Role of Information and Communication Technology in Medical Research: A National

Perspective

Dr Rajni KantIndian Council of Medical Research

Department of Health Research (Ministry of Health & Family Welfare, Govt of India)

New Delhi

Indian Council of Medical Research

Apex body to formulate, conduct, coordinate and promote biomedical researchFounded in 1911 as Indian Research Fund AssociationRenamed as ICMR in 1949Intramural Research: through network of 32 Institutes/ centres and over 100 field units Extramural Research through funding to medical colleges, universities / institutions - average 1200-1500 projects annually (ongoing and new) HRD : About 1000-1200 student fellowships- JRF, SRF, PDF, STS (ongoing and new, every year)International Co-operation in Health Research

Network of ICMR Institutes/Centres1. BMHRC, Bhopal2. CRME, Madurai3. EVRC, Mumbai4. DMRC, Jodhpur5. FTDRC, Hyderabad6. GRC, Mumbai7. ICPO, Noida8. ICMR Virus Unit,

Kolkata9. MCC, Pune10.NARI, Pune11.NCDIR, Bangalore12.NCLAS, Hyderabad13.NICED, Kolkata14.NIE, Chennai15.NIMR, New Delhi16.NIMS, New Delhi

17. NIN, Hyderabad18. NIRT, Chennai19.NIREH, Bhopal20.NIV, Pune21.NJIL&OMD, Agra22.NIOH, Ahmedabad23 NIIH, Mumbai24. NIOP, New Delhi25. NIRRH, Mumbai26.RMRC,

Bhubaneswar27.RMRC, Port-Blair28.RMRCT, Jabalpur29.RMRIMS, Patna30. RMRC, Dibrugarh31. RMRC, Belgaum32. VCRC, Puducherry

Malaria, Leishmaniasis, Filariasis, Diarrhoeal diseases, Leprosy, Tuberculosis,HIV/AIDS, Poliomyelitis, other viral diseases, Cancer, Occupational HealthBlood Disorders, Reproductive Health, Nutrition, Epidemiology, Medical Statistics, Regional Health Issues

Health Information System

Health information systems strongly influence quality and efficiency of health care, and technical progress offers advanced opportunities to support health care.

BenefitsInformation technology is critical to health

care’s infrastructure and key to transforming how health care operates

IT can improve…◦ Quality of patient care◦ Business of health care◦ Compliance with regulations and policies◦ Mobilizing the field to address the fragmentation

and lack of coordination in health care…improving quality and performance through standards-based information systems

◦ Connectivity & network/communications

Informatics in Medical Research

Informatics has become an integral component of medical research due to exponential increase in volume and complexity of data.

Informatics tools and techniques are being used world-wide for:◦ Better understanding of disease prevalence and pathogenesis◦ Developing better prognostic/diagnostic markers and

therapeutics

Three important reasons for limited use of informatics by Indian medical professionals are:◦ Lack of awareness◦ Lack of sufficient infrastructure particular for big medical data◦ Lack of expertise

ICMR- TASKFORCE ON BIOMEDICAL INFORMATICS

Biomedical Informatics Centres of ICMR were initiated in project mode in 2006 Under TF .

Established 9 Biomedical Informatics Centres of ICMR at medical colleges and medical research institutes.

During the duration of the project (six years) the Centres conducted 57 training programs, completed 122 collaborative projects, developed 47 databases of clinical and biomedical information and published 98 peer-reviewed publications.

ICMR extended the program into the second phase and enhanced the mandate to a total of 20 Biomedical Informatics Centres.

Mobile-based Surveillance Quest using IT  (MoSQuIT) Disease Surveillance System for Malaria using a Mobile Platform

Innovation:Disease Surveillance System for Malaria using a Mobile PlatformImplementer:Centre for Development of Advanced Computing

Indian Council for Medical Research/RMRC

Mobile based Surveillance Quest using ITMoSQuIT

Collaborators:Centre for Development of Advanced Computing, Pune

• Track, monitor the status of malaria in the community

• Detect changes in trend, distribution of malaria in order to initiate investigative, control measures

• Measure the effectiveness of anti-malaria programme

• Malaria Prevention & control

Objectives

Design & Methodology•Identification of OPD/Healthcare centres & Health workers for data collection •Training the Health workers for data collection/transfer •Involvement of Medical officers, ANM, MPW, ASHA, Technical supervisor, Surveillance workers for tracking and monitoring •Instantaneous data transfer to the data mart at the PHC/Regional Medical Centre •Data analysis for trend identification and outbreak prediction ;

