ABDM-Compliant Hospital Management Software

Read the project details which talks about ABDM-Compliant Hospital Management Software: Streamline Compliance and Patient Records Management with Ekanshi Solution’s Solution.

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      Executive Summary

      About Client

      ABDM-Compliant Hospital Management Software for all-size hospitals.

       
      Ekanshi Solutions Pvt Ltd offers expert management consultation services to healthcare organizations. They provide strategic guidance and support to help organizations achieve their goals. With the in-depth expertise and industry knowledge, they help organizations optimize their operations, make informed decisions, and achieve excellence in patient care.

       

      https://ekanshisolutions.com/
      Location: Lucknow, Uttar Pradesh, India

      Project Background

      Ekanshi Solution requires reviewing its clients’ hospitals and clinics to ensure they meet the compliance requirements. To achieve this, we recommended developing a software solution that meets the basic compliance requirements and also eases the operational burden on hospitals.

      1. Registration and demographic data collection.
      2. Patient history and medical record management.
      3. Appointment scheduling and reminders.
      4. Patient check-in and waiting list management.
      5. ABDM Compliance M1  , M2 and M3 scenarios therefore create Verify ABHA and to manage patients records
      6. The movement of this on-premise app to a cloud-based infrastructure is aimed at improving performance, ensuring data security, and enabling seamless integrations with other digital health services.
      7. AWS Automated HIPPA Compliance check and aligned with best practices. 

      Scope & Requirement for ABDM-Compliant Hospital Management Software

      In the 1st Phase of custom application development, we discussed the implementation as follows:

      • A customized app, furthermore, helps to generate ABHA ID and integrates ABDM-compliant APIS 
      • The client hospital team should be able to view patient records easily and receive and send to the central server
      • Able to book appointments and moreover schedule reminders easily. 
      • We would create a Web version of the app to help manage the above functionality, which will replace the current paper-based and unorganized work the admin was doing. 
      • Plan and execute the migration of application code, data, and databases from the on-premise system to the selected cloud platform.
      • Ensure minimal downtime by utilizing cloud migration tools and strategies, such as database replication, to synchronize on-premise data with the cloud.
      • Compliance with HIPPA and using config rules to do ongoing monitoring of compliance 

      Implementation

      Technology and Architecture of Hospital Management Software

      Read more on the technology and Architecture we used for AWS Custom Application Development using ESRI ArcGIS.

      Technology/ Services used

      The web app was deployed with the below technological component

      • Backend Code: .NET Core, C#
      •  Web App code: AngularJS
      • Database: PostgreSQL
      • Cloud: AWS

      Integrations:

      • Google APIs 

      •  ABDM Integration

      • Auth0

      • SendGrid

      Security:
      • AWS WAF service is used for the firewall
      • All API endpoints are token-based

      Scalability

      • The application is designed to be running on serverless services so that it can easily scale up and down automatically based on usage. 

      Backup and Recovery

      • Additionally, Automated backups are configured to backup the database and store multiple copies of the backup. 

      Cost Optimization 

      • Alerts and notifications are configured in the AWS to notify if the budget is being exceeded. 
      • Deployed on serverless infrastructure, the application does not incur any additional costs when it is not in heavy use.
      •  Peritos, being a cloud partner, is managing the environment for the client, keeping a close watch on the cost, and finding ways to optimize the same 

      Code Management, Deployment

      • CI/CD is implemented to automatically build and deploy any code changes

      Features of the Application

      • Integrated Patient Profile with NDHM: This application seamlessly integrates with NDHM, enabling the swift creation of ABHA IDs and facilitating the exchange of patient health data. By interfacing with the National Digital Health Mission, the system ensures that patient data is standardized, up-to-date, and easily accessible, fostering more informed medical decisions.
      • Multi-tenancy Architecture: The system’s ability to cater to multiple hospitals or health providers under a single unified platform is a significant advantage. Each hospital can manage its operations while benefiting from centralized updates and features, ensuring scalability and simplifying administrative tasks.
      • Data Encryption at Rest and In Transit: Implemented encryption using AWS Key Management Service (KMS) for both data at rest (S3, EBS, RDS) and in transit (SSL/TLS) to ensure compliance with GDPR and HIPAA requirements for securing sensitive data.
      • Identity and Access Management (IAM): Designed and enforced strict least-privilege access policies using AWS IAM. This included creating custom roles and policies with granular permissions for specific users and services, ensuring only authorized personnel had access to sensitive data.
      • AWS Config and Compliance Rules: Set up AWS Config to track and audit configuration changes across the environment. Applied AWS Config Rules to continuously monitor compliance against GDPR and HIPAA requirements, such as encryption enabled on S3 buckets and logging for API Gateway and Lambda.
      • Audit Logging and Monitoring: Configured AWS CloudTrail and Amazon CloudWatch for continuous logging and monitoring of API calls, changes, and actions within the AWS environment. This was crucial for meeting HIPAA requirements for audit trails and GDPR’s data access visibility.
      • VPC Flow Logs and Security Groups: Deployed Virtual Private Cloud (VPC) with properly configured flow logs to monitor and log network traffic. Used AWS Security Groups and Network ACLs to ensure secure network segmentation and prevent unauthorized access to sensitive resources.
      • Data Residency and Data Transfer Controls: Implemented controls to ensure data residency compliance by restricting data storage and processing to specific AWS regions as required by GDPR. Utilized VPC endpoints and AWS Direct Connect to secure data transfers and reduce the exposure to the public internet.
      • Backup and Disaster Recovery: Designed an automated backup strategy using AWS Backup to meet GDPR’s requirement for data recoverability, ensuring regular snapshots of critical databases (e.g., RDS, DynamoDB) and storing them in encrypted S3 buckets across different regions for redundancy.

