Automated Community Outreach through Tablet Application Helps Sankara Eye Hospitals Reduce Patient Screening Cost by 69%


Today, an estimated 180 million people worldwide are visually disabled. The loss of sight causes great human suffering besides representing a public health, social and economic problem for countries, especially the developing ones.


Identifying people group who require eye care intervention is a challenging phenomenon in developing countries like India. The states are not equipped with resources to keep a database of eye diseases in the given population. In fact, one of the obstacles in detecting and treating preventable impairment is the paucity of community-level data on a real-time basis.


The way forward to accessing data that is reliable, real time and sensitive enough for decision making is to automate the community outreach process. Sankara Eye Foundation has done this through innovative use of mobile technology. The solution deployed by the hospital is essentially an Android based tablet application, called SERVIS.


Before SERVIS the hospital’s outreach process worked in a de-centralized mode wherein the field workers entered all the household details manually into physical registers. The entire outreach data collected manually at each level (household survey to campsite) is entered in excel sheet at the base hospital for further analysis and decision making. “The manual data collection and management process, as seen in various community level activities, is fraught with issues of data accuracy for the purpose of reporting and decision making,” exclaims Bharath Balasubramaniam, President, Sankara Eye Foundation.


This called for automation of the outreach process. The tablet application is a role based system, which is used by the field workers during the household surveys or by the nursing staff, optometrists, ophthalmologists, paramedical staff and field workers in the camp sites. They are equipped with tablets loaded with the SERVIS application to record patient specific data, to provide instant advisories and to promote preventive eye awareness. The application is configured for both 2G and 3G data services and has an inbuilt GPS sensor support.


Since the field workers travel to remote villages, lack of network connectivity and electricity are big constraints. SERVIS is designed to overcome these constraints. It utilizes a local Decision Support System. Hence, even with zero network connectivity, instant advisories can be provided to patients. SERVIS automates the screening process and helps identify patients who might need a surgery based upon predefined rule sets and advises on the patients who should be referred to the camp site. The collected data is stored locally and synced with the database hosted in the cloud as and when connectivity exists. Moreover, during household surveys, patient information is geo tagged to help in monitoring the movement of field workers and providing geo-spatial insights into eye health data.


“Identifying people groups that require eye care intervention is a challenging phenomenon but once it is done, the battle is half won. The project has got the potential to create a foundation for an eye disease surveillance system to identify people needing intervention. A valid database drives the mission of eradicating curable visual disability at the national and global levels,” adds Balasubramaniam.


There are security protocols to ensure accuracy and privacy. The server is hosted in the cloud within the premises and works on the communication protocol HTTPS. To strengthen security measures, data is encrypted both at source and destination. Reporting module is also hosted in the cloud, which communicates with the SERVIS cloud server to provide real-time reports.


The outcome of SERVIS has been quite positive. The hospital covered 178 and 740 villages in 2015–2016 and 2016–2017, respectively. In 2015–2016, during the implementation phase, 8700 households were screened and 5487 patients were referred to the camps using SERVIS. Household screening and patient referral took a major jump in 2016–2017 with 41,724 households getting covered during vision screening and 28,765 patients being referred to camps.


According to a study, the time taken to do a survey per individual with SERVIS has reduced to 6.6 minutes from 11.9; cataract screening and referral to camp site has increased to 73 from 52. On an average 52 individuals were screened by SERVIS from an average of 32 households per day by a field worker as opposed to an average 33 individuals screened by manual method from an average of 17 households per day by a field worker. Additionally, post SERVIS implementation, the cost of screening has significantly reduced from Rs. 24,780 ($370.4) to Rs. 7633 ($113.9)—a whopping 69.2% decrease.

Categories: Technology

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Muqbil Ahmar

Muqbil Ahmar is a tech evangelist, environmentalist, women's rights advocate, editor, and founder of www.greenubuntu.com. He writes on ...

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