UK Research and Innovation | Survey

1st Submission Bronze Trophy

PaperEMR

Paper is the most commonly used and available interface for documentation of medical consultations. The difficulty of obtaining digital data from paper has pushed the digital health community to focus on electronic interfaces for healthcare documentation - typically computers or laptops, and in a few cases mobile phones or tablets. These interfaces are difficult to implement and sustain in low-resource settings. My idea is to seamlessly  integrate paper-based and mobile-based workflows for generating and using data on primary healthcare services.

How could digital technologies provide a solution to this challenge?

We have developed computer vision-based apps to automatically extract data form paper-based templates for clinical documentation. This involves interfacing the ancient technology of rubber stamps (to print templates on demand) with modern computer vision algorithms on smart phones.

Osu 1 month ago

Will the scanned document be saved on the mobile phone or in the cloud?

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Pratap Kumar 1 month ago

Both - the approach is to have both hard and soft copies of the records maintained in the facility (including facility-level statistics and analysis), while also having access to data in the cloud for broader, de-identified analytics.

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Osu 1 month ago

I am curious about the infrastructural setup, will a cloud service be used or on site setup? In both ways which one will be economically viable ?

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Pratap Kumar 1 month ago

'On site setup' is as simple as visiting a website or downloading from the play/app store. Rubber stamps could be locally manufactured or ordered from Nairobi. Alternatively, clinicians can use printed paper templates instead of stamps. Digitisation of templates can be done using personal phones and the extracted data is stored both in the phones and the cloud (using asynchronous syncing like whatsapp). So there's no split between 'local' and 'cloud' implementation - I hope I've been able to address the question.

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Osu 1 month ago

For on site..I meant system setup like servers and storages for storing the digital scanned information.

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Pratap Kumar 1 month ago

No servers or storage beyond individual smartphones ... typically one smartphone per facility.

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Osu 1 month ago

Ok thanks

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Pratap Kumar 1 month ago

Do vote :)

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Josephine Muchogu 1 month ago

Hi Pratap,
You can also investigate the advances being made in graphics technology. There is a wide array of digital tools that can digitise handwriting and sketches, thus eliminating the need use of a scanner. Medical consultants can write on their pads with pens, and this can instantly be digitised.

Further advances are eliminating the need to buy specialised pens or pads, and one can use normal pens and notepads to take notes that can be digitised.
https://www.youtube.com/watch?v=I3k38gafEbU

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Pratap Kumar 1 month ago

Thanks very much for sharing your thoughts! I agree - digitising handwriting and sketches are important. However getting such digitisation to accuracy levels needed for medical needs is not likely to happen in the next 5-10 years - there are significant 'last mile' challenges. Hence the use of simple, paper-based templates, and rubber stamps were the best solution we could think of - ubiquitous availability, low cost, minimal training and easily digitsed like QR codes.

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Pratap Kumar 1 month ago

Do vote, if you like the initiative

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lauren clarke 2 weeks ago

Status label added: 1st Submission Bronze Trophy

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BHUVANA K.B 2 weeks ago

Hi Pratap,

This is excellent innovation. It helps a lot in clinical care setting. I am really excited looking at this.

So with extraction of data from paper document to app,

1. did you evaluate whether drugs prescribed were guidelines directed medical therapy?
2. Does app had mechanism to capture drug drug interactions?
3. App with features to automatic reminders for follow up dates for next consultation?

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Pratap Kumar 2 weeks ago

Thanks for the comment!
1. Yes - we have a paper coming out on antibiotic use and how it aligns to guideline recommendations.
2,3. Not yet, but these are some of the app-based functionalities we are working on, which are relatively easy to implement from a tech perspective, but more complex as a use-case. We need to clearly define the role of notifications, when they are triggered, who receives them, what the actions/responses should be, etc. Even for something relatively simple like a notification for a next consultation, there are quite a few things to be worked out - e.g. which conditions need it (e.g. mostly needed for chronic disease mgmt), who in the clinic reviews the appointments, how do we keep track of appointments kept/missed, etc.

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BHUVANA K.B 2 weeks ago

Actually we have designed app, but we are entering details of patient and their management manually as of now. Though it has branching logic kind of option, to choose and complete data entering in less time, this consumes lot of time.

We are working in the area of CVDs. It would be nice to share our ideas on this. Elsewhere I have told about kind of our we are doing.

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Pratap Kumar 2 weeks ago

The paper linked to this post (https://goo.gl/mAFqeX) describes implementation for chronic disease mgmt (including hypertension). This is an active area of work and I'd be happy to share ideas.

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BHUVANA K.B 2 weeks ago

Its showing as link, not found.

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Pratap Kumar 2 weeks ago

Please delete the bracket at the end ... it shouldn't be part of the link: https://goo.gl/mAFqeX

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BHUVANA K.B 2 weeks ago

Though in app we have the option to take a picture and scanned copy of discharge summary will be stored in the app. So we(both patients and care provider) can look at these when its essential to clarify and recheck things. Also idea is to share to their primary and secondary care centers when they go back home, discharged from tertiary care center for continuity of care.

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