Good morning Ladies & Gentlemen, I am Yvonne representing the project, A Mobile eHealth Solution for Patients in Emerging Countries
Speaking of the contents of this presentation, we first brief you on the Background of the Sri Lankan Health Domain. Next, the Research Problem we identified and the Research Methodology we undertook in arriving at our solution.Next, the eHealth Solution followed by the Post Analysis Subsequently possible Future Enhancements and a ConclusionLast but not the least, the Acknowledgement
Which is, Developing an Optimal eHealth Solution to Sri Lanka,That encompasses, Health Care for patients; in Less time, with Less Cost, in a Less Distant with a better experience Improved Patient Medical Data StorageAnd the Consultant Time Management
So in solving this problem, first we thoroughly reviewed existing literature such as “Dr. Chapman’s Concept paper” which was a major reference for our solution and local eHealth Applications. Next, we researched on Human factors and legal implications associated with eHealth And, the required Infrastructure and the Financial Provisions in sustainably deploying an eHealth Solution All these factors contributed equally in coming up with our solution from which we gave birth to our evolutionary prototype; the famous “ViduSuwa” As a proof-of-concept we made ViduSuwa available at the Base Hospital, Marawila and District Hospital Dankotuwa.
So our solution consists of four major components: A web-based EMR model that would critically address the effective Patient Data Storage along with an mHealth Model to optimize the communication channel between the patient and the Health Care ProviderA Change Management Methodology to smoothly introduce the EMR and the mCommunication System into the manual system.And finally a Business Model that would specify the possibility of sustainably replicating the whole solution elsewhere to provide facilities for ePatients and eConsultantsAn eConsultant would be providing Consultation to patients from a location of his/her choice via internet. This location could be called as the eConsultation Center, and need not necessarily be a Health Institute. This could be even a specialized vehicle with the required resources to conduct the eConsultation Center.And the ePatient would be receiving eConsultation via internet at the presence of a General Medical Practitioner.
So, there were certain considerations we took in developing this system such as;Usage of existing technology and infrastructure to prevent the re-invention of the wheelMaintaining Simplicity to improve User-friendlinessGetting the end-user involved in the design phase, to make them feel of the ownership of the systemIntroducing ICT progressivelySuitability for the Developing WorldAnd most importantly to uplift the living standards of the society
So, let us look at the Business Model of this Solution that could be used to sustainably replicate the system elsewhere.
A Mobile eHealth Solution for Emerging Countries
A Mobile eHealth Solution for Patients in Emerging Countries<br />PRESENTED BY: <br />Dinusha Vatsalan, Saatviga Sudhahar, Yvonne Wickramsinghe, Dulindra Wijethilake<br />SUPERVISED BY:<br />Dr. S.M.K.D. Arunathilake<br />ADVISED BY: <br />Mr. G.P. Seneviratne, Dr. DilhariAatigala, Dr. PrathibaMahanamahewa, Dr. Keith Chapman, Mr. Kenneth Thilakaratne<br />1<br />
Background<br />Resource Anomalies<br />35% of a Medical Consultant in Colombo<br />Issues In Rural Communities <br />Travel Distance<br />Travel Time<br />Travel Cost <br />Frustration<br />Issues In Urban Communities<br />Waiting Time<br />Frustration<br />Delayed Attendance<br />Ineffective Medical Data Storage<br />3<br />
Background<br />“There are <br />2.2 billion mobile phones in the developing world, <br />305 million computers <br />but only 11 million hospital beds”<br />4<br />Terry Kramer, the strategy director at British operator Vodafone has mentioned at the Mobile World Congress held in Barcelona<br />
Research Problem<br />“Developing an Optimal eHealth Solution to Sri Lanka”<br />Health Care for patients with<br />Less Time<br />Less Cost<br />Less Distance<br />Improved Comfort<br />Ubiquitous Patient Medical Data<br />Consultant Time Management <br />5<br />
Clinical Efficiency<br />Time-to-waite in the manual system = Tw<br />Time-to-consult in the manual system = Tc<br />Time-to-travel in the manual system = Tt<br />Time-to-waite in the eHealth system = T’w<br />Time-to-consult in the eHealth system = T’c<br />Time-to-travel in the eHealth system = T’t<br />19<br />(Tw >> T’w) AND (Tc < T’c) AND (Tt >>> T’t)<br /><br />(Tw + Tc + Tt ) << (T’w + T’c + T’t)<br />
