e-healthcare - dr madhu raikwar, director, ministry of health & family welfare, government of...
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E- HEALTHCARE
Dr Madhu RaikwarDirector & Head
Central Bureau of Health Intelligence(CBHI)
Dte. G.H.S.Ministry of Health and FW
Govt. of India
INTRODUCTION TO CBHI • Established in 1961 by an Act of Parliament after Mudaliar Committee’s recommendation
• National Nodal Health Intelligence Wing of the Dte.GHS/MOHFW/GOI
•WHO Collaborating Centre on Family of International Classifications (ICD-10 & ICF) for India
A strong Health Intelligence System in the country
VISION
To strengthen health information system in every district of the country up to facility level, for evidence based decision making to improve population health
MISSION
Web Based Maintenance and Dissemination Of
National Health Profile of India (NHP) Health Sector Policy Reform Options
Database National Health Resource Repository
OBJECTIVES RELATED WITH E- HEALTHCARE
NATIONAL HEALTH PROFILE Contains information under 6 sub-heads:
a. Demographic Profile
b. Socio- Economic Status
c. Health Status
d. Health Finance
e. Human Resources &
f. Health Infrastructure Indicators
NATIONAL HEALTH PROFILE Collection of Data
Monthly online morbidity & mortality data from all States/UTs on – Communicable diseases & Non-communicable diseases.
Annual online data of the country on:– Health Infrastructure, Health human resources & Health
Finance
Dissemination of NHP online thru CBHI Website and e- book on national Health Profile.
Health Sector-Policy Reform Options Database
Developed by the CBHI with the aim to share information about good practices and innovations in Indian health sector.
Initially developed as a collaborative venture between GOI & European Commission
CBHI uses its 6 FSUs located at different RD offices to explore information related to reform initiatives
An easily accessible tool to publicise successful endeavours and share reform know-how to solve common problems.
Grouped under 16 major health sector areas Further details about HS-PROD are available at
http://hsprodindia.nic.in
CBHI website HS-PROD India (Home Page)
NATIONAL HEALTH RESOURCE REPOSITORY
MAPPING AND PROVIDING INSIGHTS INTO HEALTH FACILITIES IN INDIA
Capturing evidence and providing analytics across:
around 2 lcs public health facilities
over 8.5 lcs private doctors
close to 7 lcs chemists
1 lacs diagnostic labs
7.3 lcs AYUSH doctors
15k private hospitals
398 medical colleges
CONTEXT---- High patient fall in private sector:
in-patient services are provided in private sector
Lack of information on private sector health resources:Numbers and types of private sector health facilities (Hospitals, Labs, Imaging centres) along with their locations, HR and types of services provided
No uniform nationwide system for comprehensive intelligence :Inadequate mechanism for obtaining and analyzing information on healthcare infrastructure and manpower in these sectors at the district level
PROJECT AIMS AND OBJECTIVES
Single platform for comprehensive information of
approx. 18.5 lacs public and private health resources
including hospitals, doctors, chemists, diagnostic labs
etc. capturing over 400 data variables
Key outcomes
o Comprehensive data on all health resources including private doctors, health facilities, chemists, and diagnostics labs
o Establishment of a National Health Resource Repository for evidence based decision making – aligned with Digital India mission
o Enhanced coordination between central and state government for optimization of health resources and effective development of PIPs
o Accessibility of data at all level, including State HODs, thus, decentralize the decision making at district and state level
Key benefits
Harmonization of public health information for judicious health resource allocation, management & monitoring through real world intelligence
Visibility of private sector health resources to enable public-private partnership - this will help in bridging the gaps in public health sector in specialized departments
Common platform with standard information for the use of central/state government, providers, payers, citizens and other stakeholders
Key benefits
Technology enabled mass outreach campaign to doctors, hospitals, chemists, etc – especially useful during the time of disaster management
Integrate with the Digital India Programme of easily accessible platform for information on healthcare service delivery
Geo-tagging of distribution pattern of health resources in the country
Creates transparency and establishes an accountability mechanism for effective centre-to-state health care funding
FRAMEWORK FOR NATIONAL ROLL-OUT
Jan 2016
Formulation of Project Steering Committee
Awareness and consensus building
Appointment of External agencies for different roles
Pre-test in few states
Dec 2016
Data collection across all 676 districts in the country
