New Delhi-based All India Institute of Medical Sciences (AIIMS) is one of the biggest medical colleges in India. The institute also provides low-cost medical aid to a very large number of patients everyday. But somewhere along the way, AIIMS found it difficult to manage information and even authenticity of patients, due to its outdated hardware and software. Keeping track of individual patients' medical records and registering them on the basis of manual cards became a major task for the institute's management. AIIMS also faced problems with fake patient registration cards (which were getting printed outside the hospital premises and being sold to patients at high prices). Due to this, there used to be a huge influx of patients carrying fake registration cards.
AIIMS therefore realized that it was in need of an automated process to resolve these issues and make its processes more systematic. The institute wanted a strong patient management system which could be further utilized for other departments and hospitals under AIIMS.
The challenge in front of AIIMS was its 20-year-old hardware. "The hardware was not suitable for data processing, so it increasingly felt like a burden. Hence, in 1998, we decided to change and upgrade the system for better workflow in the hospital," says Dr R S Tyagi, the deputy director and head of computer facility at AIIMS.
Since AIIMS is a publicly-funded entity, it had to go through the process of approvals and public bidding. It was only in late 2003 that the project got approval from the concerned ministry. The hardware procurement again went in for retendering because there was a tremendous change in hardware technology from the time it had been proposed to the ministry.
The automation began in early 2006 with a small team of three developers designing an in-house patient management system. This system went live in 2007. The OPD was the first department to benefit from the new patient management system, after which it got implemented in other departments of the hospital within two years.
AIIMS' patient management system is one of the most ambitious projects for the institute considering the time and money spent. "We projected it as a self-financing mission," says Tyagi. "The overall time saved by all the doctors and nurses came to around 1009 months per annum, which saves us almost Rs 3 crore. Therefore, we will be able to recover our patient management system's cost of development and implementation in three years."
With the new automated system and a computerized method of printing cards, the institute was able to streamline the number of patients, and doctors got more time to treat patients. AIIMS' patient management system project was further extended to satellite centers such as the B R Ambedkar Center for Cancer. "They have advanced their patient management system to the extent of putting patients' records online," notes Tyagi.
Giving more information about the project, Tyagi says that the .Net-based patient management system was developed in the span of six months. It has been an ongoing development and implementation since then. "As expected, it took us a while to develop the application," recalls Tyagi. "Everytime we developed something, users would come to us and ask for a specific change. We have 56 departments and 112 experts, so it took us a long time to accommodate the recommended changes in our patient management system."
Looking at the patient management system's successful implementation at the OPD and satellite centers, the cardio and neuroscience centers have also put in requests to extend the facility to them. Currently, Tyagi's team is in the process of automating the registration process at the main hospital and the laboratory. "We are also planning to utilize our patient management system for doing things like generating lab reports and keeping track of the discharge process. Because our in-house team is small and the infrastructure requirement is very large, it is difficult for us to cover everything at one go," says Tyagi.
Looking ahead, Tyagi plans to add a knowledge management system which could diagnose patients from remote places. "We see an influx of around 8,000 patients a day, but we are able to admit only up to 2,000, which means that three-fourths of them have to go back. Meeting their requirements through knowledge management is therefore our next target. When a patient enters his symptoms online, he should be able to get information on the necessary tests required for the diagnosis."