e-Health & Telemedicine

 

Ministry of Health & Family Welfare has undertaken various initiatives using Information & Communication Technologies (ICT) for improving efficiency & effectiveness of the public healthcare system. Ministry is continuously working on planning and introducing more of ICT initiatives. The ICT initiatives by Ministry are briefed as under:

 

Online Services:



National Health Portal

With an overall objective to create awareness amongst the citizens about health, Government programmes & services in Health Sector, National Health Portal (NHP) provides information to citizens and stakeholders in different languages (currently six languages Hindi, English, Tamil, Gujarati, Bengali, and Punjabi). A voice portal, providing information through a toll-free number 1800-180-1104 and Mobile App are also available.

Website: http://www.nhp.gov.in

Online Registration System (ORS):

In order to improve ease of services for citizens, Online Registration System (ORS) launched in July 2015 provides services to citizens for taking online registration & appointment, payment of fees, online viewing diagnostic reports, enquiring availability of blood online etc. in various public hospitals. As on date, over 100 hospitals are on board

ORS and so far around 9 lakh appointments have been transacted online. ORS has significantly help in improving patient management services at registration and appointment desk.

Website:http://www.ors.gov.in/

`Mera Aspataal’ (Patient Feedback) Application :

To empower citizens to participate in improvement of healthcare service delivery by providing feedback on service quality, facilities etc. at hospitals and ultimately help establish patient driven, responsive and accountable healthcare system, this application has been launched which is an IT based feedback system to collect information on patients’ level of

satisfaction using a multi-channel approach viz. SMS, Outbound Dialing, Web Portal, and Mobile App. It is expected to help the government to take appropriate decisions for enhancing the quality of healthcare delivery across public facilities which will improve the patient’s experience. The patient will be able to receive an effective and appropriate care. Currently, more than 150 hospitals  have been covered.


Website: http://meraaspataal.nhp.gov.in/

Central Drugs Standards Control Organisation, “SUGAM”  :

To provide a “single window” for multiple stakeholders (Pharma Industry, Regulators, Citizens) involved in the processes of Central Drugs Standards Control Organisation, “SUGAM” enables online submission of applications, their tracking, processing & grant of approvals online mainly for drugs, clinical trials, ethics committee, medical devices, vaccines and cosmetics.


Website: http://www.cdsco.nic.in/

Food Safety and Standards Authority of India (FSSAI):

For ease of services to food sector stakeholders, Food Safety and Standards Authority of India is offering services for Online License, Clearance, Product approval  to the Food Business Operators.


Website: http://www.fssai.gov.in/


National Organ & Tissue Transplant Organisation (NOTTO):

In order to promote organ donation amongst citizens at large, National Organ & Tissue Transplant Organisation through its web-portal offers services for Online Registration for Organ/Tissue Transplantation or Retrieval and Online pledge registry by citizen for organ donation.


Website: http://www.notto.nic.in/

Mobile Applications:



To harness the wide penetration of mobile connectivity (~ 1 billion connections), various mobile apps have been launched so far; namely :

i. Vaccine Tracker (Indradhanush Immunization) : support parents in tracking immunization status of their children and helps them in ensuring complete and timely vaccination.

Launch- April, 2016

Google Play

http://www.nhp.gov.in/nhp-indradhanush_pg

https://play.google.com/store/apps/details?id=com.nhp.ui&hl=en

 

 

ii. India Fights Dengue (enables a user to check Dengue Symptoms, get nearest Hospital / Blood bank information and also share feedback)

Launch- April, 2016

Google Play

https://play.google.com/store/apps/details?id=com.nhp.ui&hl=en 

 

iii. NHP Swasth Bharat:(information dissemination on Disease, Lifestyle, First Aid)             

Launch- April, 2016

http://www.nhp.gov.in/nhp-swasth-bharat_pg

Google Play

https://play.google.com/store/apps/details?id=com.nhp.ui&hl=en

 

iv. NHP Directory Services Mobile App. (provides information related to Hospitals across India)            

Launch- June, 2015

http://www.nhp.gov.in/nhp-health-directory-services-mobile-application_pg

Google Play

https://play.google.com/store/apps/details?id=com.nhp.ui&hl=en 

 

v. No More Tension Mobile App. (information on stress management related aspects)             

Launch- November, 2016

https://www.nhp.gov.in/mobile-no-more-tension

Google Play

 https://play.google.com/store/apps/details?id=com.myphoneme.www.stress

 

vi. Pradhan Mantri Surakshit Matritva Abhiyan Mobile App. (for reporting pregnancy care related information from across states)

            

