As a research, training and service institute, the Institute of Child and Mother Health (ICMH) will have to deal with large amount of information, gather large volumes of data to produce various documents. Patients are the key people of this institute. Patients' records are vital for better management as well as medical research and also for training programs. For this reason a good and effective management of medical records is essential.

Only a well-designed Management Information System (MIS) can provide information exactly and immediately when needed. A computer network service is able to give momentum and optimize the information activities of ICMH.

Keeping the above background in mind, Computer Science Division (CSD) was established here to provide computer support for the institute to achieve its goals.

Some of the major functions of the division are:

• Software development and maintenance
• Network support and administration
• Computer hardware trouble-shooting
• Organize and conduct computer training programs
• Assess computer need and adapt newer technologies
• Assist in procuring computer and related equipments
• Keep liaison with computer dealers and computer based information dissemination centers.
  

The existing hardware system consists of two Computer Servers (Central high performance computer to manage network resources, files etc), about 60 Pentium Workstations computers, two laptop with two multimedia projector, scanner and different types of printers. The database server Operating System (OS) is Windows NT 4.0 with workstations at different departments running in Windows 98/ Win Xp . In the existing Star network, the workstations are connected via UTP cables and the two sets of existing Stacked Hubs are linked through optical fiber. The institute has the provision of 60 network points at the moment. The proxy and mail server is running in Linux OS.

To provide computer training for the medical professionals recently a well equipped Computer Laboratory has been added to the section with the help of JICA. The lab is furnished with nine latest computer and a laser printer. The PC's are brought under our central network system and browsing facilities are added to the lab.

Meanwhile the division has provided different training programs to improve the computer literacy of the ICMH staff like:

• Basic computer literacy program
• PRMS orientation program
• Training on Laboratory medicine module of the PRMS.
• Computer Module development for Skilled Midwifery training project
• Basic computer training for the participants of Community based safe motherhood project

Moreover, we are preparing to offer basic computer-training programs for the health care professionals in collaboration with the DG health.

Activities of CSD:

The CSD has come forward to computerise different activities of ICMH. Some of the achievements are briefed below:

1) As a part of the patient MIS, we have successfully overcome the challenge to set-up computers at outpatient registration and developed the software which currently posses information of all patients of ICMH. The database is assisting to retrieve patients' previous history, analyse the patient information, answer different managerial queries and handling ticket fee accounts with handsome reports.

2) Completed the Laboratory Management System for the department of Laboratory Medicine. The Histopathology, Cytology, FNAC, Pap-cytology, Blood, Urine, Stool modules are currently being used to enter test results.

3) Created other data entry interfaces on demand for different research activities and data analysis including interfaces for Diarrhoea Centre and Flood 1998.

4) Patient management system for SCDDMC, currently used by the Saleh Foundation.

In addition to the above mentioned in-house software development, the CSD is also working with the IBCS Primax software development team to develop Patient Record Management System (PRMS), Accounts and Payroll.

5) The Payroll is already completed and accepted by the concerned department (Consent letter from the user in file ref: Software Dev), which contains Employee general information, leave, pay, bonus and other information and providing computerized salary sheets for the non-gazettes staff. The salary sheets for the gazette staff are also completed. We hope the accounts division will start function this portion immediately.

6) The Accounting module facilitates different types of entries including chart of account, opening balance, transactions, various vouchers, and which immediately provides balance sheets and other reports on demand. The development of this module is completed and waiting to be used by the respective department.

7) Development of PRMS is completed. It contains all necessary data beginning with the first medical statement and ending with the final result of treatment. The major areas of PRMS are

• Central Reception
• Registration
• Nursing Assessment
• Doctor's Assessment (Consultant)
• Tests & Investigations (like Pathological and Radiological tests)
• Inpatient Departments
• OTs
• Pharmacy
• PRMS covers other units like- Asthma, Immunization, Echo-cardiograph, ORT, Physiotherapy, Colposcopy, Laparoscopy, Fetal monitoring, lactation management etc

The authorised users have access to all necessary information of a patient through the system connected computer terminals. The system is implemented partially. Initially the PRMS was an integrated system, facing the difficulty in implementing recently we have modified the system. Now Pathology and radiology modules can be used independently. The modifications of the modules are now complete; pathology module is already implemented (user consent sheets are in file ref: software dev).

Evaluation of the PRMS:

We are pioneer in developing a complete Hospital Information System (HIS) in our country. There are scopes to implement the system as it is

• Completely developed
• We have good infrastructure- network, computers, skilled user

Our drawbacks:

• The complete system involves a large number of user interaction
• Such volume of user motivation to accept new system needs strong determination from the decision making level