MIDAS TOUCH INTERNATIONAL JOURNAL OF COMMERCE, MANAGEMENT AND TECHNOLOGY
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1 MIDAS TOUCH INTERNATIONAL JOURNAL OF COMMERCE, MANAGEMENT AND TECHNOLOGY A Monthly Referred e-journal ISSN: Vol-1, No. 8, October
2 MIDAS TOUCH INTERNATIONAL JOURNAL OF COMMERCE, MANAGEMENT AND TECHNOLOGY A Monthly Referred e-journal ISSN: Midas Touch International Journal of Commerce, Management and Technology is the monthly publication to disseminate knowledge and information in the area of trade, commerce, business, management, engineering and technology practices. The aim of the journal is focuses on concepts, ideas, practice, applied and interdisciplinary research in commerce, business studies, management, engineering and technology. It provides a forum for debate and deliberation of academic, researcher, industrialist, practitioners and technocrat. The journals invite original research and review papers, executive experience sharing, book reviews and case studies in the respective functional areas. The contributions should be original and insightful, unpublished, indicating an understanding of the context, resources, structures, systems, processes and performance of organizations. The contributions should be research based and reflect the standards of academic rigor. Visit:
3 Midas Touch International Journal of Commerce, Management and Technology ISSN: EDITORIAL BOARD Dr. Pratapsinh Chauhan, Rajkot Dr. Sanjay Bhayani, Rajkot Dr. Daksha Chauhan, Rajkot Dr. A. Vinayagamoorthy, Salem Dr. R.K. Raul, Silchar Dr. Karmajeet singh, Chandigarh Dr. R. P. Patel, V.V. Nagar Dr. Achalapati, Hyderabad Dr. J. U. Ahmed, Shilong Dr. Suresh Panchani, V V Nagar Dr. Ahok Agarwal, Jaipur Dr. J.D. Takalkar, Pune Dr. Jaydip Chaudhary, Surat Dr. B.P. Bhuva, Anand Dr. Butalal Ajmera, Bhavanagar Editor Dr. Jayesh Vachhani Editorial Advisory Board Dr. Sachin Parikh, Rajkot Mr. Enayet Hussain, Bangaladesh Mr. K.S. Dhammaika, Sri Lanka Mr. Abdul Bari, Bangaladesh Dr. K.S. Chnadresekhar, Thiruvananthapuram Dr. Hanuman Prasad, Udaipur Dr. J. P. Majamudar, Bhavanagar Dr. D. Lazar, Pondichery Dr. Sunil Gupta, Delhi Dr. S. S. Sarangadevot, Udaipur Dr.Filipe Rodugues e Melo, Goa Dr. Vinod Patel, Surat Dr. H. D. Thorat, Pune Dr. Shiv Prasad, Ajmer Dr. P. K. Rathod, V.V. Nagar
4 Midas Touch International Journal of Commerce, Management and Technology ISSN: Vol-1, No. 8, October-2013 CONTENT No. Paper Title Author (s) Page 1. Awareness & Perception of Reverse Mortgage Scheme Kanchan Naidu 1-7 Across India 2. Critical Evaluation: Current E-Governance Scenario in Healthcare Sector in Gujarat Usha Banker An Integrated Approach in Retail Sector Through CRM Maitri Shah Kamaljeet Bhatia 4. From Retailing to E-Tailing and Beyond Manubhai I Parmar Contemporary Issues of Encrypting Human Resource in Books of Records Mitesh M. Dadhania Human Resource Management: Technological Impact Dharam Pal Singh A Study of the Factors Affecting Eco-Literacy and Eco-Friendly Attitude Amongst The Youth Ravi D. Vaidya Richa Agarwal
5 CRITICAL EVALUATION: CURRENT E-GOVERNANCE SCENARIO IN HEALTHCARE SECTOR IN GUJARAT ABSTRACT Usha Banker, Deputy Director, GTU, Ahmedabad & Research Scholar, JJTU Health care is one of the fastest growing sectors in Gujarat. The health care landscape in Gujarat is changing rapidly. Actually health care systems are usually large, complex and slow to respond to changes.public health care services run by Government are overburdened and failed to provide adequate quality services. Large geographical size, increasing population, inaccessibility, illiteracy, poverty, poor nutritional status in children and women, different food habits are various impediments. The government priorities for providing basic necessities are yet to be fulfilled. Lack of funds and coordination of various activities the bench marking of the health care services as medical services is fast developing sector, there is urgent needs for dissemination of knowledge interrelate primary, secondary data and various territory of health centers by information computer technology. In this paper we have reviewed ICT in Gujarat State.We have also presented the facts various tele services and video conferencing. The prospectus and the hurdles of ICT implementation for the practice of good governance in the area of health care sector.understand identify and proposed changes that are suggested. Keywords: E Governance, Health Care, India 1. Introduction: With the combination of good governance, speedy implementation, brisk decision making abundant and undisputed resources, Gujarat is moving towards specific positioning in health sector. There is rapid change in health care sector in Gujarat. Many studies have shown that Health IT has the potential to enable a dramatic transformation in the delivery of health care making it safer, effective and efficient. Actually health care systems are usually large, complex and slow to respond to changes but the surge of new ideas approaches and institutions in Gujarat