Data is the core for any business activities to take better decisions. Healthcare is not exceptional. The integral questions in any body mind will be that, “What are the type of data can be captured in healthcare industry?”, To answer it, I started to explore, it’s begun with front office patient registration, for scheduling an appointment first visit & revisits, for improving the operational efficiency of healthcare setup and to reduce the patient waiting time. Then the exploration, moved towards other core departments like Emergency, In-patient Department, Out-Patient Department, Diagnosis, Pharmacy, Operation theatre, etc,.
In continuation to that, I came across HMIS, EMR, EHR. The question popped in my mind that all the 3 are similar or different. When I explored through the textbooks, search engines, articles, journals, experts opinion, It’s been confirmed that all are different, but synchronizes at some point, where the data are used for different purposes, based on that such clarification made.
For example, EMR is all about the electronic records of patient (data) will be available in the premises, means in the local server, whereas EHR, is about, if any patient data has to be accessed from any hospital, by exchanging data through the interoperability may be classified as technical, process, semantic, clinical.
HMIS, is used by the organization to make the decisions for improving the operational efficiency, quality of care, resource management, RoI, etc.
Still, I believe, the core of any activity is running around data, but the purpose is different.
I tried to understand from Public Health perspective, again same issue begun, where to start. I figured it out from few understandings, to be started from the term called CAPI, Computer Assisted Personal Interview, using CSPro, ODK, Kobo, etc. The process continued with same pattern data collection to visualization for decision making. Problems are different, but the solution are offered through the same process.
All such things has been discussed using different technical terms may be Health IT, e-Health, Digital Health. But I would like to bring under another “Health Informatics”.
Health Informatics means, in my view is, how we are going to process the data of healthcare for obtaining the information using computers to any classifications like, Clinical Informatics, Bio Informatics, Public Health Informatics, Medical Imaging Informatics, International Health Informatics, etc,.
All these are possible, only if interoperability in place with the strong regulatory system in place. These interoperability is falling under different categories like, technical, semantic, process and clinical, these interoperability can be achieved using the standards, HL7 for exchanging data using FHIR R4 based on resources, Imaging standards using DICOM in PACS System, Clinical coding (Semantic) using SNOMED CT, ICD 9/10/11, CPT (US Healthcare), Laboratory coding using LOINC, RxNorm, ICD, etc all these are combinedly working in the back end as EBM(Evidence Based Medicine).
For exchanging the data the there are so many interface engines existing, which exchanges data by webservice technologies like SOAP, REST api’s, using xml, json.
By closely working on all these, I came across another interesting healthcare term OpenEHR, is based on archetypes. It made to analyze so closely with all these standards.
Initially, Our Government has shared NDHB – National Digital Health Blueprint, for taking the stakeholders opinion and developed an integrated system. The developed system NDHM – National Digital Health Mission, was announced the launch on 15th Aug 2020.
Our Indian Government has given a well-defined integrated system – ABDM Ayushman Bharat digital Health to address all the issues, announced the system launch on 27th Sep 2021.
In conclusion,
Few references:
- During the Virtual Convocation, at IIHMR Bangalore, held on 20th June 2020, Dr. Devi Prasad
Shetty, Founder and Chairman, Narayana Healthcare as Special Guest, while addressing the
graduating students said that, “Healthcare Industry is going to drive the economy of 21st
Century, it’s over 8.2 trillion dollar industry & requires large number of smart managers. We
believe, Digital technology disrupt the way healthcare is delivered. Once we remove the pen
and paper from the hands of Doctor’s, Nurses, Medical technicians, believe me healthcare
become safer, affordable & accessible”.
- In a Executive Workshop “Reimaging & Managing – The New Age Hospitals”, held at IIHMR
Bangalore on 25
th Mar 2022, Dr. Uma Nambiar, Managing Director – Zeeden Life Sciences Pvt
Ltd, mentioned that, “ No healthcare without technology, both are partners, inseparable.
Technology rebuilds healthcare system, saved us during Pandemic. Senior most Doctor’s to
Door Keepers need to have them digitally trained, to use data and technology for better
future”.
Healthcare is a complex system, where this complexity can be addressed with effective utilization of
IT Standards and deep understanding about the system to resolve the existing & newly generating
problem by efficiently applying the e-Health system using ICT tools. We have a strong regulatory
guideline, given by ABDM, to handle the integrating issues of healthcare system.