      Challenges in implementing ABDM Compliant Hospital Management Software

      • Integration with ABDM APIs is needed to achieve compliance; however, the API documentation was not up to date. Also, the API versions keep checking. During the app development from v1 to V3, we had to reach the APIs and perform code refactoring to ensure the utilization of the latest set of APIs.
        • Furthermore, Help from PWC team was provided and explained the API endpoints and the test scenarios to cover to ensure the app compliance checks can be passed. 
      • Testing of the application with multiple end users who were experts in their domain was a challenge.
        • We found the data quite complicated to understand and relied on the client’s team to test and inform us about the expected result in case of any issues. Additionally, we identified key users such as doctors, administrators, nurses, department heads, etc., to ensure coverage of all user scenarios.
      • Given the sensitive nature of medical data, ensuring robust security measures against breaches and unauthorized access is paramount.
        • The hospital management application ensured data security and privacy through end-to-end encryption for both data at rest and in transit. AWS’s suite of security tools, including IAM for access control, KMS for key management, and VPCs for network isolation, were leveraged. We fortified the APIs with security tokens and rate limiting and conducted regular training sessions for staff on security best practices.

      Project Completion

      Duration of Hospital Management Software Implementation

      Jan 2023 – Dec 2023 ~ 1 year   months 1st Version 

      @nd Version- Jan 2024 – Present Currently working on Reporting, Enhancements, and Billing , In patient and Out patient feature addition along with M2 Billing

      Deliverables for ABDM-Compliant Hospital Management Software

      Setting up the AWS environment for the client system

      • Custom web application for two environments production and UAT system 

      • We delivered the features as agreed in the scope 

      1. Registration and demographic data collection.
      2. Patient history and, furthermore, medical record management.
      3. Appointment scheduling and reminders.
      4. Patient check-in and waiting list management.
      5. ABDM Compliance M1, M2, and M3 scenarios to create Verify ABHA and to manage patients records
      6. HIPPA compliance report for managing workloads and following best practices for HIPPA and also ongoing monitoring report. 
      7. We developed the following set of core features. 
        User: Manages user registration, authentication, roles, and permissions.
        Hospital: Multi-tenant application to handle hospital registration, department management, and related configurations.
        Doctor: Manages doctor profiles, availability, specialties, and associated scheduling.
        Patient: In addition, Interfaces with ABDM for patient data operations, ABHA ID creation, and retrieval of patient health history.

      Support

      • As part of the project implementation we provide 2 months of Ongoing extended support.
      • This also includes 20 hrs a month of development for minor bug fixes and an SLA to cover any system outages or high-priority issues.

      Testimonial

      After working for 6 months on the project, we took feedback from the Product owner whom we have worked closely for project execution:

      Feedback image

      Peritos and using AWS have been instrumental in transforming our hospital’s operations for clients. It empowered us to create a custom multi-tenant application that not only meets our current needs but also positions us for future growth and innovation to showcase this to our larger client base and prospects. With a solid system now, we have the confidence to continue our mission of providing exceptional healthcare services to our community, knowing that our technology backbone is secure, reliable, and ready to scale. Additionally, We are happy with the services and look forward to completing more projects in the future with Peritos team.

      Akanksha Niranjan
      OWNER, EKANSHI SOLUTIONS

      Next Phase

      We are now looking at the next phase of the project which involves:

      1. Furthermore, Ongoing Support and adding new features every Quarter with minor bug fixes

      2. Electronic Medical Records (EMR) Integration: Incorporate a system that not only stores patient data but also tracks their entire medical history, including medications, allergies etc

      3. AI-Powered Predictive Analysis: Moreover, Use AI and machine learning to analyze patient data for potential health risks, helping doctors make informed decisions

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