Development of technical applications
Till 2017
Periodic data updates and validation
Awareness and consensus building
Capacity building and training workshops
Knowledge transfer
Program Initiation Data Collection Data update,
Communication
Data collection Monitoring support
oEvery 3 year data updateoLinkage with National Registry Network (NRN)oMechanism of periodic updateoMechanism of monitoring and data validationoSynchronizing with HMISoUtilizing existing technical infrastructureoUtilizing existing manpower capacity in CBHI
Continuity Plan
Prioritization of the states
Phase 2: August’16
ChandigarhPunjabDaman & DiuUttarakhandAndhraTelanganaTamil NaduKarnatakaMaharashtra
MPGoaDadar & Nagar
PuducherryKeralaHimachalTripuraLakshadweepAndaman
SikkimAssamMizoramArunachalOdishaWest BengalMeghalayaNagalandManipur
Phase 3: December’16
Phase 4: August’16
Phase 1: Feb’16
UPBihar HaryanaJ&KRajasthanChhattisgarhGujaratJharkhandDelhi
Launch of National Health
Resource Repository 15th August
2017
Progress summary…
pilot to test the feasibility in four districts:DimapurDungarpurHazaribaghVellore
2016
Data across 400+ data variables was collected and analyzed
22 September 2015Hon’ble Union Minister for H&FW, announced the nationwide roll-out of National Health Resource Repository
Project implementation
20152014
Stakeholder meeting on NHRR and demo of pilot tool
2017
Based on the successful pilot, a detailed project report for national roll-out was prepared and submitted
Overview Of Project Pilot project covering 4 districts – Dungarpur, Vellore, Dimapur,
Hazaribagh
Exhaustive mapping done for health resources for both public and private facilities
Geo tagging for abt. 2,100 health facilities with over 400 data variables
The pilot was funded by Bill & Melinda Gates Foundation and executed by IMS Health
District PopulationPrivate Public
Doctors Hospitals SC PHC CHC SDH DHVellore,
Tamil Nadu 20,00,000 869 56 231 57 5 - 3
Dimapur, Nagaland 3,78,811 107 14 38 10 2 - 1
Dungarpur, Rajasthan 13,88,552 66 15 346 50 14 1 1
Hazaribagh, Jharkhand 17,34,495 56 17 116 12 10 - 1
Data Variables for Pilot study
Quality Control
Equipment and Drugs
Manpower & Training
InfraStructure
Services
Access
Facility Details
Technology Orientation
400+Data
Variables
Facility Name Facility Contact NumberRegistration NumberConsultation FeesConsultation Days, timingWard charges
GPS CoordinatesDistance between facilitiesDistance from farthest village
Basic ServicesSpecialist Services Services under National Programs
Building Sections Beds and WardsUtilitiesFurniture
No of Management Staff, Clinical Staff, Paramedical Staff, IV grade StaffType & Level of TrainingNumber of staff trained
TypeAvailabilityFunctionality DurationEssential and Critical drug availability
Citizen charter DisplayedRecord MaintenanceRogi Kalyan Samiti
Usage of computer/internet
Email Id,Website
KEY FINDINGS FROM PILOTUn-availability of specialty services – one of the key concerns for adequate service delivery
Roadblock to deliver AYUSH Mission – 75% of PHCs do not have Medical Officer for AYUSH
Un-availability of Manpower non-availability of specialty services – one of the key concerns for adequate service delivery
Roadblock to deliver AYUSH Mission – 75% of PHCs do not have Medical Officer for AYUSH
19%
77%
58%
39%
19%32%
42%
3%
94% 97%
General Surgeon
Physician
Pharmacist
Gynecologist
Peadiatrician
Anesthetist
Public Health
Program Manager
Eye Surgeon
Laboratory
Technician
ANMs
CHC fulfilling I PHS HR norms
Geographical AccessRemote villages still far away from service delivery point – 40% CHCs have farthest village located at a distance more than 25 km
Access to tertiary care (DH) is a major concern
39%
39%
22%
0-25 km 25-50 km >50 km
58%
36%
6%
CHC to farthest village
CHC to DH
KEY FINDINGS FROM PILOTQuality of service Lot of CHCs not performing c-section because of either manpower, infrastructure or equipment unavailability
Infrastructure Basic infrastructure not adequate – Unavailability of Piped water supply, Toilets, etc
Technology orientation Computer usage shows a declining trend - Relatively good in DH and CHCs, however, needs significant improvement at grass root
83.33% 80.64%
40.31%
9.16%
DH CHC PHC SC
Facilities using Computers for Record Keeping
65% 67%40% 31%
10% 17%30%
27%
26% 17% 29% 43%
CHC DH PHC SCBelow IPHS As per IPHS Above IPHS
>1.2L80K - 1.2L
<80K
>10L9 - 10L
<9L
>30K
20 - 30K
<20K
>5K
3 - 5K
<3K
Facility Utilization
To function as India Head for WHO Family of International Classification
• CBHI collaborates with all the WHO – Collaborating Centers on Family of International Classifications (FIC) in the World, Asia Pacific Network on FIC and Countries of South East Asia Region.
• International Networking
WAY-FORWARD :-
CBHI is in the process of digitalization of Medical Records of govt. hospitals
Planned to use ICT in implementation & advocacy of WHO- FIC in India for standardized coding of diseases
THANK YOU