National Cancer Grid initiative for electronic medical records, India.

Problem: Inefficient workflows, incomplete data and lack of interoperability can hinder the uptake of electronic records systems, challenges particularly relevant in cancer treatment with its complex longitudinal and multidisciplinary nature. Further, products developed in high-income countries are not designed for compatibility with the workflows of low- and middle-income countries, which face additional issues of cost. Approach: We evaluated centres with different resources and geographical locations to develop the requirements of our product. We published an invitation to potential vendors, evaluated submitted product development bids and enlisted six vendors. Our subcommittees developed workflow modules and templates, ensured interoperability and developed key performance indicators. Setting: The National Cancer Grid, a network of more than 360 cancer centres in India, assembled a team of experienced oncologists and digital health experts to develop electronic medical records products with specialized oncology capabilities. Relevant changes: Our collaboration between clinical and technical experts led to the development of six new, high-quality and interoperable products, compliant with the varying needs and resources of hospitals. We supported more than 20 centres with procurement and adoption through partial funding and technical assistance. Lessons learnt: In developing product requirements, we gained an understanding of the challenges faced by hospitals in implementing such systems; by inviting vendors to submit a product development bid, we ensured that the product development cost was borne by the vendor and not hospitals; and by monitoring user feedback, we can continue to address issues raised by health workers and encourage the adoption of electronic medical records.