be easily located through the portal. The latitudes and longitudes of the health
facility centers are also stored in the database.

This GIS is regularly supplied with data and helps in providing an
interactive map of the health facilities available across the city. According
to Jayathilak, the assimilation and compilation of data for this system was one
of the heftiest tasks while the project was under construction.

The success of this project was highly dependent on the correctness and
timely updating of data. Finalization of data collection performa and collection
of correct data from hospitals were the main challenges, he says. But he is
also quick to give credit where its due. Very good support was received from
the district medical office, Kozhikode for finalizing the data collection
performa. Efficient services of block level field staff of NRHM, Kozhikode was
utilized for data collection. The district medical office ensured correctness of
data. Second phase data updation/collection has been already started by NRHM,
he adds.

Facilitating Change

Jayathilak agrees that a huge amount of change management had to be
initiated before the project was bought into existence. A good amount of
Government Process Re-engineering (GPR) was also required. But all this he says,
are part and parcel of the preliminary process for any e-governance project.
Many workflows, job designs, control mechanisms, and organizational structures
are either superfluous or obsolete, and should be completely redesigned, he
says.

Training people and integrating them into project-driven processes is another
major challenge. For this purpose, a well-equipped training center was
established at the Collectorate with a seating capacity of twenty people, for
providing periodical training programs to all the employees in this project.

However, no user-intensive training was required given the familiarity of the
general public with the mobile devices. Only the formats of the SMS were
communicated to the public through mass media.

Technologies Utilized

The project envisages the development of spatial as well non-spatial
database using state of the art Geographical Information System (GIS) and
database and MIS Technologies. The final delivery of application is through
Health GIS System. It is to be noted that GIS is the technology and application
tool used to map the parameters of health survey and provide location-specific
status of public health infrastructure facilities and services.

Another interesting thing is that this is a system developed purely on open
source technology. The software is developed in the LAPP (Linux Apache PHP and
PostgreSQL) model. In this project, the GPRS modem is used to give the result of
the queries to the public. The gateway software, which is required for
configuring the modem for communication (Kannel software) is also an open source
tool. The cost of the setting up of this project was close to nothing.

The Impact

The Dr SMS project has got a very good response from the public. This is one
of the first initiatives in the country on the Health Information System.
According to Jayathilak, there are two main factors responsible for this effect:
one is the mobile savvy nation that we are, and our love for SMSes, and the
second is the growing concern for all issues related to health.

Jayathilaks views on e-governance projects gives us much to hope for. He
says that a widespread use of e-gov methods will ensure efficiency,
effectiveness, transparency and accountability of informational and
transactional exchanges within the government, between the government and
government agencies of national, state, municipal and local levels, citizen and
businesses, and to empower citizens through access and use of information.

E-governance not only makes tasks and functions much easier and relatively
error free, it also allows citizens to participate actively in the system. Says
Jayathilak, A concept of government to citizen to government (G2C2G), in many
ways, is opening up avenues for direct participation of individuals in the
governance processes. This model fully exploits the potential of ICT/Internet
and leverages it for greater participation, efficiency and transparency in
functioning of the government as well as savings in time and costs relating to
decision-making.

Given this favorable opinion of e-gov projects, it is hardly surprising that
Jayathilak hopes to ape this project and initiate many such projects across the
state of Kerela. He hopes to build a knowledge nation based on best e-gov
practices. We say Amen to that.

Mehak Chawla

mehakc@cybermedia.co.in