The document describes a report submitted by a group of students from Bharati Vidyapeeth College of Engineering on an "Integrated Health Information Platform". The report provides an introduction to the need for integrated health information systems and discusses key aspects of an integrated platform such as electronic medical records, electronic health records, how the platform would work, advantages, and implementation. It aims to present information on applying information technology to healthcare to create a nationalized healthcare database.

1. BHARATI VIDYAPEETH COLLEGE OF ENGINEERING
SECTOR NO.7, C.B.D. BELPADA, NAVI MUMBAI-400614
A Report on
“INTEGRATED HEALTH INFORMATION PLATFORM”
Under guidance of
Dr. BHAWNA RUCHI SINGH
Submitted by
ROLL NO. NAMEOF STUDENT
66 DEEPALI U. PATIL
67 MAYURESH PATIL
51 AMEY MHATRE
53 OMKAR MHATRE
63 SAMIKSHA H. PARAB
2016-17

2. BHARATI VIDYAPEETH COLLEGE OF ENGINEERING
SECTOR NO.7, C.B.D. BELPADA, NAVI MUMBAI-400614
CERTIFICATE
This is to certify that the following students of third year of department of Information
Technologyhave successfully completed the report on “Integrated Health Information
Platform” in partial fulfilment of the course Business Communication and Ethics as
prescribed by University of Mumbai.
ROLL NO. NAMEOF STUDENT
66 DEEPALI U. PATIL
67 MAYURESH PATIL
51 AMEY MHATRE
53 OMKAR MHATRE
63 SAMIKSHA H. PARAB
Dr. Bhawna Ruchi Singh Prof.S. M. Patil Dr. M. Z. Sheikh
(Report guide) (HOD of Information Technology) (Principal)

3. Preface
We take an opportunity to present report on information technology in healthcare
which will provide the readers some useful information.
We have made sincere attempt and have taken every care to present this matter
in precise and compact form. The language being as simple as possible. Weare sure that
the information contained in this volume would certainly proveuseful for betterment of
people.
The taskofcompletion ofthe reportthough being difficult was made quite simple,
interesting and successfuldueto deep involvement and complete dedication of our team
members.

4. Acknowledgement
We express esteemed gratitude and sincere thanks to our worthy project guide
Dr. Bhawna Ruchi Singh.
Our vocabulary is yet to find suitable words benefiting to high standards and
words set by her and extreme sincerity and affection with which she has regularly
encouraged us to put our heart and soul in this work.
We are also thankful to our HOD Prof. S. M. Patil and all other staff members
whose support and cooperation always helped us.
We also convey great thanks to our honourable principal Dr M. Z. Shaikh. We
also thank our parents and relatives who always bear with us in very critical situations
and provide the support whenever required.

5. TABLE OF CONTENTS
SR.NO. TITLE PAGE NO.
1. Introduction
2. Need of integrated health information platform
3. Goals
4. Electronic Medical Record(EMR)
5. Electronic Health Record(EHR)
6. Working of integrated health information platform
7. Advantages of integrated health information platform
8. Implementation of integrated health information platform

6. INTRODUCTION
Over the last decade, with development in IT sector, Health Care in India also has conquered
huge hurdles in its path. It has achieved product innovation as well as process innovation. Many
hospitals have switched to use electronic database/warehouse. This system helps in many areas in
hospitals like Practice management system, patient record, costing system, Ambulatory surgery,
Radiology, pathology, financial system, HR system etc. Here Electronic Medical Record (EMR)
of a patient are stored in the database. This system has solved many of the issues faced in healthcare
industry thus improving the standard of hospital management.
But the above mention solutions don’t apply in cases where the person will be admitted in a
different hospital, where his/her healthcare data is not available in their EMR. As each hospital has
its own database, obtaining new patient’s medical history from elsewhere is difficult and time
consuming.
The solution for above faced problem is presented in this report. Here we shall discuss
application of information technology in healthcare to make healthcare database nationalized.
Integrated Healthcare Database (IHD) is the area of IT involving the design, development, creation,
use and maintenance of information systems for the healthcare industry where all the EHR systems
are integrated.

