Mumbai hospital’s 2018 projects help maintain medical records of 23K Covid patients

However, amid the Covid pandemic, a pilot project of Mumbai’s Nair hospital, that was initially implemented in 2018 — Hospital Management Information System (HMIS) — has provided a sigh of relief to the healthcare workers

A critical Covid-19 patient has to undergo several diagnostic tests daily in a hospital. Maintaining essential reports of thousands of Covid-19 patients is an uphill task for the already overwhelmed medical staffers. However, amid the pandemic, a pilot project of BYL Nair Hospital, Mumbai Central that was initially implemented in 2018 — Hospital Management Information System (HMIS) — has provided a sigh of relief to the healthcare workers (HCWs). The project was widely criticised by doctors in 2018. All the medical documents including prescriptions, discharge summary, bed count, X-ray films and CT scans are maintained online with individual unique health identity (UHID) cards of the patients.

Beneficiaries wait to get inoculated against Covid at Nair hospital in Mumbai (Anshuman Poyrekar/HT PHOTO)

HMIS is an ambitious project of BMC that is aimed at revamping the structures of the hospitals.

Easy to maintain records

Under this, ₹100 crore worth system, all the data starting from the medical records and reports will be made online across the civic-run hospitals. Under the pilot project, over 700 high tech Lenovo computers were brought in 2018 to replace the old ones at Nair Hospital to run HMIS. The application has been developed in a joint venture of the IT department of Brihanmumbai Municipal Corporation (BMC), Nair Hospital, Inspira Enterprise Private limited, Manorama Info Solutions Limited, Med synaptic Private Limited and Dynacons systems and solutions Limited.

Since the outbreak of the pandemic in March 2020, over seven lakh individuals have contracted Covid-19 in the city and almost 20% of them have procured treatment in civic-run hospitals. Amid the overflowing of patients during the first and second wave, the medical staffers, especially the nurses, struggled to maintain the records of the patients. Often due to the manpower crunch, several doctors complained of getting the reports from the radiology and laboratory late, which are essential in providing timely treatment to Covid-19 patients.

However, the HMIS in Nair Hospital eased up the work of the HCWs.

In the last 18 months, the HMIS of the hospital has stored medical records of 23,293 Covid-19 patients. Of these, 449 of them were outpatient department (OPD), 11,159 were inpatient department (IPD) and 11,685 of the patients were in an emergency ward.

“With the growing number of Covid-19 patients, it is important to digitally record all patients. For enhanced management of Covid-19 crisis, HMIS is also enabled with different dashboards and advanced analytical reporting that provides a summarised as well as a detailed view of hospital departmental statistics like total registered cases, hospital beds occupancy, symptomatic and discharged patients,” said Dr Ramesh Bharamal, dean of the hospital.

Facilitate faster, safer diagnosis of patients

The radiology department is directly connected with the software which helps in faster and more efficient reporting. Through an advanced technology— Picture Archiving and Communication System, the reports of the CT-scan, X-ray, sonography among others are directly uploaded on the system. This has helped in reducing the dependency on the manpower strength and wastage of the films.

“As we have seen, the health condition of a Covid-19 patient can deteriorate suddenly within a few minutes. So, this requires time detection of the health complications of the patient. Now, as the laboratory and radiology department are synced with the system, doctors are being able to access the reports quicker on their desktop, without waiting for the HCWs to physically procure those,” said Dr Sarika Chapane, nodal officer of HMIS.

All patients are provided with UHID cards that hold their individual unique number with barcode numbers. The cards also have the name of the patients, locality, age, gender and contact number.

Not only that, the record of the daily usage of medicines is being maintained online under the sales registry. The data is uploaded online with the drugs’ batch number, quantity with the UHID number of patients. This helps in maintaining transparency and curb cases of malpractice in the hospital. Due to these live updates, the hospital is able to keep a tab on the availability of drugs and their shortages.

In OPD, the patients according to their UHID numbers are separated into new and follow up wards. The hospital has also installed over 15 LED TVs in OPDs which are linked with HMIS. The screens keep updating the patients in the waiting area when they are due for the checkup with their names and UHID numbers.

“Amid the pandemic, it is essential to maintain the social distance in the OPD. So, with this system in place, we have been able to disperse the crowd,” said Dr Chapane.

The UHID cards have played a pivotal role in reducing the physical contact of the HCWs with the suspected patients on OPD.

“So, with the scanning of the barcode on UHID cards, the on-duty doctors or nurses on OPD can see all the detailed medical reports on the desktop without touching the physical files of the patients, this has helped in controlling the spread of the infection,” said Dr Chapane.

With the successful implementation of HMIS at Nair Hospital, the system has also been initiated in other civic-run hospitals like Dr RN Cooper in Juhu, Rajawadi in Ghatkopar, Shatabdi Hospital in Kandivli and Kasturba Gandhi Hospital in Chinchpokli.

In 2018, when the system was initiated, medicos refused to use it without data operating officers. The doctors at Nair Hospital claimed it would only add up to their workload.

But now, amid the pandemic, the hospital hasn’t received any such opposition.

“When a doctor is new, the data operating officer assists him/her for some time. But eventually, the doctors themselves have to upload the details of the patients. Doctors are also being trained to provide printed prescriptions to the patients in OPD through the system,” said Dr Chapane.