Briefone_Svaasthyaproject

Section1Projectsummary1
Section2Briefintroduction...................................................................1
Section3e_Svaasthya:Ourapporachandcurrentstatus..2
Section4Publicityefforts7
Section5Publications7
Section1:Projectsummary
ThisprojectstartedasanexperimentalactivitywhenDervanhospitalapproachedusforanopensource
HospitalInformationSystem(HIS).
AnexistingopensourceHIS,Care2X,wastakenandenhancedsoastoavoidreinventingthewheel.
ThePharmacymoduleandBloodBankmoduleweredevelopedafreshbyus.Thedoctors'andnursing
modulesweremodifiedtosuittheIndianspace.Thesewereallintegratedintoonepackage.
Section2:Briefintroduction
ThisprojectstartedasanexperimentalactivitywhenDervanhospitalapproachedusforanopensource
HospitalInformationSystem(HIS).Thehospitalhadaproprietarysystemwithbugsandthevendor
closeddown.Giventhisexperience,theywerefirmthattheywantedanopensourceHISsolution.
DervanhospitalgotourcontactthroughIBM,forwhomwehaddonemultipleprojects.Thus,theIBM
teamwasourinterfaceforallcommunications.
Availableopensourcesolutions
SinceCDACNoidahadexpertiseintheareawefirstcheckedwiththemontheiravailablesystem.
Sincetheydidnothaveanopensourcesolutioninplacewedecidedtoimplementthesame.Wedida
reviewoftheavailableopensourceHISbutfoundthatnonecateredtotheIndianrequirement.Hence,
wedidacomparativestudy(reportenclosedseparately)oftheexistingopensourceHISandchosethe
mostsuitedofthemCare2X.Weenhancedthistogete_Svaasthya.Bythiswesavedonbothtimeand
efforts to develop the solution. The licensing of Care2X allowed us to modify the system and
redistributeitasopensourceproduct.
WehavedevelopedsomesubmodulesfromscratchandmodifiedothersubmodulesofCare2X.Someof
theseweredoneasstudent/MCAprojectsandintegratedwithe_Svaasthya.Thishelpedthestudent
communitytoworkonaliveopensourceprojectandalsohelpedfasterimplementation.
Section3:ESvaasthya:Ourapproachandcurrentstatus
eSvaasthya aims at catering to hospitals of any size and will help in computerization of all the
activitiesofthehospitalrightfrompatientregistration,toaddingandaccessingpatientdatasecurely,
onlineconsultationandtreatmentbydoctors,bloodbankmanagement,wardandoperationtheatre
120072013CDAC,Mumbai

management, etc. eSvaasthya is a webbased system, thus enabling data sharing across different
regions.Thiswillalsohelpanyfuturedevelopmenttosupportanetworkofhospitalstosharedata
acrosstheworld.
ThebroadapproachthatisfollowedfordevelopingeSvaasthyaisasfollows:

eSvaasthya is being developed for the Dervan hospital, a charitable trust hospital in
Maharashtra. Thus all the base requirements for building the HIS are obtained from this
hospital.This ensures thenecessarydomainknowledgeneededtodevelopasystemofthis
nature.