is making away the age old barriers to change. The available medical infrastructure and easily accessible health care facilities have improved the health of population of state remarkably over the years. The state Government is taking several initiatives to make Gujarat a global health care destination. Gujarat is evolving in terms of number of hospitals health care centers beds and is expected to continue positive trend in future. Doctor to patient ratio is 1:10 and nurse to patient ratio is 1:5.By the use of latest technical equipment s efficient health insurance, a major corporate investments and services of highly skilled medical personnel, Gujarat health care sector has set itself on a boom. Health care sector in the state has potential to grow at a much faster rate in the force able future and shall be number one in providing health care facilities. The use of information and communication technology has been considered to be fundamental to the concept of integral care considering the need of patient rather than institutions and introducing a whole system of approach. The adoption of carefully thought national health IT plan will result in win win situation for all the stake holders. If adopted ina meaningful way IT systems have potential of relieving physicians from routine documentation and other clerical functions. It helps the hospital to cutdown on the paperwork, sparing more time for patient care, reducing error and increasing accuracy in transmission and storage of data.it systems enable establishment of consistent clinical standards across the enterprise and practice. Easy and direct access to varied information regarding patent through remotely located terminals and even on mobiles helps in achieving highest level of continuous monitoring and clinical decision making. Storing of information in digital form accessible and transferrable, where ever and whenever needed is essential. Tele- health care can be defined as the use of ICT to support the delivery of health care directly to people outside the conventional care centers such as hospitals or residents. Tele health care system can be as simple as providing a patient with the means to alert a remote care provider of Page 8
6 their need for assistance. European Tele Communication Standard Institute (ETSI) formed a Specialized Task Force (STF) to prepare an ETSI Guide (EG) designed(bruno,et.l.) to help tele health care delivery. The guide focused on trust, privacy, confidentiality, ethics, integrity, safety, reliability, availability keeping in mind legal aspects and satisfaction of end users. The pressure on health care industry is well known for shortage of human resource, constraint of fund, higher sensitivity of patients for health issues, high expectations for best quality treatment at lowest cost without inconvenience. There has been undue delay in implementing e-governance and e health care in developing countries like India due to the following reasons: (1)Absence of competition in health care sector for long health care is handled by public health system (PHS) with no competition. (2) Week customer with low bargaining power. (3) Non existence of funding system like insurance or social security agencies (4) Strong professional culture among doctors hostile to new ICT applications (5) doctors and nurses believe on their skill than on computers (6) Lack of computer-aid in medical and nursing education. Consequently e-governance thinking is nearly non-existent or in initial/ad-hoc stage health sector. 2. CURRENT SCENARIO The health IT adoption in India currently is based on business need rather than regulatory requirements.the use of HIT is concentrated in tertiary and secondary setups but Primary setups and clinics are yet to rip the benefits. The main reasons behind this is that the awareness about potential benefits has not yet pre-located to the medical professional community who are the business drivers in clinics and primary set ups.(iii) Corporate tertiary hospitals have been pioneers in adopting world class hospital IT systems for which they have also received the rewards in terms of return on investments and being able to provide high quality of care. Govt. hospitals are lagging far behind the meaningful adoption of HIT. A strong requirement has been felt through by the Govt. and in various states and each is taking actions based upon its perceived need. Because of lack of guidance and central leadership we are seeing fragmented efforts in various quarters. Below are the few examples of few IT implementations in Governments setups. Wipro For Delhi Municipal Corporation: Hospital Information System for 6 hospitals under DMC TCS in Tamilnadu: Solutions to maintain electronic medical record (EMR-for Govt. Setup) 21 ST century Net in Goa; Hospital Management Information systems called health Net in Goa Medical College (GMC) HP in Maharashtra: Automation project of 19 Govt. Hospitals and 14 Medical Colleges. 