Go See the Doc, Paperless

With electronic registry, medical records will go digital across healthcare facilities from 2016.
Go See the Doc, Paperless

NEW DELHI: Carrying old prescriptions to your doctor visits might soon be a thing of the past with the Ministry of Health and Family Welfare moving to create an electronic registry of medical records of all citizens.

The system of creating Electronic Health Records (EHR), which is prevalent in Western countries, including USA and the UK, will help in generating data related to diseases and their treatment. An EHR is a digital version of a patient’s prescription. It is a real-time, patient-centred record that make information available instantly and securely to users.

“We have begun the process of standardisation of names of various diseases, drugs and the treatment protocols, which is a must for having electronic health records,” a health ministry official told The Sunday Standard. The official said the government has procured a license for SNOMED Clinical Terms (CT), a systematically organised collection of medical terms providing codes, terms, synonyms and definitions used in clinical documentation and reporting.

SNOMED CT is considered to be the most comprehensive, multi-lingual clinical healthcare terminology in the world. Its primary purpose is to encode the meanings that are used in health information and to support effective clinical recording of data with the aim of improving patient care. It provides the core general terminology for electronic health records and includes clinical findings, symptoms, diagnoses, procedures, body structures, organisms, pharmaceuticals and devices.

The programme is maintained and distributed by IHTSDO, an international non-profit standards development organisation in Copenhagen  , Denmark.

The official said that the license has been procured and Centre for Development of Advanced Computing (C-DAC), Pune, has started working on the standardisation process. Some private hospital chains like Apollo have come on board.

The government plans to roll out the programme for all the 19 AIIMS across the country from next year. “While in the first phase the programme will be rolled out in all the AIIMS, the next phase will include all central government hospitals, clinics and primary health centres in villages,” the official said.

However, officials involved concede that it will be difficult to involve government hospitals in the programme as they lack the requisite human resources and technological know-how. “Apart from the technical know-how, it is also important that there are people apart from doctors to punch in the data received from each patient. All these things need to be looked into,” an official said.

While an EHR contains the medical and treatment histories of patients, an EHR system is built to go beyond standard clinical data and can be inclusive of a broader view of a patient’s care. They can contain a patient’s medical history, diagnoses, medications, treatment plans, immunisation dates, allergies, radiology images and laboratory and test results. “It helps doctors access evidence-based tools that providers can use to make decisions about a patient,” the official said.

Health information in EHR can be created and managed by authorised providers in a digital format capable that can be shared with other providers across healthcare organisations such as laboratories, specialists, medical imaging facilities, pharmacies, emergency facilities and school and workplace clinics. They contain information from all clinicians involved in a patient’s care.

This will help generation of data regarding prevalent diseases and the number of people suffering from them.

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