Interview: Need to introduce computer and other IT related services in public healthcare sector — Dr M C Misra

Sunday, October 13, 2013

by Vidhi Rathee


Dr M C Misra

Director
AIIMS, New Delhi

Dr Mahesh Chandra Misra is the new director of All India Institute of Medical Sciences (AIIMS), New Delhi. He took charge on Friday. Before being appointed to the coveted post, he was the chief of Jai Prakash Narayan Apex Trauma Centre at AIIMS.

Dr Mahesh Chandra Misra

Dr Mahesh Chandra Misra

Dr Misra (61) joined AIIMS as senior resident (general surgery) in 1980. He was appointed as professor and head of the AIIMS surgery department in 1993 and chief of the JPN Apex Trauma Centre in 2006.

In 1996, Dr Misra was honoured with Dr B C Roy National Award of the Medical Council of India (MCI) for developing the specialty of minimally invasive surgery in the country. He received the award from the President of India.

Dr Misra is a medical graduate from Maharani Laxmi Bai (MLB) Medical College, Jhansi with MS (General Surgery) from Moti Lal Nehru Medical College, Allahabad.

He has received fellowships from American College of Surgeons (FACS); National Academy of Medical Sciences, India (FAMS); and Royal College of Physicians and Surgeons, Glasgow, UK (FRCS – Glasgow).

In an exclusive interview with India Medical Times, Dr M C Misra talks about his new role and challenges ahead:

Did you have an intuition about your possible selection for the coveted post?

This is an era of competition. Selection for the post of director is a democratic exercise. I too submitted my CV and put up my best efforts as much as other 70 contenders did. Yes, I believe that I definitely had some positives and good past records to be considered for the post like I have played a key role in setting up the AIIMS Trauma Centre, which is known for its excellence and is a role model for several others to follow, and is a jewel in my crown. I believe I had put my best possible to be considered for the post. And the selection committee must have found my expertise well suited for the job.

What are the challenges that AIIMS faces today?

AIIMS is a world known institution and has established itself as a brand since it was set up in 1956. From 800 beds to 2500 beds today and 52 special departments under one roof it is unparalleled in the country. We receive almost 10,000 patients every day, 50,000 footfalls every day and around 1 million footfalls every year. We perform 1.5 lakh special operative procedures every year. This shows the faith and hope people have in us.

So, with this kind of workload and ever increasing number of patients, keeping our image as patient friendly and offering low cost treatment continues to be a challenge and priority. And we achieve this challenge by working hard every day right from our doctors, residents, nurses and other support staff.

Managing a huge crowd is a challenge and we are devising some effective mechanisms to treat maximum number of patients and to continue welcoming those who look up at AIIMS as a hope for treatment.

I am proud to say that I have spent 43 years in the medical industry and have visited several countries but nowhere in the world I have seen such an institution that provides world’s best treatment at low cost, as low as $1 for the poor.

AIIMS has been judged by independent national and international surveys as the best medical institution and I feel gratified to be its director and now the responsibility lies to maintain its image nationally and in the world too.

What are your priority areas to work upon?

While, 80-90 per cent of the patients that we receive feel satisfied by the treatment that we provide, my priority is to remove the gaps because of which the rest 10-20 per cent of the patients couldn’t be pleased for various reasons. The challenge is to maintain the quality that AIIMS is known for throughout the world and the country.

Providing low cost treatment to the patients remains our goal, and we will continue to abide by it even at a time when healthcare throughout the country is going through a stage of metamorphosis. Today, many private hospitals have mushroomed throughout the country, which boast of providing best in class health treatment. But where is the nation building?

Personally, if I get ill, I cannot go and afford treatment in some high-class private hospital. So if I can’t, how our 80 per cent population will? It’s good for those who can afford but the truth is majority of people cannot.

So, we at AIIMS have to continue our efforts to provide low cost healthcare to our patients, who keep a lot of expectations from us and thus, our role as a public sector hospital cannot be undermined. Because it is not only a mandate on us by the constitution but also our sincere responsibility and duty to help in nation building. Health is an intrinsic part of nation building. So, my objective would be to ensure that we at AIIMS help the society at large by providing low cost and quality healthcare to all.

Another is to pay attention to the needs of every staff right from my faculty, doctors, nurses and residents, even our group D staff. They all work effortlessly for so many hours without complaining. I would like to take everyone on board by acknowledging their efforts.

You have played key role in establishing AIIMS Trauma Centre. Which qualities make it unique?