2.1 Current Scenario of egovernance in Gujarat Gujarat has been an enthusiastic state to bring quality health care to the citizens with a long range of programs such as PWD online registration of person with Disability,108 Emergency Transport and e Mamta mother and child tracking (IT Application), Gujarat Hospital Management Information System GHMIS, Drug Logistics Information and Management System (DLIMS), BADEA etc. Government of Gujarat has started an online web based application for data collection in case of Person with Disability(PwD) and to issue computer generated Disability Certificate up to PHC level. Any PwD can get himself registered to all of them within a specified time frame in the system by own or through NGO/Government on The data bank can be used for resource mobilization according to the distribution of type of disability up to village level. The key component of the project is to identify persons with Disabilities and issue disability certificates to all of them. Another good initiative is the Gujarat Hospital Management Information System GHMIS in Gujarat to ensure the quality health using Information and Communication Technology (ICT) as the tool to provide standard clinical and diagnostics tools, hospital management tools and integration of management information at the state level to ensure online review and monitoring. This is a total hospital and patient care management solution for providing better care through Electronic Medical Record (EMR) and IT based hospital services. GHMIS has reached out to 30 hospitals in Gujarat. Government of Gujarat initiated e-mamta (Mother and Child Tracking System Name based Tracking).It is estimated that in the state of Gujarat about 1.3 million children are born each year and 4600 of this mothers do not survive at the time of delivery because of several reasons. The MMR rate Page 9
7 of the state is 389 per 100,000 live births (iv) because majority of the deliveries are domiciliary and are conducted by untrained persons in unhygienic conditions. e Mamta is an IT based management tool to plan, deliver and monitor quality MCH services, track drop outs and ensure complete service delivery through Work Plans, analysis of performance and message alerts, thereby reducing IMR/MMR.When a parent in Gujarat doesn t remember to vaccinate an infant, Govt. of Gujarat s e Mamta scheme will know and ensure it gets done in time. 2.2 Drug Logistics Information and Management System (DLIMS) is also a very good system. It has online indenting and tracking of indent system for all Direct Demanding Officers (DDOs) of medical college affiliated hospitals, district hospitals, sub district hospitals, community health centers and chief district health officers for primary health centers and sub centers. It also offers online tender process and information for vendors. It also enables real time monitoring of drug stock up to PHC level in the State. BADEA System has been developed to store and monitor statistical data of Birth, Death and Still Birth of State. System is in use since Demographic analysis and various reports can be generated through this application. It is used to generate reports like Birth Reports, Live Birth by Place of occurrences (district and town with population 1 lakh and above), Time gap in registration of death (Rural and Urban), Deaths by age, occupation, sex (Rural and Urban), Still births by sex and type of medical attendance received at delivery (Rural and Urban) and more. The State has deployed GPRS based vehicle tracking system on more than 118 mobile health units and mobile medical units in remote and difficult areas. It is absolutely necessary to monitor and track these units through a tracking system; GPRS technology based tracking services are being outsourced for the purpose through (n) Code Solutions, a GNFC venture. Gujarat Government is also working on comprehensive patient transfer system wherein, all ambulances of community health centers, sub district hospitals and district hospitals and MMUs/MHUs will be tracked through integration with 108 EMRI vehicles by (n) Code Solutions. Gujarat has turned around its status in emergency medical services which was in a neglected state a decade back by bringing qualitative and grass rooted changes in it. Government of Gujarat is committed to provide Emergency Response Service through toll free number 108 for Medical, Police and Fire emergencies. In order to ensure efficient delivery of service to the people of Gujarat, GVK Emergency Management and Research Institute has been appointed as nodal agency under PPP (Public Private Partnership) model to professionally manage and deliver comprehensive, speedy, selfless, reliable and quality emergency service in Gujarat. 