Future Work<br />Enforcing Industry Standards (Dicomm, HL7)<br />Voice Recognition (Dragon, FOSS)<br />Hand Writing Recognition<br />Localization<br />Mobile Access to the system<br />Rapid Development<br />Interfacing Medical Equipment (ECG Machine)<br />25<br />
A Participatory Action Research Approach<br />The need for a system<br /> Requirement Analysis<br />Changes to be done<br />How to manage<br />Technologies<br />Change Management<br />Researcher <br />Practitioner<br />Research Methodology<br />Adaptation of the Sustainable Model<br />Change Management <br />Specifics of the eHealth Solution<br />Pre Survey Analysis<br />Post Survey Analysis<br />26<br />
Web based EMR System<br />Value Chain Model for the EMR System<br />Administrative Functionalities<br />Integration with other systems<br />Support Value Processes<br />Knowledge Transfer<br />Clinical Research<br />Access to Patient information irrespective of time and place<br />Availability of specialists across a distance of eClinics<br />Easy Decision making with Holistic View of Patient information<br />Reduced cost and time<br />Primary Value Processes<br />27<br />
eHealth in Developed Countries<br />Spain - Doctors & nurses transferring EMRs using <br />Tablet PCs on to mobile devices (PDAs) <br />Satellite Videoconferencing System<br />Online consultations <br />Specialized diagnosis (radiology, cardiology, surgery, dermatology)<br />Sweden & Denmark<br />90% of doctors using EMR <br />Electronic Participation of Chronically ill patients <br />Reduced visits by >20% <br />Wireless devices <br />24 hour Wireless Ambulatory<br />Mobile & Remote Patient Monitoring<br />Diagnosis <br />Web-based Health Information Systems (Pubmed, Websurg,)<br />
eHealth in Developing Countries<br />Telemedicine in rural India<br />Personal computer <br />Customized medical software <br />Medical diagnostic instruments <br />Commercial VSAT at every location <br />Video-conferencing<br />Telemedicine Initiatives at SGPGIMS, Lucknow<br />Tele-education<br />Tele-consultation <br />Tele-follow up sessions <br />Tsilitwa , Africa – Rural Tele-consultations<br />Wireless network link <br />Uni-directional Video link<br />Sister-Doctor communication via a simple webcam<br />
mHealth in Developing Countries<br />Uganda <br />Mobile Devices for Health workers<br />Update from the field <br />South Africa - the SIMpill<br />A sensor-equipped pill bottle with a SIM <br />Informs doctors of patients<br />Tuberculosis medication for patients <br />The Amazonas state of Brazil <br />Surveys on Mobile phones<br />Marking incidents of dengue fever<br />Mexico<br />A medical hotline - MedicallHome<br />Patients’ medical questions via SMS<br />Diseases updates via SMS<br />
Benefits for Consultants<br />For Consultants<br />Virtual Presence of the Consultant and the Patient <br />24x7 Patient Information Access<br />Clarity of data<br />Compensation of lost Diagnostic cards due to <br />Patients Negligence<br />Natural Disasters<br />Easy decision making<br />Potential for Research<br />Less congestion of in-ward patients <br />
Benefits for Rural Health Institutes<br />Access to Consultants<br />Knowledge Transfer to General Medical Practitioners<br />Reduced Cost <br />Patient transfer<br />Electronic Patient Health Records <br />Pro-active decisions on Resource Allocations <br />Pro-active decisions on Patient Care <br />Potential for Research<br />60<br />
Terms & Conditions<br />We offer help problems regarding Non Critical Patients only in ViduSuwa. Patients referred by a respective consultant are allowed to register.<br />No record will be Deleted or Disclosed which are related to Medical History of a particular patient.<br />The service provided by this site is no substitute for a critical patient visiting a consultant a qualified, licensed health care professional. <br />This site would enable Officers in the medical field to share medical knowledge for research and academic purposes.<br />Prescribing medications online may contradict with to medical ethics. Thus our Consultant would be accompanied with another Government Qualified Medical Practitioner to assist the patient. <br />You may consult the Doctors through ViduSuwa:<br />If you are advised to do so by your Consultant<br />If you have any medical question or problem and want to consult the medical doctor<br />If you want to know the routine screening tests or immunizations to keep you healthy<br />If you want to know the second opinion of your medical condition or treatment<br />If you want to know the medical condition causing your symptoms<br />If you are not recovering with your current treatment<br />62<br />
Change Management<br />“It is not the strongest of the species that survive, <br />nor the most intelligent, <br />but the most responsive to change“<br />Charles Darwin R<br />Aspects of Change<br />McKinsey’s 7S model<br />66<br />