Launch- November, 2016

https://www.nhp.gov.in/mobile-pmsma

Google Play

 https://play.google.com/store/apps/details?id=com.nhp.pmsma

 

vii. Mera Aspataal Mobile App (for reporting pregnancy care related information from across states)

            

[ Launch- August, 2016 ]

https://www.nhp.gov.in/mobile-mera-aspataal

Google Play

 https://play.google.com/store/apps/details?id=com.mahiti.myhospital

Service Delivery & Tracking :


Mother and Child Tracking System (MCTS) / Reproductive Child Health (RCH) application

It is an individual-based tracking system implemented across all the States & UTs to facilitate timely delivery of antenatal and postnatal care services and immunization to children with an objective of improving IMR, MMR, & morbidity; providing alerts to health service providers about the services due list and service delivery gaps; appropriate health promotion messages to beneficiaries. Currently over 12 crore pregnant women and around 11 crore children have been registered on MCTS / RCH portal since inception.

Website: http://www.rch.nhm.gov.in/RCH/

 

 



Kilkari:

It delivers free, weekly, time-appropriate 72 audio messages about pregnancy, child birth and child care delivery to families’ mobile phones. Approximately 6 crore successful calls have been made so far under Kilkari in Bihar, Chhattisgarh, Haryana, Himachal Pradesh, Jharkhand, Madhya Pradesh, Odisha, Rajasthan, Uttar Pradesh and Uttarakhand.

Toll free number: 1800-3010-1703

 

TB Patient Monitoring System “Nikshay”:

For tracking of individuals for treatment-adherence has been implemented across all States for monitoring of TB patients. Also a Missed Call Centre facility with Toll Free No: 1800-11-6666 for reaching to unreached TB patients is available, for counselling and treatment support. Approximately 80 lakh patients have been registered on Nikshay.

Toll free number: 1800-3010-1703

 

 

 

Tobacco Cessation Programme

Is is a mobile-based interventional initiative for counselling and helping people to quit tobacco, by giving a missed call to 011-22901701. Currently over 20 lakhs total missed calls have been captured and around 15 lakhs users are registered for this programme.

Website: http://www.nhp.gov.in/quit-tobacco

 

mDiabetes Program :

It is a mobile-based initiative for prevention and care of diabetes by giving a missed call to 011-22901701. Currently more than 1 lakh users are registered for mDiabetes

Website: http://mdiabetes.nhp.gov.in/

Process automation :


Hospital Information System (HIS):


HIS is being implemented in hospitals for automation of hospital processes to achieve better efficiency and service delivery in Public Health facilities upto CHC level. Targeted impact includes facilitation in hospital workflow management leading to better delivery of services to patients and improvement in efficiency of processes at hospitals. Key implementation milestones include:

a) e-Hospital developed by NIC has been implemented on cloud platform in over 100 hospitals as on date and more than 50 hospitals are on standalone platform

b) e-Sushrut application of C-DAC Noida has been Functional in Rajasthan (State-wide: 80 facilities) & 15 hospitals in other states

ANM on Line (ANMOL):

 A tablet based application for Integrated RCH Register which allows ANMs to enter and update data for beneficiaries of their jurisdiction has been piloted in the State of Andhra Pradesh and currently around 15,000 ANMs are working on ANMOL in  Andhra Pradesh  and pilot districts of MP & Telangana

Drugs and Vaccines Distribution Management System (DVDMS) (‘eAushidhi’):

It deals with purchase, inventory management and distribution of various drugs, sutures and surgical items to various District Drug Warehouses of State / UT, District Hospitals (DH), their sub stores at CHC, PHC etc by automating the workflow of procurement, supply chain, quality control and finance department in State / UT level. DVDMS has been implemented so far in 9 States/UTs – Andhra Pradesh, Gujarat, Jammu & Kashmir, Madhya Pradesh, Maharashtra, Odisha, Punjab, Rajasthan &Telangana and is in process in 8 States/UTs- UP, UK, Bihar, HP, Manipur, Jharkhand, Meghalaya & Chhattisgarh. DVDMS has also been implemented in Central Medical Services Society (CMSS) - a Central Procurement Agency under Department of Health & Family Welfare and is under implementation TB Division & Family Planning Division of MoHFW. States like Tamil Nadu, Tripura, Haryana, Karnataka, Kerala, Delhi and West Bengal have implemented IT based supply chain management systems other than DVDMS, but which have similar features.


eRakt Kosh:

eRakt Kosh has been launched which is a comprehensive, efficient and total quality management approach with the help of online systems and is being rolled out for all the licensed blood banks in public and private health facilities in States / UTs. eRakt Kosh  is online in 7 Blood Bank in States/UTs of Delhi, Madhya Pradesh, Uttarakhand and Uttar Pradesh. Around 124 Blood Banks are registered on e-RaktKosh Portal for Blood Stock Updation. 2 blood banks in Uttrakhand, 1 in UP and 1 in West Bengal are in process of using the application.