We receive almost 200-250 patients every day and 60,000 patients every year at the centre out of which some are very critical cases. We perform almost 5,000 laser surgeries including neurosurgeries, brain surgeries. We are also running Advanced Trauma Life Support Course besides other and planning to introduce some more courses.

What makes AIIMS Trauma Centre unique is our excellent doctor-staff coordination so that every patient is given exclusive attention. Every patient right from the admission to discharge is given special attention by allotting staff that exclusively handles the patient they have been assigned. This is the reason why patients feel exclusive care and attention and give positive feedbacks. Any gap mentioned by them is taken into notice and we try plugging them in best possible manner.

Nurses are given an important role and training in patient care here. We have formed different teams of nurses for effective handling of situations. One is TNC i.e. Trauma Nurse Coordinators who work in such a manner that they are entitled to a patient right from admission to their discharge from the hospital. They play role of effective coordinators. Second group is HICT, i.e. Hospital Infections Control Team, as infections remain a big concern in hospitals. Giving special attention to prevent infections in hospital brings down antibiotic usage in hospitals. Third group is WCN, i.e. Wound Care Nurses. Final group is NIP, i.e. Nursing Informatics Programme, which is exclusive to AIIMS.

So, we ensure that no patient is transferred without a doctor, nurse and other support staff to the trauma centre. As it is known, we have salvaged some of the most critically injured patients like patients with double iron rods in their chest, hence, we have proved our expertise in the area to the whole world.

Any thoughts of bringing changes in the education system at AIIMS?

We started with 50 undergraduate seats. Now we have 75 seats, which according to me is optimal for effective training to students. But, yes increasing it up to 100 seats is a possibility, more than that would only degrade personalized approach of teaching. The classes would be overcrowded and this will hamper the objective of providing best future doctors and teachers for the country. We will continue to provide best medical education and I will ensure we continue maintain the quality.

What are your plans about computerization of services to make healthcare delivery better at AIIMS?

The idea of electronic health record systems has been still hanging at AIIMS. Computerisation of services can help in better coordination not only in the hospital but also between the hospitals. In western countries, the figure is two computers per patient whereas in India the figure is as low as one computer for 100 patients. The ratio indicates an urgent need to introduce computer and other IT related services in public health service sector. It can bring positive change in processes leading to much needed clarity and ensure better level of satisfaction to patients in the hospitals. Adopting paperless practices could help in providing useful information to large number of visiting patients by readily available database that can curb disorder and confusion that generally happens due to lack of information regarding details of patients and availability of services.

So yes, introducing technology and apportioning maximum computers for ease of work and timely services remains my priority.

What’s your message for the readers?

My message is that every single person associated with the medical field should think what they can do to serve the people by playing their own respective roles. Public sector hospitals are for the people, of the people and by the people and so are we. We should work as a team as no hospital could function properly without the support of one and all associated with it.

by Vidhi Rathee

Categories: INTERVIEWS

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2 Comments »

Comment by Drgopalakrishna
2013-10-14 14:44:28

Very good medical journal

 
Comment by Dr Vivek Sharma
2013-10-20 15:43:12

I have worked at AIIMS. It is a ridiculously over resourced, overstaffed and over hyped institution. It is false to call health care it provides as cheap because of the overall burden on patient’s pocket is less, when the govt spends more than 2k crore rupees on it every year. In terms of quality derived per rupee spent, AIIMS is no different from any other govt hospital in India. Will stand as a joke when compared to some of the corporate hospitals in terms of quality, who spend much lesser amount of money per patient. It has all the problems of a govt institutions in India. Only true asset that AIIMS has is the talented students it attracts from all over the country and it smothers their talent by the end of their training, turning them into blind imitators of West, with no flavour for innovation, creation of knowledge or research. AIIMS was created to be the world leader in the field of medical education and research, a creater of knowledge rather than blind imitator of whatever West discovered by the way of research. It was meant produce new methods of medical teaching and research methodologies and treatment and other aspects of health care providing. Methods specific to Indian environment, attitudes, patient profile and other norms. It doesn’t even have a clue about its supposed role. I have worked at AIIMS casualty’ it is as poorly managed any other govt hospital in India. The people who are brought at helm have no leadership qualities or management skills to speak of. Have no vision, no will to work, not even an understanding of the system they are supposed to steer, usually have an extremely detrimental elitist exclusivist attitude towards medical education in general and AIIMS like institutions in particular. Can you believe that the idea of six new AIIMSes was opposed by many AIIMSonians on the ground that it will dilute the brand AIIMS!!!!!!!

 
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