Medical Informatics: A Health Enabler for the Country
A doctor by profession, Project Director for the National Health Portal of MoHFW, Prof. Suptendra Nath Sarbadhikari, in conversation with Ekta Srivastava, talks about the pros and cons of the medical informatics in the country.
You are a versatile personality in medical field. Please share your journey from being a medical doctor to Project Director for the National Health Portal.
I am a medical doctor (University of Calcutta, 1989) and have a PhD in Biomedical Engineering (1995) from IT, BHU, Varanasi (now IIT-BHU). Currently I am associated with the Ministry of Health and Family Welfare (MoHFW), Government of India, as the Project Director for the Centre for Health Informatics of the National Health Portal (NHP) at the NIHFW, New Delhi.
I have been the Founder and Director of Supten Institute (offering online courses on health informatics) and a Visiting Professor in Health Informatics at Bangladesh Institute of Health Sciences, (now Bangladesh University of Health Sciences) at Dhaka, Bangladesh. I have been the Founding Director of CAL2CAL Institute, a faculty member with the Manipal Group, IIT Kharagpur (School of Medical Science and Technology), Amrita group (Course Coordinator for M.Sc. Medical Informatics in AIMS, Kochi and for M. Tech Biomedical Engineering in Amrita University, Coimbatore) and PSG group (Founding Chair of Biomedical Informatics in PSG IMS & R and Visiting Faculty for BME in PSG Tech). Other than that I had done my Post-doctoral Fellowship at the Machine Intelligence Unit of Indian Statistical Institute, Kolkata.
My areas of expertise are in Standards for Health Information Exchange (HIE), Requirements analysis and management in Healthcare information technology, e-learning, medical journalism and clinical decision support systems. I am the Immediate- Past Chairman of HL7 India. I’m also a member of the Project Review and Steering Committee of Indian iNRC of SNOMED-CT, and of the EHR Standards Implementation Committee under the MoHFW, Government of India.
Could you please throw some light on the project that you are working at Centre for Health Informatics?
Well, that I can tell you through the milestones and the achievements that the project has gained till now.
- Recommendation for India Health Portal by the National Knowledge Commission: 2008
- Formation of Working Group (of which I was a member) for Detailed Project Report (DPR) preparation of the NHP: 2009
- Approval from MoHFW: June 2011
- Steering Committee of the NHP (SCNHP) formation: August 2011 NHP made live for beta testing: 15/11/2013 (Beginning of 2-year Pilot Project in NIHFW)
- NHP formally launched by Shri J P Nadda, Union Minister for H & FW: 14/11/2014
- Currently in Pilot Project mode till 14/11/2015
- Information on Health and Diseases – especially current public health alerts – through validated content, Sliders, and Infographics
- Information on Directory Services – Hospitals, Blood Banks, Ambulances – according to state / city / PIN Code
- Information on Regulatory Laws, Protocols, Standards, Health Policies and Programs, Committees and Commissions, besides information on Disaster Management, First Aid and AYUSH
- General Forum for general discussions among common persons, patients, care givers and healthcare professionals
- Professional Forum for discussion among health care professionals:
- Help Desk for Implementation of EHR Standards: Forum for discussing implementation of HER
- Feedback on the content on NHP
How do you perceive the state of Medical informatics in India?
In 1995 I had written a Guest Editorial in JIMA (Journal of the Indian Medical Association) titled: “Medical Informatics – are the doctors ready?”
Unfortunately, the answer seems to be negative, even two decades later! Nevertheless, India has made considerable progress with the notification of Standards for EHR. Further, India has also got the country license for the controlled medical vocabulary standard SNOMED-CT by becoming a member of International Health Terminology Standards Development Organisation (IHTSDO). So there have been progress.
Health is a state subject in India and various states have undertaken (often independently) various projects to implement eHealth in their respective states. The Digital India initiatives also mandate the adoption of eHealth. To facilitate the smooth adoption of eHealth, the present central government is in the process of setting up the National eHealth Authority (NeHA). I personally believe that once the NeHA is formed, its first job should be to formulate a realistic National eHealth Strategy / Policy, in consultation with all the stakeholders.
India is a country where accessing basic health facilities is a far-fetched thing for a common man. So, how technology, say Health Informatics can bring any change in their life?
If you want to hear the magic word “Telemedicine”, that may not be a panacea! We definitely need proper water, nutrition and sanitation (Swachchh Bharat will lead to Swasth Bharat) to achieve better health. Of course technology/ informatics will act as an enabler for all such efforts. Improving access/ infrastructure will also be a strong enabler.
According to you what are the major challenges in improving the medical informatics in the country?
In 2005 I had written an article stressing on the need for a flexible syllabus for health informatics, according to the needs of various users – like, healthcare delivery professionals, ICT professionals, and public health experts. The need exists even today.
Change management is another area that needs to be given adequate emphasis. When a flyover is being built, it does cause a lot of inconvenience to the residents of that area. However, once the flyover is completed, it is likely to save a lot of time of those same people. Same is for an eHealth system. A change manager has to make the users aware and prepare them for the transition during the building phase of the system. Moreover, end users must be actively involved right from the requirements gathering phase and throughout the development / modification phases of the system. After all, “people” are equally important as the “tools / technology” and “processes / workflows” for any eHealth system to succeed.
Do you think it’s important to include medical informatics as one of the major subject in medical education?
This is my favourite topic. I had written in 2004 in the Indian Journal of Physiology and Pharmacology – “Basic medical science education must include medical informatics.”
Again, in 2008, I had published a small case study in the Really Good Stuff section of the journal Medical Education: “Applying health care informatics to improve student learning.”
As I said before, health informatics education must be an integral part of education – not just for all healthcare professionals but also for all ICT professionals.