Website: http://www.eraktkosh.in/

MIS & Surveillance :

Health Management Information System (HMIS) :

HMIS is a web based portal for monitoring the programmes under National Health Mission (NHM).

For monthly service delivery data reporting from public health facilities to improve program monitoring and management.   Approximately 2 lakhs Health facilities are regularly reporting on HMIS Portal. It is integrated with GIS and available in public domain.

Website: https://nrhm-mis.nic.in/

Integrated Disease Surveillance Programme  (IDSP):

Online portal for data entry, reports, data  analysis, training modules, on which ~90% districts report weekly surveillance data through portal. There is also a 24x7 call centre for disease alerts on a toll free number; for verification and initiating appropriate action

Website: http://idsp.nic.in/

Central Dashboard:

Central Dashboard is being developed for monitoring of key indicators related to different health programmes of the Ministry.

Dashboard system collects data from existing public health information systems (i.e. HMIS, IDSP, MCTS, Nikshay, etc) The Dashboard system will also help in analysing/ measuring progress on newer healthcare initiatives of MoHFW, Government of India

Standards & Regulations :


National Digital Health Authority (NDHA)

NDHA is being set up by MoHFW as  nodal agency for formulation, adoption & regulation of eHealth Standards in India as well as work as nodal agency for all strategic eHealth initiatives in India. The Act for setting up of NDHA has been drafted and is under approval process to be placed in public domain for suggestions and comments.

EHR Standards:

(revised version of 2013 Standards) has been notified in December 2016. The EHR Standards include standards for Disease Classification, Medicine and Clinical terminology, Laboratory Data exchange, Digital Imaging and Communication etc. for semantic interoperability.

Website link: http://mohfw.nic.in/sites/default/files/17739294021483341357_1.pdf

Metadata & Data Standards (MDDS):

Committee on Health Domain Metadata and Data Standards has approved the Health Domain MDDS standards. The MDDS is intended to bring semantic interoperability among all health IT system. This is a prerequisite for establishing interoperability among disparate health information systems. Health Domain MDDS has created more than 1000 data elements and 142 code directories. Most of these standards are drawn from global standards however these are developed keeping in view local health information systems requirements. The standards were developed following a rigorous consultation and review process and public opinion was also sought and incorporated on these standards.

National Resource Centre for EHR Standards (NRCeS):

NRCeS is set up in order to augment facilitation for adoption of the notified EHR Standards in technical association with C-DAC, Pune for providing assistance in developing, implementing and using EHR standards effectively in healthcare IT applications in India. NRCeS would also support NDHA.

Website link: http://snomedctnrc.in/

National Identification Number (NIN)

A unique identification number, which a key requirement for achieving inter-operability and creation of EHRs, is being assigned to all health facilities (both public & private) to facilitate inter-operability among health IT systems deployed. So far more than 2 lakh Public Health Facilities have been allocated NIN. The process for setting up mechanism for allocating NIN to private facilities is underway.

Website: http://nin.nhp.gov.in

Capacity Building :


Mobile Academy

It is a free audio training course designed to expand and refresh the knowledge base of ASHAs and improve their communication skills Launched in 2016. A total of over 70000 ASHAs  have completed the Mobile Academy course since inception in Bihar, Chattisgarh, Himachal Pradesh, Jharkhand, Madhya Pradesh, Rajasthan and Uttarakhand.

Toll free number: 1800-3010-1704

Training Management Information System (TMIS):

 

TMIS implemented by a number of States Haryana, Karnataka, Odisha, Telangana, Himachal Pradesh etc. for management of skill development/upgradation of health professionals/workers 

Digital health has huge potential of improving the healthcare delivery system and capable of changing the landscape of healthcare industry across the globe. Government of India has been increasingly focusing on Digital Health to bring about improvements in Indian public healthcare delivery by progressively using Information & Communication Technology under the overall objective of Digital India.



