|By Steve Landman||
|December 30, 2013 09:00 AM EST||
The medical needs of developing countries are staggering and come in many shapes and sizes. The trouble is the real issues can only be understood once an individual or organization gets involved. About 10 years ago, our organization was routinely shipping medical supplies to hard-to-reach places. But what we found was that in many cases there were no hospitals to receive the supplies. We overcame this challenge by adapting the shipping containers used to move goods internationally into portable clinics outfitted with supplies and laptops. Once we were "on the ground" and learned more about the healthcare systems in countries such as Kenya, we found that even where there was an existing brick-and-mortar hospital, the medical software in place wasn't really compatible with local needs. This was for two reasons: either it was too complex or it was not designed to tolerate the frequent Internet service gaps or disruptions that are common in developing regions.
Caregivers in developing countries need every tool available to overcome the barriers of poverty and remote environments. They need to capture data, create comprehensive patient profiles and perform a litany of other tasks just like healthcare providers in more affluent areas. But they are forced to do so with whatever equipment is available and limited budgets. We discovered that a Platform-as-a-service (PaaS) solution could help us build an application that could overcome a lot of the road blocks these remote clinics were experiencing, and that we could realize widespread implementation at a fraction of the price of more complicated solutions. Working with Progress, we used their PaaS offering, Pacific, to build Carego Complete, an integrated, cloud-based electronic health records (EHR) Practice Management application that automates clinical, hospital and business processes for small clinics to large hospitals.
Case Study: Kenya
Kenya is using the PaaS-enabled app in an area of the country that had traditionally served its patient population through government clinics and hospitals. The initial roll out was in a catchment area of 250,000 people comprised of some of the poorest people in Africa.
Today the technology assists operations such as reporting for disease and births as well as drug distribution. It also helps in creating standards for quality of care, which is done by incorporating ICD10s, the international classifications of diseases and health-related problems created by the World Health Organization. This allows for treatment protocols and plans that can be widely deployed. All of which contributes to addressing a range of issues from infectious disease to pregnancy and birth.
The low cost and ease of use of this PaaS-enabled application allows small and mid-sized clinics in Kenya to drastically improve the quality of care they are able to provide, often on a shoestring budget. The clinics have been able to reduce redundancies and errors, while improving productivity and quality of patient care. The application also helps caregivers capture massive amounts of valuable data that would otherwise go undocumented.
For example, in the clinics using the cloud-based software all vaccinations are now tracked and documented and in some areas they have been able to better track the spread of infectious diseases. This integrated approach to sharing data has alerted populations to health risks and played a role in prevention. The application can also track and alert populations to disease outbreaks to get ahead of the issue. For example, the system recognizes that in a cluster of clinics in a northeastern region of Kenya there is a certain level of cholera cases occurring. The application can generate alerts to the clinics to watch for new cases and then quarantine that area, as well as report to the Ministry of Health.
In addition to disease surveillance, the PaaS-based application can help with drug management. In one case there was a clinic that was having trouble with drug management and stock control. Previously, the process was manual. Drugs were lost, prescribed to patients for the wrong disease and there was no way of knowing when stocks were depleted or low. Now the clinics know when they are low on stock so they can order more, and more importantly track to whom, when and why the drugs were prescribed and dispensed.
Other user-friendly features help with traditional healthcare functions such as patient scheduling, charting and history, electronic prescriptions, referral lab tests, and billing. PaaS has also played a critical role in allowing the solution to function anywhere, and with minimal management complexity. This has fostered adoption of the technology on a widespread level and enabled clinics with less technological resources to realize its benefits.
By providing administrative and clinical staff with complete and immediate access to patient health information, PaaS is helping remote health care sites expedite, personalize and improve the quality of care for underserved people around the world. It's an exciting space and there's no doubt that other PaaS enabled breakthroughs in healthcare are just around the corner.