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Medical & Health Information System In Indian Environment Experiences with Project Dhanwantari

Medical & Health Information System In Indian Environment Experiences with Project Dhanwantari. By. Maj Gen (Dr) RK Bagga, AVSM (Retd.) Dr M V Krishnamurthy Dir UOL. IT Enabling Technologies. High speed Micro Processors - Affordable Massively Parallel Computer

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Medical & Health Information System In Indian Environment Experiences with Project Dhanwantari

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  1. Medical & Health Information SystemIn Indian EnvironmentExperiences with Project Dhanwantari By Maj Gen (Dr) RK Bagga, AVSM (Retd.) Dr M V Krishnamurthy Dir UOL

  2. ITEnabling Technologies • High speed Micro Processors - Affordable • Massively Parallel Computer • High Resolution Graphic Monitor • High speed Data Networks-Visualisation • AI and Expert System • Robotics • Multi Media & Virtual Reality • 2G->3G->4G Mobile Revolution

  3. IT for Health Care Management • Networking • Internet • Intranet • Extranet • Web • Online Search • Ocean of Information

  4. IT for Health Care Management • Database Technology • High Performance Database Servers • Object-Oriented Databases • Distributed Fault Tolerant Databases • Data Ware Housing • Data Mining • Security and Privacy • Grid/Cloud Computing

  5. IT in MedicineTypical Application Areas • Computer Diagnosis • AI/ES • Genemapping • Surgery • Digital Visualisation • Heart Modelling • Education & Research • MM & VR • e-Learning

  6. IT in Medicine Typical Application Areas • Rehabilitation of Handicapped • Robotic • Information System • Patient Care • Hospital Managements • Telemedicine

  7. PRINCIPLES OF COMPUTER-ASSISTED SURGERY Preoperative scanning 3D View of the Operation area & the instrument’s position 3D Position measurement Z X CT or MR Slices Y CT - Computer Tomography MR - Magnetic resonance Generation of the Volume Model

  8. Children’s Hospital of Pittsburgh Presbyterian University Hospital School of Medicine; Neurological Surgery School of Medicine Anesthesiology Eye & Ear Hospital Monteflore Hospital Veterans Admn. Hospital Magee Women’s Hospital School of Engineering Electrical Engineering Real Time Monitoring - 1600 Brain Surgeries/year Deptt. of CS MEDNET - LINKS REMOTE MEDICAL FACILITIES IN REAL TIME

  9. Virtual Reality Assisted Surgery Program (VRASP) Plan Review/Rehearse Compu ting system Comms Conduct Surgery Virtual image Surgeon-B Surgeon-A World frame of reference Patient Patient

  10. MENU BAR Patient Parameters - Graph Temp BP ECG Neuro Comn Pulse TV PICTURE MEDNET SCREEN:- X WINDOW INTERFACE

  11. DHANWANTRI(1994-1996) A Computer based medical information system for military hospitals to facilitate patient care and hospital administration. A joint effort by DEBEL, Bangalore Computer Centre, DRDL, Hyderabad MH, Secunderabad

  12. Modules of Dhanwantri • Phase-I • Central Registration • Medical Inspection Room(MI Room) • Polyclinic • Pathology • Phase-II • Medical Stores • Dispensary • Radiology • Operation Theatre • Wards

  13. Salient Features of Dhanwantri • Focus on patient care rather than billing. • Capturing of all the relevant information of a patient. • Quick updation and retrieval of patient’s case history. • Elimination/Minimisation of duplication of data. • Simultaneous access of the database at several places by several users.

  14. Salient Features of Dhanwantri • Automatic generation of various statistical/ summary reports, registers, slips etc. • Immediate answers to several adhoc queries • Quick accessing of medical data for research or any other purposes. • Better management of hospital resources such as bed, wards, medical stores etc. • Highly sophisticated user-friendly interface. • Smooth transition from manual to computerised system.

  15. System Configuration Central Computer: Pentium server with 32 MB memory & 2 GB hard disk Standby Computer: PC 486 with 16MB memory & 2GB hard disk. Remote Stations: Terminals connected through port boxes & line drivers. Software: SCO UNIX Operating system & ORACLE 7 RDBMS (multiuser).

  16. Methodology • Feasibility Study • Formulating broad objective • Economic & technical feasibility • Submission of feasibility report • Requirements Analysis • Studying the existing manual system • Study of forms, registers, reports, slips, etc. • Meetings, Interviews, Presentations etc. • Working out the Configuration Requirements • Hardware, Software, Communiction • Preparation of SRS Report & Review of SRS

  17. Methodology • Preliminary Design • Detailed Data Flow Analysis • Data Modelling & Design • Architectural Design (Structured Charts) • User Interface Design • Control Flow Analysis • Preparation of PDR • Review of PDR

  18. Methodology • Detailed Design & Implementation • Implementation in Oracle 7.0 • Screens (Forms 3.0) • Reports, Registers, Slips (Report Writer) • Testing & Integration • Function wise testing • Integration with the Module • Module wise testing • System testing

  19. Methodology • Installation • Cabling • Installation of HW • Porting & testing of Dhanwantri • User Training • User level training • System Administrator training

  20. Methodology • Operational Support • Overviewing • Onsight Hardware/Software Problems • User Feedback • System & Database Administration • Streamlining Startup/Shutdown Procedures • Streamlining Backup/Archival Procedures • Security

  21. Methodology • Maintenance • Correction of bugs • Modifications • New Requirements • Remote Maintenance

  22. Dhanwantri Software 1. No of Modules 90 2. No of Tables 210 3. No of Forms 200 4. No of Reports 100

  23. Dhanwantri Project Team • Software Development • Scientists 4 • Staff 8 • Project trainees 12 • Hardware & Networking • Officers 2 • Staff 3 • Coordination with MH • Officers 2

  24. Dhanwantri Milestones • Initiation of Project by SA to RM 2 Oct 94 • Phase-I • Requirement Analysis Dec 94 • Preliminary Design Mar 95 • Implementation Jul 95 • Testing & Integration Sep 95 • Hardware Installation & Cabling Oct 95 • Software Inst. & User Training Oct 95 • Launching by SA to RM 25 Nov 95 • Revised Version 1.0 Apr 96 • Revised Version 2.0 Aug 96

  25. Dhanwantri Milestones • Phase-II • Initiation of Project Apr 96 • Requirement Analysis Jun 96 • Preliminary Design Aug 96 • Implementation Nov 96 • Testing & Integration with Phase-I Dec 96 • Installation at MH Dec 96 • User training & feedback under progress • Operational support from Oct 96 • Hardware maintenance • Software maintenance

  26. Experiences • Development Phase • Difficulties in Extracting/Specifying Requirements • Design Difficulties • Implementation Problems • System Problems

  27. Experiences • Operational Phase • Resource Constraints • Terminals, Printers, Stationary etc. • Infrastructure Constraints • Power, Communication etc. • Cultural Change • Lack of awareness • Initial fear/apprehension • Additional work load • Need for Continuous Support

  28. Experiences • Underestimation of Development Time and Effort • Manpower Problems • 10 Years ahead of Indian Government Scenario RR Hospital Delhi

  29. CONCLUSION & LESSONS • It is must for India & Medical field • Realistic plans/Projects in our context • Affordable Infra-Structure-Must • Safety-Critical System-Highly Reliable • Info System for Medical Care-Available • No Computer can replace man • Maintenance of computerised System-Must • Software cannot be taken for granted.

  30. Any Questions ?

  31. Thank You

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