Online Consultation - Tele-Medicine


For universal outreach of healthcare services in an affordable manner, MoHFW has aligned its initiatives along with the Sustainable Development Goals (SDGs) to ensure healthy life and well-being of the citizens. MoHFW has proactively taken a leap to utilize the effective fusion of Information and Communication Technologies (ICT) with existing health infrastructure in meeting the challenges of healthcare delivery to rural and remote areas to ensure continuum of care. Keeping in view the benefit which can be reaped from the ICT innovations in Healthcare service delivery, MoHFW has espoused citizen centric approach in transforming the way the healthcare is being functional presently. By encompassing ICT innovations, Tele-health solutions are being promoted to deliver basic and specialized health care services nearest to the end user in inaccessible and rural areas. The key initiatives of the Department in this direction include National Medical College Network, National Telemedicine Network, Use of Space Technology for Telemedicine etc. The key officials and their contact details in Telemedicine Division are:



National Medical College Network (NMCN) :

Under National Medical College Network (NMCN), scheme,  50 Govt. Medical Colleges  are being inter-linked with the purpose of  Tele-education, e-Learning and Online Medical Consultation by utilising the connectivity provided by National Knowledge Network (NKN).

Under this initative, a virtual layer of  Specialty/ Super Specialty doctors  from these Medical colleges would  be created  for providing “Online Medical Consultation” facility to citizens which will be similar to OPD facility but in a virtual way through a web-portal. This will help patients from rural, remote and urban areas to access doctors and specialists easily even from their home location through their Smart Phones, through Government healthcare institutions (PHC/CHC) {and through Common Service Centers (CSCs)}.  Also eClass room are being set up at these medical colleges for sharing and streaming the important Lectures/ seminars.

Under Phase I of the scheme a National–cum-Regional Resource Centre, 7 Regional Resource Centres and 42 other Medical Colleges having connectivity provided by National Knowledge Network (NKN) shall be networked.


National Telemedicine Network (NTN):

 National Telemedicine Network (NTN)” has been envisaged to provide Telemedicine Services to the remote areas by upgrading existing Government Healthcare Facilities (MC, DH, SDH, PHC, and CHC) in States. Telemedicine nodes across India are being created inter connecting SDH/PHC/CHC, District Hospital and Medical College in every State for providing Citizen-centric services. This  TM  Network will start in Synchronous with the roll out of NOFN across country . In the first phase of National Telemedicine Network project, it is proposed to connect 500 PHC/CHC/SDH at remote/rural locations with 100 District Hospitals and 50 Medical Colleges..

Mission Directors of NHM of all the States/UTs have been advised to seek financial assistance under their respective State/UTs Programme Implementation Plan (PIP) of National Health Mission (NHM) scheme for strengthening and promoting Telemedicine network. So far financial aid has been provided 7 States.


Establishment of SATCOM based Telemedicine Nodes

 Department of Space (DoS) through Indian Space Research Organisation (ISRO), had initiated a nationwide Telemedicine (TM) programme in 2001 and provided TM systems hardware, software, communication equipment as well as satellite bandwidth for 384 Hospitals with 60 specialty hospitals connected to 306 remote/rural/district/medical college hospitals. Eighteen (18) Mobile Telemedicine units were also enabled for Satellite connectivity. The existing TM nodes are underutilized and at present only around 100 Telemedicine nodes are operational.
 A Memorandum of Understanding (MoU) has been signed between MoH&FW and ISRO (copy enclosed) on 15.07.2016. As per MoU MoH&FW would adopt and revive the existing Telemedicine Nodes in Phases.

 In line with the Prime Minister vision of using space technology to deliver health services, and considering the shortage of doctors in remote, inaccessible and rural areas of the country, MoHFW & Department of Space (DoS) jointly have been taking steps to set up Satellite communication based Telemedicine nodes at various unreachable geographical locations including Chardhams and other important pilgrimage centres (Amarnath, Ayappa and Kedarnath) where the quantum of pilgrims are massive for health awareness, screening of non-communicable disease (NCD) and for providing specialty consultation to the devotees visiting these places.  Initially the tele-health services are operationalized in the field of medicine, orthopedics, respiratory and cardiology disciplines.  All these telemedicine nodes are now part of the ISRO National Telemedicine network and could also be serviced by any of the specialist nodes across the country like, PGI-Chandigarh, SGPGI-Lucknow, JIPMER-Pondicherry and AIIMS-New Delhi etc.

A Telemedicine Mobile Van has been deployed at Ujjain Kumbh Mela from 22nd April, 2016 to 21st May, 2016 from SGPGI, Lucknow. The Telemedicine van equipped with Medical Equipment is being used for health awareness, screening of Non-Communicable Diseases (NCD) of the devotees visiting Kumbh Mela. Required Specialist consultation for some devotees is also being provided by Doctors from AIIMS, Bhopal and SGPGI, Lucknow through telemedicine by using VSAT connectivity provided by Department of Space (DOS).