Building Blocks: •Data collection via Mobiles ; •Data transfer from Mobiles to Servers ; •Data collation/analysis on Server ; •Multimedia User Interface

• Video clips (Training of using malaria detection kit..) ; • Voice/Audio clips (Precaution during epidemic..) ; • Health games (Malaria prevention..) ; • Alerts of epidemic

•System deployed in Primary Health Centres (Tengaghat, Assam) with 10 subcentres covering Population of size 60,000 from 66 Villages

•Fifty Accredited Social Health Activists (ASHA) involved in door-to-door visits

•Besides these, Lab Technicians, Medical Officers and other Support Staff including Nurses are involved

Deployment

Up-scalingBased on the success of this work, further scaled-up deployment of MoSQuIT has been approved along International borders of North East India (Mobile based integrated surveillance system for malaria along international borders of NE .

Prevents delay in data dissemination from field to decision-makers

Early diagnosis reduces morbidity and mortalityEarly detection of epidemic situationFast reporting, close to real time

Improves accuracy of decision making Facilitates better treatment and care of patients

VsMobile based Conventional

Benefits

Tuberculosis Screening, Diagnostic & Treatment

Adherence system using ICT & mobile Technology

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Developed by RMRC, Dibrugarh

Objectives• Design, Development and Deployment of Screening,

Diagnostic & Tuberculosis(TB) Treatment Adherence System for inaccessible hilly area & tea gardens which will provide region specific risk factors on Web and Mobile platforms

• Connect stakeholders of Revised National Tuberculosis Control Programme (RNTCP) by providing near-real time information to TB Home Visitor(TBHV), Senior Treatment Supervisor (STS) & Directly Observed Treatment (DOT) provider/Accredited Social Health Activist (ASHA) to identify TB treatment defaulters

• Build Pill box compatibility to help with Treatment Adherence

• Cost effective and Non-invasive TB Screening, Diagnostic & Monitoring using Information and Communications Technology(ICT) for better X-Ray reading & Cough sound pattern analysis

• Generating awareness amongst community regarding hygiene habits especially about spitting & coughing etiquette for the prevention of spread of TB

Mobile Edutainment for TB

Preventive TB ManagementKnow about TBMy Family Care… Curative TB ManagementPrepare for Investigations: Sputum, X-ray… Drug regime, Dos & Don’ts for TB Diet & Lifestyle for TB patient…

Entertainment TB related mobile games

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Health Apps

Health Informatics Through Mobile Technology(HIMT)

Connecting to People

CANCER AWARENESS:

Development of Cancer Web Portal for public by ICPO, Noida

www.cancerindia.org.in

Mapping Vector-borne Diseases- Usage of Space Technology • Mapping of village level ecological

risk of malaria.• Impact of deforestation on

malaria vectors in Sonitpur (Assam).

• Risk map of filariasis in 3 blocks in Odisha.

• Niche modelling of Kala-azar vector.

• Early warning tools for malaria.• Early warning system for

Japanese encephalitis.• Determined Climate suitability for

cholera using weather parameters.

With images of IRS P6 MX, villages categorized into high ( ) and low ( ) malarious villages in Kallembella (Sira Taluka , Tumkur)

Mapping of Zone wise Dengue Cases, Aedes Breeding, GPS Track & Way Points

for Aedes control

•Buffer zone of 200 m around the 20 locality of West zone Delhi was created

•Aedes Aegypti breeding was controlled in 2012 -14.

•No case of dengue was reported from the localities and in buffer zone of 200 m in 2014 & 2015.

Use of GIS technology in dengue control

e-learning programmes in health research

NPTEL- National Programme on Technology Enhanced Learning Joint initiative of IITs and IIScFunded by Ministry of Human Resources Development

• In 2016, NIE-NPTEL collaboration will launch the following courses: • Research methods• Good Clinical and Laboratory Practices• Principles of Bio-ethics• Human Subject Protection and Operating

Guidelines for Human Ethics Commitees

Digitization of IJMR since inception (1913)

Text/Image

Cleaning Software

Indexing & Keyword Generation

Pdf conversion/OCR Metadata

Digital Record

Upload

To increase visibility & Impact, Full-fill regular high demand for articles, Facilitate easy access & retrieval

Physical Information Digital Form

(Project in collaboration with CDAC, Noida)

Journal Archive

Content Page

Exhaustive search options

Project Proposal and Management

System

Appropriate use of e-connectivity E-governance for administrative work. E-governance for project management. Knowledge Management Policy for optimum utilization

of National Knowledge Network for health service delivery, medical education and research (e Health)◦ Integrating research with service, medical

education and health care delivery systems. ◦Sharing knowledge about best practices to raise

the productivity and efficiency of health systems and improve the outcome related indicators.

