The provider e-object can also facilitate capturing of signs, symptoms, vitals and procedures data during an active surveillance, which would in turn be useful in studying, analysing disease outbreak
The need for the eObjects arose because most of the healthcare-IT applications are being developed without any standards by different agencies and vendors in the public and private sector in India. Each application is developed for standalone use without much attention to semantic interoperability. Later when the thought of interoperability emerges – it becomes difficult to connect the systems and make them talk to each other because they were never designed for that purpose.
Even if technical and organisational interoperability is done the semantic interoperability may remain a challenge. For example – all applications must have the same facility master. When Application A sends the ANC data for Facility 123, the receiving Application B should understand ANC and uniquely identify Facility 123. Another example is if a hospital application sends the insurance reimbursement bill to the insurance company / government, the recipient application should be able to understand and re-present the same meaning of bill information.
Interoperability among e-Governance applications for the health sector requires exchange of information across applications. There is a need for commonly accepted data definitions for the various data elements used in e-Governance systems in healthcare. Hence, standardisation of data elements is the prerequisite for systematic development of e-Governance applications in the health sector.
The old HIS and EMR systems or even the new breed digital health apps lack credible Global Digital Health Standards. Hence, they exist in silos and don’t interact with each other or the larger healthcare ecosystem. The data cannot be referred for any meaningful analysis. For example, we still don’t know clearly the size, scale and depth of the dengue, chikungunya and H1N1, flu epidemics that strike us every year. Hence, we are always left gasping for breath when the seasonal spike starts.
India is already the diabetes capital of the world with 70 million cases and counting. There are no standard protocols based on the Digital Disease Management Platform. The HMIS / HIS / EMR market in India requires Digital Health Standards based FHIR / JSON eObjects that can help the existing systems to communicate with the external world in a standardised format.
These Provider eObjects were first published in Health Systems for New India book by Niti Aayog and comply with NDHB, EHR and Meta Data standards, guidelines provided by Medical Council of India, Clinic Establishment Act and as per the latest Telemedicine guidelines released by the Government of India.
Details of the eObjects have been published on the openbodhik.blogspot.com. To facilitate standard value sets for the entire ecosystem, all the required value sets / code directories / master have been provided in an excel format.
- eEncounter note
- ePrescription and
- eDischarge summary
Please follow the link provided here to access the e-provider objects and related documents:
- Presentation on what are eObjects and How to use it: https://drive.google.com/open?id=1i48bAib4lAdbeZqsRm2IsytdbFrYaCXk
- eObjects Details: https://drive.google.com/open?id=1p622-1yaeTdu3dkHKYbHckU29XsX2R-c
- Code Directory Details: https://drive.google.com/open?id=1JBC7S69oMUQVrUsotI6pCg-PK7deqETu
All respective healthcare delivery systems should be able to generate the Provider eObjects formats. One can use the eObjects as input forms i.e. if one is building a new system. Legacy systems will use eObjects as Standard Output format.
The provider e-object can also facilitate capturing of signs, symptoms, vitals and procedures data during an active surveillance, which would in turn be useful in studying and analysing a disease outbreak.
Requesting all to kindly use these eObjects to collect data in their respective health delivery systems, that can together help facilitate Government with valuable clinical data for analysis and planning.
Reach out to digital.health@accessh.org for any help to understand or implement the e-objects. Access Health Digital can set up a group call to explain these eObjects in detail or even can set up one to one calls.
Existing Healthcare Solutions can also consider these to create a Bolt-on layer even if their base products do not comply with the National Digital Health Blueprint.
Data aligned with Standards has been the difference between countries that have successfully encountered COVID19 and those who havent’t been able to.