The first digital revolution in health care

By V Srinivas

Building strong Institutions is one of the major objectives of Good Governce. The Digital India initiative represents a landmark in ushering in the First Digital Revolution in Health Care at AIIMS. The successful implementation of the AIIMS e-Hospital Project and the AIIMS OPD Transformation Project, transformed AIIMS to India’s first fully digital public hospital. In 16 months of implementation since the launch in July 2015, the AIIMS e-Hospital project has had the largest footprint of Digital India projects. The creation of a patient friendly hospital has benefitted 35 lac patients till date, reducing wait times at the Hospital by nearly 6 hours, brought transparency to OPD appointments; created digital medical records and represents a sustaible and replicable model for hundreds of India’s Hospitals.

The very me invokes images of crowds, a sea of humanity that is present at the hospital doors, waiting from 3  in the morning, to rush for expert medical consultation at 8.30 am when the OPD opens. With an average of 10,000 OPD patients per day, 35 lac OPD patients per annum,  55 Departments, 640 faculty, 2000 resident doctors and 5100 Nurses,  AIIMS represents India’s behemoth in tertiary care super specialty hospitals.

It was in January 2015 that the first step in the Digital AIIMS project was taken with the creation of an effective linkage between AIIMS, Unique Identification Authority of India (UIDAI) and the Department of Electronics and Information Technology (DeiTY). A unique health identification number for every patient visiting AIIMS was generated on an Aadhar platform.

The e-Hospital project proceeding at a modest pace, suddenly gained significant momentum with the launch of Digital India Initiative. There was a new urgency in DeiTY and NIC for expeditious development of the software so that the Online Registration System could be established. This was followed by the collaboration between AIIMS and Pay Gov for creation of a payment portal.

The e-Hospital project necessitated transparency in OPD appointments. AIIMS always encouraged walk-in patients and also had several follow-up patients coming for consultation. The streamlining of the new OPD cases began with 15 percent of the total new OPD appointments being given for online registration. The out-patient appointments of each of the Departments of AIIMS was placed online and every consultation room in the OPD was allotted a fixed number of OPD patients identified by me.

The AIIMS-TCS collaboration for the AIIMS OPD Transformation Project was conceptualized as a Corporate Social Responsibility Project in April 2015. It was only after several months of observations at OPD followed by conceptualization, discussions, capacity building, consensus building and software development that the TCS prescribed a model of AIIMS OPD transformation.

The newly adopted model envisaged construction of a Patient Registration Center, with 50 Registration Counters each one equipped with a computer termil loaded with e-Hospital software. It was constructed and operatiolized in a record time of six months. Now the registration time was a mere 40 seconds for all new appointments with UHID numbers generated from the online registration system. Fast Track Queues were created where the patients who had already registered themselves under the online registration system could get their OPD cards and move quickly to the Patient Waiting Areas. Patient Care Coorditors ensured that Patients understood clearly where to visit during the entire process. The whole approach was one of empathy and efficiency. The successful operatiolization of the Patient Registration Center meant that the waiting time in the Hospital had come down by nearly 6 hours per patient. The 3 am serpentine lines were no longer there. They were replaced by a more orderly queue system that commenced at 8 am and reached the OPD consultation rooms by 9 am.

AIIMS attracts 10,000 patients per day but the patient waiting areas had only 2500 seating capacity. This meant that patients rushed to consultation areas without any wait time in a comfortable environment. The TCS model envisaged creation of seating spaces for an additiol 3500 patients.

AIIMS transformed itself into a patient friendly hospital by its willingness to adopt the modern day digital practices and create specialized cadres who ebled rapid scaling up of the new technology. The Nursing Informatics Specialists provided the linkage between the Clinical Departments and the OPD appointments. Nurses with an aptitude for technology were deployed to coordite between the Departments, OPD, Wards and the software professiols. The Patient Care Coorditors touched every patient entering the OPD with their empathy.

Hitherto, the implementation of the e-Hospital project had not been orderly. For AIIMS to be a fully Digital Hospital, each of the e-Hospital modules needed to implemented in an orderly manner to create a comprehensively digital hospital. By June 2016, the e-Hospital module implementation in AIIMS was completed. The NIC took a big step forward in completing the AIIMS e-Hospital Project. NIC Teams from Tripura worked with each of the Departments in AIIMS in a prescribed time frame to transform AIIMS as India’s first fully digital public hospital.

The transformation of AIIMS to a patient friendly hospital under the Digital India Initiative can be compared to “Saving the Titanic”. (PIB)

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