◦Building up the capacity for management of health effects of disasters/outbreaks.

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Action Plan for Telemedicine To prepare the Policy Document on Knowledge

Management for Health- Service, Education and Research in the country (KMP).

To develop an efficient Health Knowledge Management System for collection, collation, dissemination and utilization of knowledge for improving the quality of Health Services, Education and Research

Under chairmanship of Prof. S.V. Raghavan, Scientific Secretary in the Office of the Principal Scientific Adviser to the Government of India & Professor in the Department of Computer Science and Engineering along with other area experts, ten projects were reviewed and five were found to be suitable to be undertaken as per KMP policy initiative

Projects related to Telemedicine

School Based Surveillance of Acute Pharyngitis and Rheumatic Fever, RHD among School Children using Mobile Phone based reporting system; prospective randomized cluster intervention trial.

Evaluate the Role of Telemedicine in Diagnosis of Retinal Diseases in Tribal Population of Keylong, Lahaul & Spiti of Himachal Pradesh Using Fundus Photography.

Impact of 24-Hour ACS Helpline on the Thrombolytic Rate in Acute Coronary Syndrome in Kangra District: A Cluster Controlled Trial

Effect of Standard E-Management Guidelines to Improve Treatment Compliance Among Patients With Type-2 Diabetes Mellitus of Urban, Rural And Tribal Area of HP

Geriatric Friendly Clinic: Primary Health Care - An Age-Friendly Approach

Strategic program to develop and evaluate the effect of an educational program for rationalizing the use of antibiotics in peripheral centers connected to telemedicine unit of a tertiary care hospital.

Software developmentShort term studentship (STS)

Management of Acute Coronary Events (MACE)

e-Recruitment

Monitoring the Engineering Services

MANAGEMENT INFORMATION SYSTEMS AT ICMR

Up-to-date databases of ◦ Extramural projects funded by ICMR ◦ Profiles of ICMR Institutes and Scientists◦ Publications of the ICMR Scientists◦ Seminars/Symposium/Workshops/Conferences funded by

ICMR◦ Indian Journal of Medical Research (IJMR)

Report generation◦ Generation of customized reports for time bound

queries, parliament queries

Interactive Extramural Information System for the Division of ECD.

Office procedure automation (OPA)

Implemented in the year 2000 at ICMR Headquarters

Four ICMR institutes (NIOH, NIRT, NIV, RMRIMS) are using it

Help in tracking the Office files and its place

VIDEO CONFERENCINGICMR has established and managing

Video Conferencing facility at its nine institutes, which help in interaction and deliberations on various health issues in short time with out involving any travel

The facility is being used extensively for National and International Conferences by all institutes having VC facility

Databases Prepared

Mega Project on Digitization of IJMR since inception (1913): Outcome- IJMR Digital Archive with searchable interface

Database on Research Papers on Malaria in the name MALPUB (1955-2005) and its Analysis

Directory of Indian S&T (including Medical Periodicals) with the name DIP (2010)

Also digitized the past available Annual Reports, Special Reports & Technical Reports.

Tuberculosis (Developed by NIRTH, Chennai)

TBDRUGS -Database of Drugs for Tuberculosis

DDRTB- Database for Drug Resistant Tuberculosis

Nutrition (Developed by NIN, Hyderabad)

Food and Nutrition Database

Diet Calculator with recipes and Recommended dietary Guidelines

National Food Borne Disease Surveillance Portal

E-Governance with the purpose of automating all activities and building an Information Base

ICMR Computational Genomics Centre

Data Repository consisting of all research data generated by ICMR through its extramural & intramural activities. Application of Data mining and Business Intelligence.

Develop E-class rooms using National Knowledge Network for teaching of Medical Students by the faculty of tertiary care Hospitals.

PROPOSED ACTIVITIES

Conclusion Use of Information and Communication Technologies in Health

Care including Health Research have immense potential.

This will help in easy connectivity, people mobilization, developing rapid response system and help in mapping and forecasting of diseases in advance as well as developing important databases.

E-health/m-health is need of the hour

Challenge is to widen the scope and be prepared to cope up with fast changing scenario as well as adoptable to new innovations/ technologies

Strengthening infrastructure and capacity building will further enhance its utilization

May also contribute to Digital India Campaign of the New Govt.

THANKS