Medical Records Program Expected to Save Lives

IEEE Humanitarian Technology Challenge helps build pilot system in India

13 August 2012
Clinic assistant collects information from waiting patients to enter their information into the RFID-ITRM system.
Photo: Ali Zalzala

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India’s health-care system is in dire straits, perhaps worst of all in the country’s countless “informal settlements,” or slums. Health centers are the cornerstone of health care in India’s rural areas, where most of the country’s 1.2 billion people reside. For the most part, modern technology is little known in the centers, with each covering a population of 100 000 spread over about 100 villages.   

That is where the IEEE Humanitarian Technology Challenge hopes to make its mark. In a pilot program, it has introduced a central database in two clinics, fed by information from RFID tracking cards that identify each patient and handheld devices through which a patient’s medical history and ailments are filed and accessed. It’s a giant step up, for the clinics often have limited patient records or sometimes none at all. Those that do keep records might use paper notebooks, but there is no filing system. And notebooks can be misplaced, memories fade, and mistakes happen.

At the heart of the new HTC program are the clinic assistants and community caseworkers, each with some medical training, who assist doctors and enter patients’ medical information. The caseworkers also fan out into the slums and rural areas to provide basic care and help patients with their medications or refer those with serious conditions to the centers.

But those workers have had no access to medical records, nor can they easily share their notes on a patient with the clinic’s doctor. The situation led HTC members to develop its electronic record-keeping system. The RFID Individual Tracking and Records Management (RFID-ITRM) Solution—which began being installed in December in clinics in Ahmedabad, Gujarat, in western India—is expected to save lives by coordinating medical care, reducing errors, and monitoring diseases and infectious outbreaks.

HTC is a partnership between IEEE, the United Nations Foundation, and the Vodafone Foundation. It involves IEEE members, humanitarian aid workers, technologists, and others working on technical solutions for urgent problems that plague developing countries. More than 15 volunteers worked on the project, including IEEE Senior Member Ali Zalzala and Members Stanley Chia and Ali Karimi, as well as nonmembers Vivienne Strettle, who assists with software development, and Laura Zalzala (Ali’s wife), who works on sustainable business models. The group posted a YouTube video about the project in April.

“The IT system keeps a history of patients’ illnesses and medications, hence minimizing errors and facilitating better services,” says Ali Zalzala, who leads the project. “The RFID tracking identifies each patient and allows field workers better interaction with clinic doctors.” Zalzala is CEO of the Hikma Group Ltd., which specializes in knowledge management and technology transfer, and is headquartered in Dubai, United Arab Emirates.

RECORDS MANAGEMENT
A pilot of the system was installed by HTC volunteers in centers that serve the poor communities of Rama Pir No Tekro and Ram Rahim Tekro, with more than 100 000 people. Ahmedabad, the fastest-growing city in India, has a population of 6.5 million, and about 40 percent of its citizens live in slums.

A person visiting a center for the first time is registered in the system and given an ID card with an RFID chip for identification. The patient’s records are updated on subsequent visits, with information entered into the database.

The community health-care workers—those who make house calls in the slums—are given an iPhone along with a Galaxy tablet with a USB-based device to read the ID card’s RFID chip. The system supports multiple mobile platforms for smartphones and tablets. The information is transmitted via wireless or cabled communications for storage in the clinics’ secure server-based database.

The system was designed to help adult patients, but infants might be tracked as an aid in administering vaccines. In the future, the system could be used to track the occurrence of pneumonia, sepsis, meningitis, and other diseases.

About 650 people have been registered in the record-keeping system so far, but only about 250 RFID-embedded ID cards have been issued, because the community is still working on accepting the concept, according to Zalzala. The system is being managed and operated by Manav Sadhna, a nongovernmental organization in Ahmedabad.

“It has been a very special experience for us to be working with this project of reaching out to the medical community,” says Viren Joshi, a trustee of Manav Sadhna. “This health project is extremely important.”

The cost for each node at a clinic, including a desktop computer, four handheld devices, an RFID card printer with 1000 cards, and software licenses is around US $6000 per clinic, Zalzala says. IEEE provided nearly $70 000 in funding, and the Vodafone Americas Foundation gave a grant of $10 000. The IEEE Computational Intelligence Society’s Evolutionary Computation Technical Committee provided advice.

EXPANSION PLANS
Zalzala says the current goal is to extend the pilot to about 15 clinics, and the group is working with a local hospital to become the clinics’ hub. If the pilot— scheduled to run until the end of next year and expected to cover both slum communities of 100 000—is successful, the Gujarat government is considering installing the system in more health centers across the state, Zalzala says.

The Institute of Management Technology, a business school in Ghaziabad, Uttar Pradesh, sponsored the training of staff in the field and conducted various studies of the system, and the American University in the Emirates, in Dubai, contributed administrative support.

“Manav Sadhna works with a lot of volunteers with diverse backgrounds from around world who always take away something from the community they work with,” says Siddharth Sthalekar, a volunteer with the organization.

If you want to get involved in a humanitarian project, you can find out how at the Engineering for Change website. E4C seeks to develop technical, locally appropriate, and sustainable solutions to humanitarian challenges. It’s the successor to the IEEE Humanitarian Technology Challenge, which ended in December.

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