“We used EMR to drive transformation and operational efficiency”

Ravishankar Sankeshwar, Chief Information Technology, KLES Dr Prabhakar Kore Hospital and Medical Research Centre, and HHH (Healthcare) Award 2017 winner, talks about developing an in-house EMR application to decrease operational costs and streamline patient care. By Satyaki Sarkar

Using technology to redefine and strengthen the doctor-patient relationship is a passion for Ravishankar Sankeshwar. And that’s exactly what he’s been doing as the Chief Information Technology at KLES Dr Prabhakar Kore Hospital and Medical Research Centre. He’s implemented all 36 modules of the source script ERP system, digitised hospital deployment and MRD integration, created a patient tracking system and an SMS interface for lab billing, and headed the organisations effort’s in transforming into a paperless, eco-green hospital. Ravishankar has also implemented EMR for 400+ healthcare professionals, including super specialty doctors and healthcare assistants, at the hospital and MRC. For his efforts, he recently won the HHH (Healthcare) Award 2017 for EMR Adoption. Here, Ravishankar tells us more about the implementation.

Introducing EMR
“Implementation of EMR is one of the most challenging technology projects in today’s healthcare industry, while also being one of the most necessary. It’s challenging because doctors and healthcare professionals have to devote extra effort and time in entering information into the EMR systems, which they are reluctant to do. But the younger generation are extremely cooperative, insisting on using the EMR system itself. We have around 1,800 OPDs every day, around 2,000 patients, and 150 OPDs in each speciality. Earlier it was a Herculean job for a doctor to sift through all the records and treat the 40 to 50 patients within a limited time every day. That’s why we introduced the EMR systems. Thanks to EMR the complete process has become simplified, right from registration to medical processes and prescriptions, everything is interfaced and uploaded.”

Making it work
“We call ours the EMR version 1.5. It’s a mobile app for which we’ve appointed a public relations team that captures the initial data required from the patients, so doctors’ time is saved. Using a simple MCQ sheet available in three different languages (Kannada, Hindi, and English), the team feeds the data into the system. Once their data is in the system, the patients enter the OPD and the doctors take over. We’ve created speciality-wise drug lists that the doctors can browse and choose from. They can even create their own drug list, along with lab and test records, so that they don’t have to sift through thousands of options every time. We’re also working on integrating a voice recognition feature into the application to make the entire process a lot smoother, faster, and easier.

“Additionally, the healthcare industry has a fairly high attrition rate. In an organisation like ours, which has over 400 doctors, once a doctor leaves the one who replaces him/her wouldn’t know the patient history, the treatments the predecessor had performed, the drugs prescribed, etc. But now that’s no longer an issue as the records are available at the tap of one’s fingers, in a detailed, organised manner.”

Application development
“The entire EMR application was developed in-house, with a team of eight members working on it for nearly three years. We developed it in-house to save on cost and time, and have better customisation. However, one of the biggest challenges we faced was the coding and continuation of work once a development team member left the organisation. There wouldn’t be any record, document, or guide to help their replacement understand their coding language, the approach taken, etc. No global conventions were followed, so we learnt to enforce the documentation and maintenance of records stringently, with regards to every part of the development, as well as the use of VFS to allow core development to stay up to date and synchronised with the work that had been done. We would hold progress meetings and sessions every Saturday, and over time, the process became smooth and co-ordinated, allowing us to finish implementation within this year itself.”

Smoother operations and improved co-ordination
“The benefits have been huge for doctors and patients. Now a single file can be accessed across multiple departments at the same time at the click of a button. In a hospital that spans 1,60,000 square feet, the physical transfer of files and documents was a huge problem for doctors. This has been completely eliminated, not only saving time, but also improving coordination and proper maintenance of records. Additionally, in case of an emergency, an auto generated SMS can be sent to the doctor’s and patient’s phone. This can be configured to send updates filtered by severity, urgency, and nature of the emergency, so doctors don’t get irritated with the constant SMS updates.”

In the works
“Now, we are working on integrating WhatsApp into the system, for both doctors and front desk operatives managing the system, to make the process even easier for both. Recently, we implemented a Picture Archival Communication System (PACS), and are planning PACS City, a new department that would use a cloud based PACS. Patients’ file images would be compressed and uploaded into the cloud, from where they can be accessed from anywhere in the world. We expect to complete the project by October 2017, and it will completely negate the need for a patient to carry a physical file, even if he/she is being referred to a different doctor in another hospital somewhere else in the country. That’s because the doctor could be allowed access to the patient files by sharing the patient ID through our PACS City system.” 

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