The Semi-Finalists: AIIMS eMLC Implementation

A simple IT implementation with potential to bring much needed transparency in medico legal system which in India is known to be vulnerable to abuse from people with 'connections'

If you are a movie buff, then you would recall a scene from the famous movie 'Munna Bhai MBBS' where an emergency patient is denied medication for not filling a 'form'. Movie may (or may not) have exaggerated the issue but in reality there is an involvement of 'Medico Legal Case sheet' (MLC) for all trauma & suspected poisoning cases in India. Manual entry in this form of judicial importance is both time consuming and prone to tampering, and even if it is filled by time constrained doctor in the Trauma center, more than often it is illegible thereby becoming a major road block in resolving cases.

The eMLC System

To come out of this dilemna, AIIMS implemented an electronic medical record system with the objective of creating a tamper-proof eMLC that could be printed in a format mandated by law thereby satisfying all legal requirements. The biggest challenge in implementing this sort of a system was to make eMLCs legally acceptabile. As format and layout of the MLC is legally defined by a gazette notification, it can't be modified. Also, there was a question on the legal validity of electronically prepared document in healthcare in India. This difficulty was mitigated by taking legal opinion from lawyers, judges and police prior to implementation. Another challenge was to make the system secure to guarantee the authenticity of the prepared document. The tech used for implementing this project is fairly simple. It's built on the .NET framework with SQL database at the backend running on a couple of Dell blade servers and HP thin clients at the front-end.

The Result

The implementation of this system has simplified the work of doctors, police and the judiciary. Doctors no longer have to waste time entering demographics of the patient because all medical details in eMLC are easy to enter as they are template driven. Plus, it also prevents duplication of work. The police and judiciary are both extremly happy with this system, because they get documents that are tamperproof (authentication can be done online), legible and fully filled. All relevant details that are required for evidence are present there.

There are occasions when there is a doubt on the authenticity of the MLC and by virtue of eMLC, one could easily check the scanned record and verify the authenticity immediately. The system is used for every case that lands into JPNA Trauma Centre, AIIMS, New Delhi. On an average, there are about 100 to 175 such cases every day. The system has recorded more than 50,000 cases till date, which are being used for generating reports for further decision making.