Download - Medical & Health Information System In Indian Environment Experiences with Project Dhanwantari
Medical & Health Information System
In Indian EnvironmentExperiences with
Project Dhanwantari By
Maj Gen (Dr) RK Bagga, AVSM (Retd.) Dr M V Krishnamurthy Dir UOL
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
IT for Health Care Management
• Networking– Internet– Intranet– Extranet
• Web– Online Search– Ocean of Information
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
IT in MedicineTypical Application Areas
• Computer Diagnosis– AI/ES– Genemapping
• Surgery– Digital Visualisation– Heart Modelling
• Education & Research– MM & VR– e-Learning
IT in Medicine Typical Application Areas
• Rehabilitation of Handicapped– Robotic
• Information System– Patient Care– Hospital Managements– Telemedicine
PRINCIPLES OF COMPUTER-ASSISTED SURGERY
X
Y
Z
CT - Computer TomographyMR - Magnetic resonance Generation of the Volume Model
3D View of theOperation area & theinstrument’s position
3D Position measurement
CT or MR Slices
Preoperative scanning
Children’s Hospitalof Pittsburgh
Presbyterian University Hospital
School of Medicine;Neurological Surgery
Eye & Ear Hospital Monteflore Hospital School of Medicine Anesthesiology
VeteransAdmn. Hospital
Magee Women’s Hospital
School of EngineeringElectrical Engineering
Deptt. of CS
MEDNET - LINKS REMOTE MEDICAL FACILITIESIN REAL TIME
Real Time Monitoring - 1600 Brain Surgeries/year
Virtual Reality Assisted Surgery Program(VRASP)
Plan
Computingsystem
Comms
Review/Rehearse
Virtual imageSurgeon-A Surgeon-B
Conduct Surgery
PatientPatientWorldframe ofreference
MENU BAR
TV PICTURE
Patient Parameters - Graph
PulseNeuro Comn
TempECGBP
MEDNET SCREEN:- X WINDOW INTERFACE
DHANWANTRI(1994-1996)
A Computer based medical information system for military hospitals to facilitate patient care and hospital administration.
Computer Centre, DRDL, HyderabadMH, Secunderabad
DEBEL, Bangalore
A joint effort by
Modules of Dhanwantri• Phase-I
– Central Registration– Medical Inspection Room(MI Room)– Polyclinic – Pathology
• Phase-II– Medical Stores– Dispensary– Radiology– Operation Theatre – Wards
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.
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.
System ConfigurationCENTRAL
COMPUTER
Monitor
Key board
Printer
UPS
Ports
Line drivers
ConsoleMonitor
Key board
Printer
Terminal
( Somestations )
Linedriver
Remote stations
Standby Computer System
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).
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
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
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
Methodology
• Installation– Cabling– Installation of HW– Porting & testing of Dhanwantri
• User Training– User level training– System Administrator training
Methodology
• Operational Support– Overviewing– Onsight Hardware/Software Problems– User Feedback
• System & Database Administration– Streamlining Startup/Shutdown Procedures– Streamlining Backup/Archival Procedures– Security
Dhanwantri Project Team
• Software Development– Scientists 4– Staff 8– Project trainees 12
• Hardware & Networking – Officers 2– Staff 3
• Coordination with MH– Officers 2
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
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
Experiences
• Development Phase– Difficulties in Extracting/Specifying
Requirements– Design Difficulties– Implementation Problems– System Problems
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
Experiences
• Underestimation of Development Time and Effort
• Manpower Problems• 10 Years ahead of Indian Government
Scenario RR Hospital Delhi
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.