Asdiscussedintheprevioussection,itwasessentialtodeveloptheHISquickly.Thiswasmore
achievableintheOpenSourceworldsincethesourceoftheapplicationsareavailable,we
coulddevelopoursystemoveranexistingHIS.Thiswaythealreadyimplementedandtested
modules,cateringfullytoourneeds,couldbeusedasisthisensuredthatwedonotreinvent
thewheelwhereverpossible.Also,analreadytestedandusedmoduleisgenerallymorerobust
than any module newly developed. This procedure, of building over an existing HIS, thus
ensuresamorereliableandrobustsysteminaquickertimeframe.
WithmanyopensourceHISexistent,choosingtherightsubsystemtobethebaseisanon
trivialtask.Thefeaturesofthesystem,itsaccuracyandrobustness,thepercentageofmatchof
thefeaturelistagainstourrequirementset,thequalityofthesystemdocumentationavailable,
etc. are some of the factors that affect this choice. After much detailed exploration of the
existingopensourceHIS,wedecidedtouseCare2Xasourbasesystem.
FeaturesofCare2xinbrief
Care2xisawebbasedsystembuiltusingPHP.Ithasabout85developersaroundtheworld,the
developercommunitystillbeingactive.Initscurrentform Care2xsupportsthePathology
module, Outpatient management, Ward management, Nursing and Doctors information
management.ItalsosupportsDICOMstandardforstoringofimages.WefoundthatCare2xhad
goodsystemdocumentationinplace,includingsomedesigndocumentsofthesystem.Though
therearesomegapsinthisdocumentation,itwasbetterthantheothersystemswhichdidnot
haveproperdocumentation.
Care2Xalsohasarichfeatureset.Thesefeatureshavesomegapswhichneedtobefilled.Like,
thereisnosharingofinformationacrossthesemodulesforinstance,toviewhisappointments
adoctorneedstoscanthroughtheentirelistofallthedoctors'schedules.Also,eventhoughthe
doctors'informationisenteredandstored,foranyactivityrelatedtothedoctor,thenameofthe
doctorneedstobemanuallytypedin,insteadoflinkingittotheavailabledoctors'information.
Thiswillmeanthatwecanentertheappointmentsofanyperson,claimingtobeadoctor,
withoutactuallyvalidatingtheinformationentered.Suchgapsneedtobefilledintheavailable
modules.Also,noneofthesesubsystemsareavailableforindependentuse.
TheothermoduleslikeStores,Billing,Pharmacy,BloodBank,Accounts,etc.arenotusable
andneedtobebuiltfromscratch.

WecarefullyanalysedtheCare2xsystemtoidentifythegaps.Accordinglywemadeachart
chalkingdownthesubsystemsthatarecompletelyabsentinCare2x,subsystemsthatneed
enhancementsandthesubsystemsthatcanbeusedasis.

220072013CDAC,Mumbai

Basedonthechartwedecidedtobuildandintegratethesubsystemswhicharecompletely
absentinCare2xfirst,followedbyenhancingthepartiallycompletesubsystems,asperour
requirement.

Asstatedintheprevioussection,oneoftherequirementsistomakeeachsubsystemofe
Svaasthya available for independent use as well. To satisfy this requirement, all the
subcomponentsthatarebeingdevelopedafreshwillbeavailableforuseasindependentsystems
too.Workisinprogresstounderstandthedesignlevelchangesrequirementssoastomakethe
alreadyexistingcomponentsofCare2Xasindependentsubsystems.Wehavedoneaprimafacie
analysisofthedesignandfromthiswegatherthattheCare2Xdesignisnotverymodular.
Though thereare separate handlers forcomponents like Lab, OPRoom, etc. this list is not
complete,givingafeelthatmakingthesubsystemsindependentmaynotbeaneasytask.

We implemented security features in all the subsystems of eSvaasthya all the activities
performedineSvaasthyaareauthenticatedandauthorised.Care2Xdoesnothavetheconcept
ofRoles.WeplantointroducethisineSvaasthya.Userroleslikepatients,doctors,pharmacists,
etc.aredefinedforthispurpose.Again,rolesaredefinedasaffectingthesubsystembeing
developed.

Allthesubsystemswillbeintegratedseamlessly.

eSvaasthyawillcomplywiththehealthstandardswhereverapplicable.SinceCare2xalready
providessupportfortheDICOMstandardthiswillbefollowedwhereverapplicable.

NotmanyusersintheIndianmedicalfraternityarecomputersavvyyet.Thismakesitvery
difficultforthemtoimaginehowtheirdaytodaytaskswillgettransformedintothecomputer,
thusleadingtoanambiguousrequirementset.
Hence,forpreciserequirements,weplantoseekcommentsfromtheclientasandwhenthe
subsystemsareready.Wewillmakethesubsystemsavailableforclienttotestremotely.Also,
wegetbacktotheclientforanyqueriesthatcomeupasthesubsystemsarebeingdeveloped.

