eHealth Centre: rapidly deployable cloud enabled healthcare solution

eHealth Centre Instant-on Cloud Enabled Healthcare Infrastructure 

Micro Health Centre mitigates ground-level issues of delivering healthcare to villages in India and in other economies that are challenged by the inadequacy of health infrastructure

Commission on Macroeconomics and Health of the World Health Organisation (2001), have argued that better health care is the key to improving health as well as economic growth in poor countries.

However, healthcare delivery at the village level is constrained by lack of basic healthcare infrastructure including inadequate supply of electricity, lack of doctors, non-functional equipments, lack of supply-chain with no appropriate monitoring of the existing healthcare infrastructure and manpower.

The aim of the Micro Health Centre (µHC) is to mitigate these ground-level issues of delivering healthcare to villages in India and in other economies that are challenged by the inadequacy of health infrastructure.

The cloud enabled infrastructure of the “Micro Health Centre” solution by Hewlett Packard provides access to specialist medical consultation at affordable cost and provides support for disease surveillance by tracking disease patterns and risk factors. Given that µHC is a rapidly deployable infrastructure, it is also appropriate to support disaster relief operations.

The µHC proposes to provide preventive, curative and emergency services, also acting as a tool for creating public awareness.

Current Healthcare Scenario in India
India has nearly 741 million rural people (72 percent of the total population, source: census of India, 2001).The Tendulkar Committee report states that 42 per cent of rural people in India are below the poverty line.

In India, about 75 percent of health care infrastructure, medical manpower and other health resources are concentrated in urban areas where 27 percent of the population lives. Contagious, infectious waterborne diseases and reproductive tract infections dominate the morbidity pattern, especially in rural areas. Moreover, non-communicable diseases are also on the rise. The basic nature of rural health problems is attributed to poor maternal and child health services.

Every year, 1.8 million persons develop Tuberculosis in India, of which about 800,000 are infectious and until recently 370,000 die of it annually–1,000 every day.

However, the reach and quality of the Primary Health Centre (PHC) needs to be enhanced in order to cater to the healthcare requirements of the last mile.

The primary health care infrastructure in rural areas in India is based on the population norms of having one PHC for every 30,000 people and one sub-centre for every 5000 people. There are 24,375 doctors serving the PHCs, which imply a doctor population ratio of 1: 34,000 in the rural areas. This is much below the global standard set by the World Health Organisation (WHO) of 1: 250.

The timely availability of appropriate drugs and equipment is much needed in the existing PHC.  Efficient management of data is difficult in the currently existing manual system, and often involves duplication of efforts and wastage of time.

The existing physical infrastructure in PHC’s and the number of existing public health facilities needs to be enhanced to meet the health care demands in large remote areas of the country.

Concept of Micro Health Centre
The better reach and quality of the Primary Health Centre is much required to cater to the healthcare requirements of the huge population. This calls for a need of a rapidly deployable self sustainable infrastructure, backed by the robust healthcare services accessible from anywhere.

The solution is equipped with built in electricity, built in connectivity, medical equipment, telemedicine services and requires minimal training to operate.

In rural areas, a simple, correct and timely diagnosis of the fever could be a challenge, yet life saving. The difficulty of reaching a blood sample to a lab and getting the report back in a reasonable time frame for the villager, who may have already travelled long distances for medication, is a serious concern. Especially in case the patient is suffering from a disease like malaria.

The µHC acts as a solution in similar scenarios as it provisions the availability of laboratory facilities and specialist consultations through tele health services. The continuous remote monitoring of equipments, data, medical staff and the stock of medicine through techniques like biometric surveillance and “cloud enabled medical devices” ensures the availability of health services without interruption at all times.

The sms based services will act as an enabler to the vaccination camps of the government ensuring a higher volume of enrollment even in rural areas.

µHC can effectively address the challenge of health work force shortage in rural areas and the issues of quality and accountability in healthcare. Through a unique simple interface, it enables community ownership of the health care services being provided, thereby acting as a self sustainable solution.

Health Cloud – Linkage to Centralised Backend
Cloud computing provides tremendous opportunities for the health sector to improve the delivery of services and reduce the cost of operations. Using cloud technology in healthcare can aid in disease surveillance by tracking disease patterns and risk factors and disaster management.

The cloud enabled µHC infrastructure can help solve some of the most pressing issues facing the health care industry today such as dismal quality of health care provided, shortage of drugs, equipments, trained personnel and specialist medical care in remote areas.

A health data base gets generated by electronic reporting of data using rapid and reliable diagnostic tools and remote sensing for the collection, storage and analysis of health data. Services provided in µHC are OPD services, tele health services: real-time support to physicians, tele consultation, information dissemination, research, video conferencing, availability of essential drugs, mother and Child healthcare services including family planning services, referral services, in-patient services, education about prevention and control of locally endemic diseases, Health Education and Behavior Change Communication (BCC) and laboratory services such as all general tests, including blood, urine and sputum tests, record of vital events and reporting and disease screening for diabetes, hypertension and COPD (chronic obstructive pulmonary disease) and ambulance on call.

The µHC will increase the reach of healthcare and will lead to improved communications between healthcare providers separated by distance through Tele consultation and video conferencing. It will address basic health issues and deliver preventive healthcare such as immunisation to the rural masses. It can act as a tool for public awareness and disaster management and provide accurate reporting of health indicators of the community.

Components of a cloud connected µHC infrastructure: •    Equipped with Cloud based network architecture •    Web based EMR with CPOE (computerized physician order entry), •    CDSS (clinical decision support system) •    Data storage and transfer to expert centre •    Video conferencing with medical experts •    Medical Equipment Connectivity: Equipments with sensors •    Automated reminder of vaccination and TB drug administration •    Monitoring of the patient visit, doctor and medical staff attendance. •    Centralised health record management •    Training and health awareness program

Conclusion
Thus, µHC presents an affordable solution proposed by HP (Hewlett Packard). It is an intelligent Telemedicine Health Centre, designed to meet the local needs and conditions without any infrastructural constraints.

It proposes to provide essential health care services with Health Cloud connectivity services, thus providing invaluable data for research and can act as a tool for disaster management, disease surveillance and public awareness.

Thus µHC can dramatically increase the reach of healthcare with the following benefits rapid deployment of nation-wide healthcare, remote monitoring of functioning of the micro-PHC and its equipment through transducers, improved ante-natal and post-natal care, addressing basic health issues and delivering preventive healthcare such as immunisation, invaluable data for research on better drugs, reduced mortality and enhanced quality of life for patients, reduced IMR and MMR, easy access to primary  healthcare facility and better quality of care, affordable healthcare, enable citizens to avoid unnecessary travel for health care needs, access to family welfare services and laboratory services, low cost diagnostics tools and methods for diseases requiring immediate attention, patient data available in EHR and counselling and teaching for preventive healthcare.

Note: Co-authored with Ritu Ghosh and Anjali Nanda