Enabling health care

C-DAC creates software suites for Hospital Information System, a state-of-the-art IT tool for the health care sector.

HOSPITAL Information System (HIS) is one of the most promising applications of information technology in the health care sector and while the corporate sector hospitals have managed to enable their operations, the large number of public hospitals have been denied these state-of-the-art tools - until now. Agencies such as C-DAC have created software suites for HIS that can be used with minor tweaking, in a number of health care environments. The aim is to use a network of computers to collect, process and retrieve patient care and administrative information from various departments for all hospital activities to satisfy the functional requirement of the users. It also helps as a decision support system for the hospital authorities to develop comprehensive health care policies.

The C-DAC system has been commissioned at the Sanjay Gandhi Post-Graduate Institute (SGPGI), Lucknow, and the Guru Teg Bahadur Hospital (GTB), Delhi. The C-DAC Noida centre is implementing a current version of the same at the Mahatma Gandhi Institute of Medical Sciences, Sevagram, Maharashtra.

ONCONET (CancerNet Phase-II) is a telemedicine project being implemented by C-DAC at the Regional Cancer Centre (RCC), Thiruvananthapuram. It includes a backbone computer network and provides telemedicine services in cancer detection, treatment, pain relief and patient follow-up at the RCC and its nodal centres. The RCC is linked to the nearest Internet gateway through a 64 kbps leased line, while the peripheral centres operate through a dial-up connection.

With the help of the local doctor at the tele-clinic, patients access specialists at the RCC for consultation and follow-up treatment. Video-conferencing provides tele-consultation between the patient at the remote end and the expert at the RCC.

A tele-pathology clinic set up at the RCC, Thiruvananthapuram, provides expert/second opinion on digitised microscopic images sent from its nodal centre. In addition to sending images to the RCC as e-mail attachment, it can send digitised images of pathology slides to experts abroad for second opinion.

Based on the success of the CancerNet, an enhancement project has been taken up by the centre, with participation by the RCC, the Indian Space Research Organisation and the Department of Information Technology. The main objective of the project is to establish `Knowledge enabled CancerNet' - Online Cancer Detection and Patient Follow-up Management System - enhancing its quality and impact using high bandwidth connectivity with matching hardware and software, upgrading and integrating backend systems and processes.

In October 2004, the C-DAC-RCC project was extended to northern Kerala with the help of the Malabar Cancer Care Society (MCCS). Chief Minister Oommen Chandy inaugurated the project at the MCCS Early Cancer Detection Centre in Kozhikode on October 28.

In another Kerala-based initiative, the health directorates and hospitals are being progressively computerised. The first phase involves the computerisation of the five health directorates: the Directorate of Health Services (DHS), the Directorate of Medical Education (DME), the Directorate of Indian Systems of Medicine (DISM), the Directorate of Ayurveda Medical Education (DAME) and the Directorate of Homoeopathy (D.H.) and the computerisation of the Medical College Hospital, Thiruvananthapuram.

The software applications being developed for the directorates are Employee Records Module for maintaining the service records of employees, file tracking module for finding the location of files, budget monitoring and control module for budget allocation and monitoring of utilisation, baseline data management module for maintaining institutional data, infrastructure facility and MIS module for enquiry and reporting on health programmes.

The software applications being developed for the medical college are OP management module for out-patient registration and queue management; in-patient and ward management module for patient admission, discharge, printing of passes and case sheets; laboratory management module for test ordering, results entry and printing; resource scheduler for scheduling of theatres and facilities and an enquiry module.

The total computerisation of medical college hospitals in Thiruvananthapuram, Kottayam, Kozhikode, as well as the district and taluk hospitals, initially in Thiruvananthapuram district, is also apace.

Another challenging task addressed by C-DAC is the monitoring and reporting of health and nutrition status of children, women and girls at the 24,000 anganwadi centres in 163 blocks.

Telemedicine is another area of concern for C-DAC. The Integrated Telemedicine Solution, Mercury, has been implemented between medical colleges in Cuttack, Shimla and Rohtak. It provides a rich set of tools to manage the Electronic Medical Record (EMR) of the patient and conduct effective TeleConsultations. Mercury allows the doctor to quickly put together the hard-copy Patient Record (PR - celluloid films, ECG strips, videos, existing reports and notes) into the patients' EMR and classify them. These may either be scanned in or can be acquired using direct interfaces to the appropriate clinical devices. The physician can quickly navigate through the consolidated EMR using Mercury's advanced navigation features. All documents and images are stored in an encrypted form. The system also equips the physicians with a rich toolset to examine different data. It supports tools to pan, zoom, rotate, mark regions of interest and to annotate the data. Extensive Image Processing features are also provided. Using Mercury's user-friendly interface, the physician can also quickly add notes on the patient's progress and can create reports.

To seek the opinion of a specialist using TeleConsultation, the physician can connect to the specialist's PC from within Mercury. The presenting physician uploads the relevant portions of the EMR to the specialist's Telemedicine Station. They can exchange text messages to confer about aspects that are not brought out by the presented EMR. They can even get into a videoconference. The advice and reports that are the outcomes of TeleConsultation are sent back to the presenting doctor, to print and pass on to the patient.

For connectivity, the system uses any existing means that supports the industry standard protocol, TCP/IP, with dial-up connections or ISDN. More options are being added. For videoconferencing, Mercury interfaces with all standard videoconferencing equipment that support MS NetMeeting 3.0.

Shruti Drishti is a Web page browser developed for visually challenged users. It allows a simplified representation of textual information available on the Web. It offers the option of presenting the displayed information either in a verbal mode using a speech synthesiser or in the Braille format. The verbal mode of information representation provides descriptive information on all elements of a Web page, including links, buttons, check box, text and so on. Shruti Drishti provides `keyboard only' accessibility using a minimal set of keys. It also provides a large text window for partially sighted users and a standard Web page browser to enable users to work together with sighted workers. Shruti Drishti is the result of a joint research and development initiative between Media Lab Asia, C-DAC and Webel Mediatronics Ltd.

Another C-DAC product developed in Thiruvananthapuram is a low-cost digital hearing aid, the DHA-1, using a specially developed chip that provides fine noise filters matched to the wearer and a digital volume control.