Initscurrentform,eSvaasthyahasthefollowingfunctionalsubsystems
Patientinformationmanagement

Usermanagement

Pathology

Wardmanagement

Pharmacy

BloodBank

Ofthese,PharmacyandBloodBanksubsystemshavebeendevelopedafresh.Theremainingsub
systemsarebeingenhancedtocatertoourrequirements.TheStoressubsystemisalmostcompleteand
workisontoenhancetheusermanagementsubsystemtosupportthefacilityforbetterorganisation
andmanagementofappointments,morefunctionalitytodoctors,introductionofrolesforusers,etc.
ThePharmacy,BloodBankandStoressubsystemsareavailableforuseindependentlytoo.
BelowisthebrieffeaturelistofeSvaasthya.
320072013CDAC,Mumbai

Pharmacycomponent
Thiscomponentisbuiltforthepharmacyunitofthehospital.Thecomponentprovidessupportforthe
pharmaciststoviewtheavailablestock,placeorderformedicines,managevendorinformation,sell
products,organisetheproducts,searchforproducts,managetheproductsandgroupmedicinesbased
ontheirchemicalconstituents,keeptrackoftheshipmentstatus,etc.
BloodBanksubsystem
ThissubsystemisbuiltfortheBloodBankdepartmentofthehospital.Ithelpsmanagingthedonor's
information,informationaboutavailablequantityofbloodagainstvariousgroups,requestsmadefor
blood,etc.Itisbuiltasperthehospital'sworkflow,whichincludescollectingbloodfromdonors,
conductingvarioustestsonthenewbloodsamplesandacceptingorrejectingthembasedontheresults,
allowingbookingofbloodbypatientsordepartments,issuingbloodtopatientsordepartments,etc.
PatientInformationManagementsubsystem
Thissystemtakescareofmanagingthedetailsofthepatientsofthehospital,includingoutpatientsand
inpatients.Ithelpskeepingtrackofthepatient'shistory,doctors'consultationresults,inpatient'sday
todayreports,patient'sbill,etc.
WardManagementsubsystem
Thissystemhelpsmanagingthewardactivitiesincludingallottingofbedstopatients,bedmanagement,
managingscheduleofnurseanddoctor'sfortheward,etc.
Pathologysubsystem
ThissubsystemisdevelopedforthePathologylabofthehospital.Itsfeaturelistincludesmanagingthe
various tests' information, keeping track of the information of the patient's undergoing the tests,
managingtestrequestsandresults,etc.
Usermanagementsubsystem
Thissubsystemallowsmanagingtheinformationofthestaffofthehospital,includingdoctors,nurses,
etc. It also includes managing information about the visiting doctors. It keeps track of the set of
functionality thatthe various users can performusingthesystem. Ithelps theusers managetheir
schedules,performtheirroutinetasks,etc.
BelowaresomesnapshotsofeSvaasthya.Figure1showsaproductbeingaddedtoavendor's
catalogue,inthePharmacysubsystem.Thisistodefinethesetofproductsbeingsoldbyrespective
vendors.

420072013CDAC,Mumbai

Figure1:Formtoaddproducttovendor'scatalogue

Figure2showsthescreentoaddtheshipmentdetailsinthePharmacysubsystem.Theusercan
searchfortheorderagainstwhichtheshipmenthasarrived.Onselectingthecorrespondingorderfrom
therightscreen,theshipmentdetailsarriveontheleftscreen.Wecanstoreinformationofpartialand
fullshipments.Thedetailsoftheshipmentlikethebatchnumberofmedicines,expirydate,etc.needto
beenteredintheShipmentDetailstableseeninthefigure.

520072013CDAC,Mumbai

Figure2:ShipmentdetailsadditioninPharmacysubsystem

Figure 3 shows a screen of the Pathology subsystem of e-Svaasthya. The form helps searching information
of a patient who has undergone a test in the hospital's laboratory.

620072013CDAC,Mumbai

Figure3:PathologyineSvaasthya

Section4:Publicityefforts
Inanefforttopublicisethesystemtheteamhasdonethefollowing:

PutinformationaboutthesystemontheCDACMumbaiwebsite.

OrganisedaStakeholder'smeet,invitinghospitalsanddoctorsacrossMumbaiandPune.The
systemwasdemonstratedandfeedbacktaken
Publishedpapersanddemonstratedthesystematconferences/workshops.

Section5:Publications
Aparna R, Sasikumar M, Kamini K, Pranaw K, Onkar P and Narsaiah BCL. "e-Svaasthya - An Open Source HIS
for Indian hospitals". Proceedings of NCOSS-09, May 2009, Mumbai.

720072013CDAC,Mumbai