Chennai: Expectant mothers at the Government Women and Children Hospital in Egmore queue up, clutching a small but indispensable document—a notebook that accompanies them through months of check-ups. It records everything from scan details and prescriptions to doctors’ notes, often serving as the only medical record across departments.All pregnant women in Tamil Nadu are registered on the Pregnancy and Infant Cohort Monitoring and Evaluation (PICME) portal, which records basic patient information. Diagnoses, prescriptions, scans, and laboratory results at govt hospitals are recorded manually in these patient notebooks, making key medical details—including comorbidities—digitally inaccessible in case the book is lost.Patients say doctors rely entirely on the notebook to prepare case sheets. “They note down the weight and blood pressure during every visit,” said P Indumathi, who is in her third trimester. “I bring it for every check-up. I don’t know what will happen if it’s lost,” she said.Across wards, nurses can often be heard warning patients and attendants that it is their responsibility to safeguard the notebook. “It has details of vaccinations, blood test results, and scan interpretations,” said A Gowri, a woman in for her routine check-up. “Govt hospitals must have an online backup. If doctors retain the notebook, even our family members can’t see it,” she said, noting that many patients struggle to read handwritten notes.Doctors and nurses say digitization has been hindered by a shortage of staff and limited infrastructure. “Internet connectivity is crucial. We need dedicated data entry operators before the system can work effectively,” said Dr T Vinitha, an assistant professor.The hospital currently does not issue standardized antenatal forms. “Patients may bring any 80-page notebook. We issue outpatient slips, and the OP number—once generated in the system—is written in the notebook and sealed.” she said. Doctors say the current way is better, as many expectant mothers visiting govt hospitals remain on the margins of the system: they depend on hospital staff to register their pregnancies on the PICME portal or the state’s THAIMAI app, said hospital director Dr C Sumathi. “Many of our patients don’t have smartphones or reliable internet. We can’t leave them behind,” she said.
