Sighing at the crowd, 28-year-old Tabassum, a resident of Sriram Nagar Colony in Hyderabad walks into the newly renovated block of a local Urban Primary Health Centre (PHC). Painted in monochromatic white, the narrow block with new furniture is entirely occupied. Tabassum has come for her antenatal care check-up. After registering herself at the reception desk by showing the Out-Patient slip, she goes for an ultrasonography (USG) scan. Almost 15 minutes later, she was given the scan report by the Lab Manager.
The 28-year-old was availing the services of the newly launched Telangana Diagnostics — a healthcare service for the underprivileged by the state government — where mini diagnostic hubs aim to provide a total of 57 pathological and imaging tests free of cost. The new initiative was officially launched on January 22 by Minister KT Rama Rao.
Ever since the services were introduced, approximately 15 lakh patients have benefitted from the services, according to health authorities. Authorities spent Rs 43 lakh towards each centre, to buy the equipment and set up the facilities over 650 sq yards. A total of 27 people are involved in this project at present. The government incurs a monthly expense of Rs 1 lakh towards salary to the Data Entry Officer, Radiologist and Lab Manager, and maintenance of each centre.
Presently, the Telangana government has established these mini hubs in eight centres within the jurisdiction of the Greater Hyderabad Municipal Corporation (GHMC). The centres are located in Amberpet, Barkas, Jangamet, Lalapet, Panipura, Puranapool, Sitaphalmandi and Sriram Nagar (near Yousufguda). The intent of the project is to provide better healthcare to the poor.
Those who cannot afford to avail diagnostic services like Electrocardiography (ECG), Ultrasonography (USG) and X-ray at private hospitals, can avail the same for free under the new initiative.
The Telangana Diagnostics work in a pyramid structure — Basti Dawakhanas are connected to Primary Health Centres (PHC), which are connected to Urban Community Health Centers (UCHCs) and Urban Primary Health Centers (UPHCs), and these eventually connect to a central hub located in Narayanaguda, Hyderabad. A total of 128 health centres are connected to this central hub.
If a patient visiting Basti Dawakhana or the Community Health Centres has an illness requiring proper diagnostics, they would be referred to the diagnostic mini hubs on the Out-Patient slip. At the mini hubs, the Data Entry Officer would generate a barcode and register the patient.
A patient getting registered at the reception for the USG scan
For a USG scan, if a pregnant woman visits a UPHC, UCHC or Basti Dawakhana, and if the local doctor requires a scan for further examination, they refer the patient to the nearest mini hub.
“At the mini hub Data Entry Officer will scan the barcode and feed the patient details in Telangana Diagnostics portal along with the details of the doctor who referred the case. After that, the radiologist will perform the procedure and the findings will be recorded in the website with the radiographer’s digital signature,” explains Hanumanthappa, Lab Manager of Sriram Nagar Mini Hub. The report, he says, “can be accessed from the portal or through email and printed.”
Aadhaar card details are also collected from pregnant women to avail the services, which will be keyed in the Pre-Conception and Pre-Natal Diagnostic Techniques portal. According to Dr Nanditha, Programme Officer of Telangana Mini Hub, the details are part of the mandatory Pre-Conception and Pre-Natal Diagnostic Techniques Act, 1994, where women agree not to reveal the gender of the foetus.
Blood samples being collected from the mini hub
While the process for ECG and X-ray are the same, for pathological services, the lab manager would collect blood and urine samples which would be sent to the central hub. After testing, the results will be shared with the respective mini hub via the portal of Telangana Diagnostics, email, and an exclusive phone application. These results will come in less than 24 hours, Dr Nanditha asserts.
At Sriram Nagar, despite many pregnant women crowding the health centre, the workflow is not hampered. Hanumanthappa credits the dry run which began from December 10 for the smooth functioning. However, the crowding is a result of a shortage of radiologists. For USG scan, the centre functions for two days — Mondays and Thursdays (between 9 am and 4 pm).
“Getting radiologists on board is very challenging for us,” expresses Dr Nanditha. At present there are only three radiologists — two on deputation and one on contract. These radiologists are rotated around the eight centres throughout the week.
The other challenge which the project is facing is, pregnant women coming on their own to the hospitals. As per the Amma Odi scheme, the ‘102’ ambulances should provide free transportation to pregnant women requiring ante and postnatal care. The ambulances should pick and drop them at their homes after treatment.
“The services of 102 ambulances are yet to be executed in this project. We will soon be streamlining this service for the pregnant women coming to our centres,” Dr Nanditha ascertains.
Talking about the equipment, she says, “The USG equipment is high-end. At present we are using a portable ECG machine, soon we will be purchasing a high-end one.” According to the Programme Officer, the mini hubs would be shortly established in the neighbouring districts of Hyderabad like Medak and Ranga Reddy districts, before expanding to the rural areas.