7. NEED OF INTEGRATED HEALTH INFORMATION PLATFORM
1) Imagine your loved one has a certain chronic condition. When a doctor asks whether she’s had an
MRI recently, your loved one says “no” because she doesn’t remember receiving one — even though
she just had one two weeks prior at another doctor’s office across town. Let’s say there was also a
prescription for follow-up care, but she never received that, either. Maybe she was also prescribed
medication, but the prescription was never filled at the pharmacy.
Without a centralized record, this person might theoretically receive the same test over and over
without ever following up with subsequent treatment or medicine the doctor feels is necessary. She
may feel she’s doing everything in her power to do what the doctor instructs, but the record may tell
another story.
What many healthy people often don’t realize is how much time and attention to detail it takes to
manage your own health care when problems arise. It’s not uncommon for several different doctors to
prescribe multiple medications, tests and follow-up care. Without a centralized medical record, many
don’t even realize the treatment they’re receiving is a duplication of effort. That redundancy adds to
the already high costs of obtaining health care.
Information technology has the potential to give doctors and providers of medical care a much more
complete picture of the patient in front of them, and patients a much easier way to access their complete
medical history.
2) As a young child, Betty had been given penicillin, turned blue, and was rushed to the hospital. She
was 15 when she got strep throat, was given penicillin, and died. No one had asked her about
medication allergies.
Medical questionnaire forms have always included a space for allergies, although this became much
more prominent after the Institute of Medicine report on patient safety in 1999.
In 2008, the Pennsylvania Patient Safety Advisory cited more than 3800 cases in which patients
received medications to which they had documented allergies. Breakdowns in communication of
allergy information include "documentation of patients' allergies on paper but not entered into the
organization's computerized order-entry systems, and allergies arising during episodes of care but not
documented in the medical record or communicated to appropriate staff."
Strategies to address the problem include adding visible prompts in consistent and prominent locations
listing patient allergies, eliminating the practice of writing drug allergens on allergy arm bracelets, and
making the allergy reaction selection a mandatory entry in the organization's order-entry systems.

8. GOALS:
TODAY TOMORROW
SCOPE cure patients care for citizens
FOCUS on the process and provider on the patient
TIME symptomatic, curative preventive, lifetime
LOCATION hospital decentralized, at home
CLINICAL DECISIONS personal preferences guide lines/evidence based
THE PROCESS fragmented, isolated Centralized system
ORDER PROCESS Manual Automated
INFORMATION fragmented, isolated consolidated / complete
TECHNOLOGY isolated systems integrated system
DATA ACCESS limited, difficult any time, any place
DATA INTEGRITY manual/error prone systematic mgt. and control
DATA COMPLETENESS Fragmented Consolidated
DATA AVAILABILITY Slow real-time

9. Electronic Medical Record (EMR):
 An electronic medical record (EMR) is a digital version of the traditional paper-based medical
record for an individual. The EMR represents a medical record within a single facility, such as a
doctor's office or a clinic.
 EMR is the digital equivalent of the paper patient chart within a specific provider organization i.e.it
contains patient’s clinical data. It is a comprehensive record of tests, prescriptions, diagnostic
images and the entire patient history.
 It is an application environment composed of the clinical data repository, clinical decision support,
controlled medical vocabulary, order entry, computerized provider order entry, pharmacy, and
clinical documentation applications.
 EMR are not designed to be shared outside individual practice.
 The data in the EMR is the legal record of what happened to the patient during their encounter at
the hospital and is owned by that organization.

10. EHR (Electronic Health Record):
 An electronic health record (EHR) is a digital version of a patient’s paper chart.
 EHRs are real-time, patient-centred records that make information available instantly and
securely to authorized users.
 While an EHR does contain the medical and treatment histories of patients, an EHR system is
built to go beyond standard clinical data collected in a provider’s office and can be inclusive
of a broader view of a patient’s care. EHRs can:
1. Contain a patient’s medical history, diagnoses, medications, treatment plans, immunization
dates, allergies, radiology images, and laboratory and test results
2. Allow access to evidence-based tools that providers can use to make decisions about a
patient’s care
3. Automate and streamline provider workflow
 One of the key features of an EHR is that health information can be created and managed by
authorized providers in a digital format capable of being shared with other providers across
more than one health care organization.
 EHRs are designed to reach out beyond the health organization that originally collects and
compiles the information.
 The information moves with the patient –to the specialist, the hospital, the nursing home, the
next state or even across the country.
 EHR is a subset of each care delivery organization’s EMR.
• Fig: PrognoCIS software

