Telemedicine-catalysed by nurses
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1) Nurses at the JPNA Trauma Centre in New Delhi conducted teleconsultations for patients in remote areas who had difficulties traveling for follow-ups due to disabilities or lack of specialists locally. 2) A pilot program started in 2011 where nurses received patient calls from a call center, accessed the patients' electronic records, discussed issues with doctors if needed, and provided responses to the patients' queries. 3) Over 86% of calls were addressed by the nurses alone. Common queries included medication, symptoms, appointments and others. The teleconsultation program helped improve healthcare access for remote patients.
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Achievements of the programme/project?
1. Following this initiative, patients no longer have to queue for appointments with doctors/ stand in line for registration and can take appointments from the comfort of their homes
2. The wait time to be seen by the doctor has drastically been cut down to less than 2 hour for the majority of the patients
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4. The token number sent as SMS remains the queue number which is displayed on electronic display boards in real time outside each doctor’s chamber.
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The benefits of an ePCR solution should extend to the whole EMS organization, not just certain groups of people or certain departments. It should provide more than just a form for entering and a database for storing information. It should also include a workflow of how information is communicated, used and stored across the entire organization.
LOW BIRTH WEIGHT. PRETERM BABIES OR SMALL FOR DATES BABIES
low birth weight presentation. Low birth weight (LBW) infant is defined as the one whose birth weight is less than 2500g irrespective of their gestational age. Premature birth and low birth weight(LBW) is still a serious problem in newborn. Causing high morbidity and mortality rate worldwide. The nursing care provide to low birth weight babies is crucial in promoting their overall health and development. Through careful assessment, diagnosis,, planning, and evaluation plays a vital role in ensuring these vulnerable infants receive the specialize care they need. In India every third of the infant weight less than 2500g.
Birth period, socioeconomical status, nutritional and intrauterine environment are the factors influencing low birth weight
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Telemedicine-catalysed by nurses
- 1. Role of Nurses in Teleconsultation for patients in remote areas JPNATC experience Dr Deepak Agrawal, Ms Metilda Robin, Nursing Informatics Specialists Program, Department of IT, JPNA Trauma centre, AIIMS, N Delhi
- 2. BACKGROUND • Bedridden and wheelchair bound patients (head & spinal injuries) have to travel long distances for follow up visits. • This increases the socio-economic load on the families. • Scarcity of specialist doctors in rural areas • Local doctors unable to attend to simple queries of these patients
- 3. BACKGROUND • Mobile penetration in India exceeds 90% – The subscriber base in wireless segment increased to 563.73 million in February (TRAI- march 2010) • Almost every family has access to mobile • Pilot study at JPNATC shows that all patients could give a mobile number at the time of registration
- 4. INTRODUCTION • Although Call-centres are common in commercial industries like telecom, the concept has been alien to hospitals. • Hospitals usually have reception desks which manage general enquiries and appointments.
- 5. INTRODUCTION • An integrated call-centre on the other hand manages extensive backend administrative chores and services besides providing a host of patient related activities on a common platform. • JPN Apex Trauma Centre has a mature EMR system along with integrated call centre
- 6. JPNATC-Call centre • Call Centre agents are able to handle basic queries and asked the patient to attend OPD/ see local doctor for all other queries. • It was envisaged to have a special cadre of nurses who would form a middle layer for these type of queries
- 7. Aims & Objectives • To evaluate teleconsultation using nurses to handle patient queries.
- 8. Methodology: • Started March 2011 • JPNATC has a call center which provides appointment for follow up patients & also respond to basic queries of patients.
- 9. Methodology • New software introduced in JPNATC (New Delhi) & call centre (Noida) in MArch 2011 – Call can be transferred to any phone in JPNATC – Nurse has access to agent screen in JPNATC – Calling party cannot access nurses number
- 10. • New Cadre of Nurses created called Nurse Informatics specialists (NIS). • Posted in ED round the clock • Job responsibilities include receiving patient queries (through call centre), coordinating with doctors In ED & resolving the queries.
- 11. Workflow • Patient phones call centre (011- 40401010) • Agent answers. In case of medical queries transfers call to NIS. • NIS understands query, opens patients electronic chart and goes through the patient condition • Discusses query with concerned doctor in ED (NS, Ortho, Surgery, Med)
- 12. Workflow (contd) • Asks Call centre to patch call with patient and gives answer to query. • Types a ‘teleconsult’ note in CPRS (EMR) detailing the query & response.
- 13. Observations • Of all calls received by NIS in 2012, 86% cases were rectified & Solved by the nurse at their level itself • 14% cases were further discussed with concerned doctors
- 14. Observations Types of queries • 63% medication queries • 9% cases related to symptoms/ signs • 16% cases related to appointments • 13% cases others.
- 15. Conclusions • Telemedicine using Nurses can play a extremely important role in follow up queries of patients • Our study shows that almost 90% of all queries can be handled at the nurse level itself.
- 16. • Use of Computerised Medical records has a vital role to enable quick briefing of case history by the medical personnel at the time of call. • This project has the potential to revolutionize health care delivery in developing countries like India