CAG faults non-implementation of e-HMS project even in pilot hospitals

CDAC trained 1,172 staff of pilot hospitals during 2015-18

Claims of the State government on creating health profile of all people across the State notwithstanding, the State has not fully implemented the e-health management systems (e-HMS) project even in the three hospitals where it was launched on pilot basis five years ago.

The Comptroller and Auditor General of India which highlighted the issue in its latest report said certain modules of e-HMS lacked validation controls and accepted incorrect data input. The inability/reluctance of hospital staff to capture real time data coupled with simultaneous continuance of manual processes defeated the envisaged objective of e-HMS.

“Though the project has been live since May 2016, the problems have not been resolved. The State wide roll out of the system has also not been implemented,” the CAG report said. The project was aimed at addressing core areas in public health care facilities and it envisaged creation of unique Electronic Medical Record for each patient.

The EMR was supposed to function as a central source of information covering the patient’s profile, history of family, clinical diagnosis, disease, treatment and investigation details among others. It was aimed at enabling easy access of medical information any time, anywhere.

Other core functions of EMR was expected to address include tracking medical history during subsequent visits to hospitals and navigation between referred departments, elimination of duplication in data entry and maintenance of duplicate register and transmission of the EMR to referred hospitals.

The State Medical Infrastructure Development Corporation procured hardware and network equipment through the TS Technology Services for implementation of the pilot project while the Centre for Development of Advanced Computing (CDAC) customised its hospital information system (e-Susruth) to the requirements of the State. The pilot project went live between October 2015 and May 2016.

“In spite of 22.47 lakh registrations in OPD in the three hospitals – Gandhi Hospital, Secunderabad, Area Hospital, Malakpet, and District Hospital, King Koti, Malakpet – 1.51 lakh inpatient records and 0.38 lakh case sheets, audit observed that EMR report was generated only in respect of one patient at Area Hospital, Malakpet. Clearly, the EMR Module was not utilised for the purpose for which it was created,” the CAG said.

Referring to the user management module which controls access to the application and its related area, the CAG said the system administrator would create user access and rights according to his/her role. CDAC completed training to 1,172 users (staff at different levels) of pilot hospitals during 2015-18. However, it was observed that 144 (12%) users, especially doctors and nurses, had not logged into e-HMS even once since the creation of their user ID.

Further, 229 (20%) users accessed e-HMS only once since the creation of their user ID while information relating to designation of 744 users was not available in the master table. Audit therefore could not verify their identity and role in the hospital. The CAG said hospital superintendents attributed the non-utilisation of modules to lack of adequate human resources and that under the present heavy patient load, the users require separate data entry operators for utilisation of e-HMS. Although the issue of non-availability of sufficient data entry operators was represented by the respective hospitals to TSMSIDC, they were not provided with sufficient staff for effective operation of various modules of e-HMS.

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