12. HOW DOES INTEGRATED HEALTH INFORMATION PLATFORM
WORKS?
 Patient registration:
 First time users of Integrated Healthcare Database system will register themselves using their
aadhaar id or pan card and an existing mobile number.
 After registration is complete users will have an account, which can be accessed by username
and password they provide.
 The user will need to update their EHR through their health care provider.
 Users will be able to view these records in their account, but to alter them they have to visit
nearest authorized medical outlet.
 Online test order and results :
1. Ordering:
 Existing users can select one or multiple tests from a list of available tests.
 All the test order history will be stored.
 The ordering system will make sure using the EHR, EMR and the test history that all the test
being ordered will not adversely affect the patient and are coherent with each other.
 After the payment is done user will receive a confirmation message and email.
 This email will contain payment details and a receipt.
2. Finding lab:
 Once the user receives their medical order confirmation, they can visit the test lab at their
convenience.
 Users can find suitable lab using the ‘find location’ tool.
 Not all labs provides all services, so based on services offered users can locate nearest lab.
 No prior appointment needs to be made, the labs will work on a walk-in basis.
3. Reports:
 Users will have several options to obtain their results. Upon completion of tests results will be
made available online, which users can access through their account.
 They can also obtain their results through labs.
 Once the reports are available the users will be able to view them, Share them with their
healthcare provider who can update their EMR.
 All the previous reports will also be maintained and will be available to the user.
 Appointments:
 Existing users will have various options while booking an appointment, eg with a doctor, with
a nurse, or for a review of a condition.
 Each practice will have a different set of choices, depending on how they run their
appointments.
 All available appointments will be shown but the user can narrow the list by doctor, location
and time. User will select an appropriate appointment.
 User will be able to print out the appointment or add it to their online calendar.
 Users would be able to integrate the appointments into their phone calendars.
 Using online booking will further facilitate in maintaining EHR.
 Waiting times will be reduced.

13.  Online prescription and consultation:
 The availability of EHR and real time EMR makes online prescription feasible. Users can
request for a refill prescription of drugs already prescribed by healthcare provider. Request for
any new drug will be reviewed based on the medical and health records and prescription
history.
 Buying drugs online also becomes easier and safer.
 EHR also enables efficient online consultations.
 Upon availability of appropriate records users can consult doctors through online video , phone
and other web services.
 This practice will save lots of time and traveling.
 Online symptom checker and diagnoses:
 Online symptom checking tools can be used which will provide a list of possible conditions.
 This tools will make use of constraints provided by the user like age, gender, locality and other
information.
 They will also make use of data from national and individual health records.
 Using the symptoms and their pattern, in addition to these constraints and statistics systems
can compute more accurately from the vast database of diseases.
 Availability of EHR, EMR and online tests reports makes online diagnoses a possibility. This
system can be combined with doctor’s consultation and finalize a diagnoses or used to
formulate a second opinion.
 History will be stored and will be used to improve the system for the user and community.
 Personal health record:
 Users can maintain their own health records. A mobile personal health record will allow the
user to monitor their health in real time with wearable devices and apps and then share the data
with their doctor to keep them in loop.
 Various application will authenticate user with their healthcare account.
 These apps will allow the users to collect their own health data, these apps can make use of
home gadgets like smart scale and even wearable devices such as blood pressure wrist monitors
and fitness trackers.
 Growing range of apps and wearables will mean that the user will be able to monitor all aspects
of their health, from weight and fitness to life-threatening conditions like diabetes, high blood
pressure, heart, kidney and chronic lung disease.
 Personal health records are maintained much like EHR and EMR, but the user has control over
the data.
 Doctors and general practitioners will be able to view these records with the user’s consent.
 Using the data collected, GP can build a complete picture of user’s health.
 User can choose the following health data types in your Personal Health Record (PHR):
i. Height
ii. Weight
iii. BMI
iv. Blood Glucose
v. Blood Pressure (Diastolic & Systolic)
vi. Distance (walked per day)
vii. Forced expired volume
viii. Forced Vital capacity
ix. Heart Rate
x. Oxygen Saturation

