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
Slide 2
IT Enabling 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
Slide 3
IT for Health Care Management Networking Internet Intranet
Extranet Web Online Search Ocean of Information
Slide 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
Slide 5
IT in Medicine Typical Application Areas Computer Diagnosis
AI/ES Genemapping Surgery Digital Visualisation Heart Modelling
Education & Research MM & VR e-Learning
Slide 6
IT in Medicine Typical Application Areas Rehabilitation of
Handicapped Robotic Information System Patient Care Hospital
Managements Telemedicine
Slide 7
PRINCIPLES OF COMPUTER-ASSISTED SURGERY X Y Z CT - Computer
Tomography MR - Magnetic resonance Generation of the Volume Model
3D View of the Operation area & the instruments position 3D
Position measurement CT or MR Slices Preoperative scanning
Slide 8
Childrens Hospital of Pittsburgh Presbyterian University
Hospital School of Medicine; Neurological Surgery Eye & Ear
HospitalMonteflore Hospital School of Medicine Anesthesiology
Veterans Admn. Hospital Magee Womens Hospital School of Engineering
Electrical Engineering Deptt. of CS MEDNET - LINKS REMOTE MEDICAL
FACILITIES IN REAL TIME Real Time Monitoring - 1600 Brain
Surgeries/year
Slide 9
Virtual Reality Assisted Surgery Program (VRASP) Plan Compu
ting system Comms Review/Rehearse Virtual image Surgeon-A Surgeon-B
Conduct Surgery Patient World frame of reference
Slide 10
MENU BAR TV PICTURE Patient Parameters - Graph Pulse Neuro Comn
Temp ECGBP MEDNET SCREEN:- X WINDOW INTERFACE
Slide 11
DHANWANTRI (1994-1996) A Computer based medical information
system for military hospitals to facilitate patient care and
hospital administration. Computer Centre, DRDL, Hyderabad MH,
Secunderabad DEBEL, Bangalore A joint effort by
Slide 12
Modules of Dhanwantri Phase-I Central Registration Medical
Inspection Room(MI Room) Polyclinic Pathology Phase-II Medical
Stores Dispensary Radiology Operation Theatre Wards
Slide 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 patients case history.
Elimination/Minimisation of duplication of data. Simultaneous
access of the database at several places by several users.
Slide 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.
Slide 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).
Slide 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
Slide 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
Slide 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
Slide 19
Methodology Installation Cabling Installation of HW Porting
& testing of Dhanwantri User Training User level training
System Administrator training
Slide 20
Methodology Operational Support Overviewing Onsight
Hardware/Software Problems User Feedback System & Database
Administration Streamlining Startup/Shutdown Procedures
Streamlining Backup/Archival Procedures Security
Slide 21
Methodology Maintenance Correction of bugs Modifications New
Requirements Remote Maintenance
Slide 22
Dhanwantri Software 1. No of Modules 90 2. No of Tables 210 3.
No of Forms 200 4. No of Reports 100
Slide 23
Dhanwantri Project Team Software Development Scientists4 Staff8
Project trainees 12 Hardware & Networking Officers2 Staff3
Coordination with MH Officers2
Slide 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
Slide 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 & feedbackunder
progress Operational support from Oct 96 Hardware maintenance
Software maintenance
Slide 26
Experiences Development Phase Difficulties in
Extracting/Specifying Requirements Design Difficulties
Implementation Problems System Problems
Slide 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
Slide 28
Experiences Underestimation of Development Time and Effort
Manpower Problems 10 Years ahead of Indian Government Scenario RR
Hospital Delhi
Slide 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.