Importance of Electronic health records in the Indian healthcare ecosystem

Importance of Electronic health records in the Indian healthcare ecosystem

India is the second most populated country and one of the fastest growing economy in the world.However the Indian health care system is in crisis particularly when it comes to public health. Two of the major hurdles the Indian healthcare system facing are, firstly limited number of healthcare professionals and secondly no  proper documentation of health records and data connectivity across various health organisations.For example ,there are little over one million allopathy doctors in India to treat it's 130 crore people. Due to this the physicians have immense workload and hardly spends on an average of less-than 5 minutes with each patient. this leads to inappropriate medical reconciliation resulting in medication errors and increased length of inpatient stays. Health check-up is not a single event, and a person may visit different doctors for different health concerns and they cannot be expected to remember all their past medical and medication history, which again leads to inappropriate medical reconciliation.

How to overcome these challenges ? Can traditional paper sheet records handle these hurdles:

A traditional paper sheet health records cannot handle these challenges as the patients cannot store them safely for long time and are also unaware of importance of maintaining health records. And  these traditional health records cannot be shared across the health care providers instantly. The only solution for this is electronic health records.

What are electronic health records ?

1. Electronic health records (EHR ) are the digital records of a patient's health information which contains data about socio- demographics, past medical and medication history, family history, vital signs, progress notes, diagnoses, lab data, immunization data, drug allergies , imagining reports and health insurance data.

These electronic health records not only stores data accurately but also provides instant access to authorised providers across the health organization's.

Benefits of Electronic health records :

1.Accurate data storage and data connectivity :

Patients health information can be stored accurately and can be shared easily to authorised providers in the hospital like physicians, clinical pharmacists, Nursing, radiology and lab technicians. A fully integrated EHRs are highly secure and provides access to authorised providers only.

2.Risk assessment and early management of diseases : 

Data from these EHRs can be used for risk assessment of certain diseases like cardiovascular problems, stroke etc.

For example, based on the AHA guidelines, certain factors like age, gender, race, BP levels , cholesterol levels , Diabetes, end organ damage and smoking status can be used to calculate a patient's 10 year risk of developing heart disease.

After conducting risk assessment physicians together with clinical pharmacist can develop a treatment plan to reduce a patient's risk of developing heart disease.

3. Reduction in medication errors and length of inpatient stays :

Medication errors are one of the contributing factors for increase in length of inpatient stays. Illegible hand writing, inaccurate medication history taking are some of the reasons for these medication errors to occur.

These EHRs can be helpful in appropriate medication reconciliation, there by minimising medication errors.

General accounting office (GAO ,1991) reported that an automated medical record system reduced hospital costs by 600 dollars per patient in a department of veterans affairs hospital because of shorter hospital stays.

4. Patient health education :

According to the health division of NITI AAYOG (National institute for transforming India) , the infant mortality rate and maternal mortality rate has declined last two decades.However rate of decline is lagging behind neighbouring countries such as Bangladesh and Nepal. The rate of this maternal and infant mortality rate are worse in rural and tribal areas as they public in rural and tribal areas are not aware of health schemes and immunizations.

Making electronic health records fully integrated, would be helpful in creating alerts and remainders for immunization dates and also in counselling pregnant women and mother's regarding importance of immunization and nutrition.

Electronic health records in the major health reforms of India:

Ayushman Barath which is considered as the world's largest government funded healthcare programme, is aimed at providing a health coverage for 50 crore people (40% of India's population) in the first phase. This runs in dual mechanism - " provision  by government and contract in from private providers". There must be transparency in data in order to achieve trust and confidence among the stake holders. By linking the Electronic health records with unique identifiers such as Aadhar could bring transparency in the data and success of such major health missions like Ayushman Barath.

Conclusion :

Artificial intelligence (AI) could bring a drastic improvement of healthcare sector. This AI would become reality only if we have foundational data , as power of AI lies in its ability to analyse extremely large amounts of data coming from highly integrated sources like   Electronic health records.                                                                      

 Siva.Achanta

PharmD intern.