14. xi. Peak Expiratory Flow
xii. Respiratory rate
xiii. Steps (taken per day)

15. ADVANTAGES
1. Sharing of medical records:
 Medical records can be shared with the specified doctors.
 You can limit how much of your personal information people can access.
 Securely sharing electronic information with patients and other clinicians.
2. Getting an experts opinion:
 It is possible to share reports with doctors throughout country.
 In many cases expert’s opinion is very important for doctors as well as patients.
 For this patients only have to select doctors to which they intend to share the data.
3. Storing and providing medical history:
 In this system medical history can be stored.
 Which includes allergies, vaccinations, previous test reports, x-ray reports.
 This reports can be accessed by doctors for further treatments.
 Also this can store information of family member in case of emergency.
 Also it can store information of current medication.
 Healthcare providers can use EHR in an emergency situation to get a more accurate picture of a
patient’s medical history more quickly than with traditional means.
4. Reduced unnecessary tests:
 This system reduces repetition of tests which are done in past and no need to perform again.Like
if a test for allergies is done in past then that report still can be used and hence no retest is required.
5. Many advantages over typical paper based system:
 The handwriting is sometimes illegible and the document cannot be electronically shared or
stored. It is not structured data that is computable and hence shareable with other computers and
systems.
 Other shortcomings of paper: expensive to copy, transport and store; easy to destroy; difficult to
analyse and determine who has seen it; and the negative impact on the environment.
 Storage space required is reduced tremendously.
6. Records are easily Available:
 Important advantage is the fact that the record is available 24 hours a day, seven days a week and
doesn’t require an employee to pull the chart, nor extra space to store it.

16. 7. Time efficiency:
 It can help to provide medical support in case of accidents immediately without wasting time in
filling the paper forms.
8. Cost efficiency:
 Cost efficiency can be achieved by reduction in repetition of unnecessary tests.
 It reduces copying, faxing and mail expenses, chart pulls and labour costs.
 Reduces revenue used in paper based records.
 Reduced storage space in turn reduces the cost.

17. IMPLEMENTATIONOF INTEGRATEDHEALTH INFORMATION
PLATFORM
1. Assess the current situation
Organizations take stock of their existing systems and users. If an office has purchased new computers
or significant new software such as a billing system, it may make sense to find an EHR that works
with those existing assets.
Documenting processes allows issues to be resolved early. Otherwise, the problems that haven't been
dealt with will be blamed on the EHR. It's like shining a bright light on the existing issues.
If staffers have limited experience with electronic records of any kind, then successful implementation
may require additional training.
Prioritizing and fixing any problems uncovered during the assessment phase also allows the
organization to develop and nurture more efficient and effective processes before and during
implementation. And, creating processes that better respond to the needs and preferences of staff and
providers increase the system's overall usability.
2. Identify leadership and project protocols
Leadership must communicate the reasons and objectives for conversion, and their full commitment
to its success.
It's essential to driving effective clinician involvement and increasing acceptance of the necessary
changes.
Deciding early on what the procedure is for dealing with physicians or staff who refuse to use the
system or delay training also can minimize disruption and tension later on.
3. Define what the system must do
This essential step identifies the goals and specifications of the EHR system and enables practices to
prepare requests for proposals (RFP) that permit objective comparison of vendors. Specifying the
required functions upfront also minimizes expenses associated with changing requirements during
implementation.
4. Compare products and support
The RFP and initial assessment can keep the evaluation team from succumbing to the siren call of
additional functionality that may drive up costs without better meeting the project or practice's
objectives. At the same time, the groundwork will ensure that the products chosen for the short list
actually provide the essential tools, processes, and linkages.
5. Estimate costs and benefits
Understanding the full cost and anticipated benefits of the system is a critical part of the evaluation.
Subsidies from regional extension centres and healthcare systems also can reduce costs for many