3. STATISTICAL DATA: 3.1 Hospital Information Management System: Through this initiative of Government of Gujarat almost more than 30 hospitals in government sector has implemented this with the objectives taking into consideration the streamlining of Operations, Improved Patient Care and effective administration and control. The HIMS has no of modules meeting the hospital needs like Patient registration, demographic details, outpatient visits, doctors appointment scheduling, Admission, discharge, transfer Order entry, Laboratory, radilolgy, cardiology result reporting, operation theatre management, billing and accounting, material management and many more. Automating these functions has helped government in handling large no of patients with better quality care as well as facilitating medical and paramedical staff. This project of governance has ensured quality health using information and Communication Technology (ICT) as the tool to provide standard clinical and diagnostic tools, hospital management tools and integration of management information at the state level to ensure online review and monitoring. 3.2 emamta: Health details of about 85 lakh families in the entire State comprising about 4.30 crore individuals covering more than 80 percent of the population have thus been entered so far in the software s database and system generated unique Health IDs have been provided to all. No. of families entered 94 lakhs. No. of members entered 4.71 crore.no. of PW registered 13.7 lakhs. Infant registered Page 10
8 lakhs Children (1-6 yrs) Registered 10.0 lakhs The programme has improved reporting of maternal deaths from 589 to 702 over previous year and infant deaths from 4732 to 7263 over previous year. This information would help to find left outs in essential programmes like immunization, anemia, and malnutrition etc. emamta- Mother and Child Tracking Application, State Health Rural Mission, Department of Health & Family Welfare, Government of Gujarat Silver Icon Award (Category: Outstanding performance in Citizen-Centric Service Delivery) 3.3 Drug Logistics Information and Management System (DLIMS): This project has benefited by timely procurement of quality drugs at affordable rates and also monitoring of status of drugs improved significantly. Importantly Optimum utilization of budget as DLIMS helped in proper inventory management like FIFO. It has provided Successful management of epidemics like leptospirosis to the general public indirectly. This project of egovernance has initiated e-indents worth 141 Crores for 2011 thru DLIMS for 1649 DDOs (CHC,Hospitals),Rate Contracts & Purchase orders (Current Year), RC for all Drugs on NET for CMSO, DDOs& RTI., 3751Regular Purchase Orders(71 Crs) & 696 Spl. Prg Purchas Orders(5.6 Crs, 610 Risk Purchase Recovery Orders worth 810 lakhs. BADEA: Since inception of project(2005),total registrations under this are as follows Year Birth Death Still Birth ,55,832 2,52, ,54,493 2,97, ,61,262 3,05, ,15,978 3,12, ,51,764 3,18, ,27,562 3,24, ,56,059 2,59, Since launch 108-Emergency services has attended more than 22 lakh emergencies and saved more than 1 lakh lives in life threatening situation. 20,265 deliveries have been assisted by EMTs of 108 ambulances or at Scene. It currently responds to between emergencies on daily basis. 108 Emergency Service has become a synonym of trust and promptness in responding to all kind of emergencies. The service caters to Police, Fire and Medical emergencies 24X7 all across the state and is provided free of charge to the users. The model of Sense, Reach, Care and follow up is operationalized by GVK EMRI with best in class technology and dedicated professionals. Ninety nine percent of the calls received on 108 are attended in less than one ring which is better than global standards. 4. CONCLUSION This paper analyses the scope for application of ICT at primary, secondary and tertiary health care institutions in Gujarat. Effective computerization of hospitals and medical colleges supported by networking and video conferencing would increase efficiency, quality of patient care and patient satisfaction. Presently ICT implementation in health services is in growing phase in Gujarat by the efforts of Government Of Gujarat but its further use in both medical education and health care industry will revolutionized the healthcare provided by Govt hospitals as well as corporate sectors. This analysis of Gujarat state s e-governance scenario with ICT application aims to create awareness among doctors, medical students and IT industry. Finally good quality health care delivery in low cost would safeguard national health leading to economic growth. REFERENCES: Page 11
9 Costs and Benefits of health Information Technology-Shekelle P G Morton SC, Keeler EB,2006 April(132):1-71 Review ;pubmed Sir Derek Wantless, Securig Our Future Health:Talking a Long Term View An Interim Report, HM Treasury,November Current e-governance Scenario in Heath sector of India Subhash Chandra Mhapatra, RameKrushna Das,Manas Ranjan Patra Computer Society of India. ehealth IT April 2013,The enterprise of health care ehealth.elestonline.com/2011/12/setting-the-stage-for-health-renaissance/ AUTHORS PROFILE: Usha Banker is a Deputy Director, Gujarat Technological University, Ahmedabad and Research Scholar at JJTU. Page 12
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