18. primary care practices. Although physicians tend to focus on the cost of the hardware and software in
an implementation, according to CDW Healthcare's research, those components typically are just 12%
of total costs. Lost productivity, training, and connectivity with hospitals, labs, third-party payers, and
regional health information organizations also must be considered.
6. Negotiate, purchase, and install
A number of organizations, such as the individual state HIT centres, have made templates available
online for RFPs and for EHR vendor contracts. Reviewing these items to check that the final contract
has the protections, usability measures, responsiveness metrics, and other necessary features to get and
keep the system working can save time and money in the long run.
7. Train for proficiency
The challenge is ensuring that the training supports the specific practice and is not a "one-size-fits-all"
application. Every practice has its unique needs that must be addressed to ensure optimal use of the
EHR. Practice-specific training that focuses on the processes used by the providers and staff rather
than the software is the most effective. Training also should be tailored to the role each person plays
in the organization.
8. Survey the system
After implementation, practices need to track whether and how providers and staff use the new system.
Surveying users about their experiences with the EHR will identify process or training issues that need
to be addressed.
For organizations that have included patient portals as part of their EHR implementation, surveys can
identify any glitches in the implementation or areas where additional education may be needed.
Appropriate use and adoption can be monitored with tools such as dashboards, checklists, and gap
analysis forms.

19. HURDLES IN CREATION AND IMPLEMENTATION OF
INTEGRATED HEALTH INFORMATION PLATFORM
 Cost
Problem: The cost associated with EHRs is often a deterrent. Not only must the provider pay for
the physical hardware and/or software, the organization must also put forth a considerable dollar
amount for setup, maintenance, training, IT support and system updates. For many smaller
practices with lower cash flow, cost alone prohibits the ability to properly implement and maintain
the system.
Solution: A critical evaluation of the cost and savings of such a system is needed. The government
can fund the plan through tax revenue generated. Private NGOs and non-profit organisation can
invest and help making Indian healthcare digital.
 Privacy of patient
Problem: The privacy of patient data is also of significant concern, particularly if the data are
accessible outside healthcare institutions and are available on the internet worldwide. Leaked
digital clinical data could compromise patients on a variety of levels and expose medical
practitioners to lawsuits related to negligence in the care of patients' data.
Solution: In response to security concerns, new security architecture for EHR including multiple
data-protection features, such as encryption, remote and protected data storage, monitored
exchanges between computer systems, digital signatures, authentication processes and usage audits
have been created. Several of these security protocols have already been applied to online
consumer interfaces such as internet banking.
 Raw data:
Problem: There is an overwhelming amount of raw data. Healthcare organizations are presented
with a flood of data. Everyone in the organization—from the CEO to the individual clinician—
needs a way to turn all of that raw information into targeted,actionable knowledge. Making sense of
the raw data on its own, without tools and processes to guide the process, can be overwhelming if
not impossible.
Solution: A data warehouse is a database of a different kind: an OLAP (online analytical
processing) database. A data warehouse exists as a layer on top of another database or databases
(usually OLTP databases). The data warehouse takes the data from all these databases and creates
a layer optimized for and dedicated to analytics.
 Network availability:

20. PROBLEM: Process of assessing and updating data may become difficult if network speed issues
are faced.
SOLUTION: Better servers can be used to increase speed of data transfer. Organizations can even
opt for Open Network System.

21. SUMMARY
An integrated health information platform refers to systematized collection of patient and
population electronically-stored health information in a digital format. These records can be shared
across different health care settings. Records are shared through network-connected, enterprise-wide
information systems or other information networks and exchanges. EHRs may include a range of data,
including demographics, medical history, medication and allergies, immunization status, laboratory
test results, radiology images, vital signs, personal statistics like age and weight, and billing
information.
EHR systems are designed to store data accurately and to capture the state of a patient across
time. It eliminates the need to track down a patient's previous paper medical records and assists in
ensuring data is accurate and legible. It can reduce risk of data replication as there is only one
modifiable file, which means the file is more likely up to date, and decreases risk of lost paperwork.
Due to the digital information being searchable and in a single file, EMR's are more effective when
extracting medical data for the examination of possible trends and long term changes in a patient.
Population-based studies of medical records may also be facilitated by the widespread adoption of
EHR's and EMR's.

22. REFERENCE:
https://www.healthit.gov/
https://www.healthcatalyst.com/category/data-warehouse/
http://www.informationweek.com/electronic-health-records.asp
http://www.informationweek.com/healthcare/electronic-health-records/national-
health-database-good-medicine-or-privacy-nightmare/d/d-id/1306644
http://www.kevinmd.com/blog/2010/01/national-healthcare-information-database.html