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EDPS2000
The Bloomberg School of Public Health, Johns Hopkins University,
conducted a study of the EDPS2000 program that was completed by December
2003 and the final draft of the report to the sponsor, The Rockefeller
Foundation, stated, "… recommend EDPS2000 as one effective way
of bringing information technology to improve the delivery of primary
healthcare in rural areas, especially where doctors are either unavailable
or absent."
The report also stated that it was "impressed with patients' reaction
to EDPS." It further stated that the program needs wider application
on a larger scale, such as the district level, to be fully tested. All
pilot-stage testing is complete and it is ready for wider implementation.
The study showed
1. diagnostic accuracy
2. high patient acceptability and satisfaction
3. high demand by patients and community
4. good potential for wider application
The study also found that PHC workers and PHC staff showed initial resistance
to working with the program. In a few weeks, there was moderate acceptability.
The Kempegowda Institute of Medical Sciences, Bangalore, conducted a second
round of diagnostic study that showed 94% accuracy.
The "process study" by St. John's Medical College showed high
receptivity on the part of the patients and improvement in workflow.
The government of
Tamil Nadu has indicted that it wants the system to be installed in all
the Primary Health Centres of one or two districts. That amounts to a
total of over more than 100 such health centres. The George Foundation
is trying to work out how the associated costs will be met.
Additionally, there
are several enquiries from India and abroad to make EDPS2000 available
to them. The George Foundation is trying to work out appropriate arrangements
that are both sustainable and affordable.
Details of the
Studies on EDPS2000
Bagalur PHC
The
George Foundation has continued to work in Bagalur PHC with the EDPS system.
A major evaluation study on the perceived and actual benefits of EDPS2000
in a PHC setting was recently completed by St. John's Medical College,
lead by Dr. Dara Amar, Professor & Head of Dept. of Community Health.
EDPS2000 Evaluations
KIMS conducted a double-binded
validity study of EDPS2000 system at their Out Patient Department during
the months of July to October 2002. The initial results are very encouraging.
Of the 933 patients who went through the system, 94 % of the diagnoses
generated by EDPS2000 were in concurrence with the diagnoses given by
the specialist at KIMS.
Bloomberg School of Public
Health, Johns Hopkins University and Rockefeller Foundation have initiated
a six month evaluation study titled "Transforming Technologies in
Healthcare in Low Income Countries; Evaluation of the Early Detection
and Prevention System in India". Dr. David Peters is the Principal
investigator, and Dr. Manish Kohli is the investigator conducting the
study in the field. Other co-investigators of this study include Dr. Mohan
Chellapa, Johns Hopkins Medicine International, Baltimore, USA; Dr. Dara
Amar, St. John's Medical College, Bangalore, India; Dr. M.K. Sudarshan,
Kempegowda Institute of Medical Sciences, Bangalore, India; and Dr. Maya
Mascarenhas, The George Foundation, Bangalore, India.
The study advisors are:
Dr. Prakash, District Medical Officer, Salem District, Tamil Nadu, India
Prof. Laura Morlock, Johns Hopkins School of Public Health, Baltimore.
This study will evaluate
three dimensions of the EDPS
1. Functionality of the technology
2. Patient benefits
3. Health system impact, including effects on health workers. The results
will provide a basis to assess the feasibility of applying the EDPS technology
elsewhere in India and other low-income countries.
Updates of Health
Projects:
Activities
- co-management"
of 2 additional PHCs
- establishment
of monitoring and surveillance functions at Baldev Medical Centre, and
- an evaluation
study on the effectiveness of our approach by Johns Hopkins School of
Public Health, Baltimore, USA.
Overall Goal
The overall goal
of this project is to improve the quality of health care services to the
rural communities in India.
Our immediate goal
is to incorporate 2 more PHCs into the program in the first phase spanning
18 months. Each PHC reaches between 20,000 - 60,000 people; this expanded
coverage will address issues of primary healthcare and health education
for about 250,000 people, and serve as a model for scaling-up to millions
more.
The evaluation
study by Johns Hopkins will confirm the validity of our approach. The
study shall concentrate on the accuracy of the diagnostic application,
the effectiveness of our management approach, and the receptivity on the
part of the staff and the patients at the PHCs.
Goals of the
expanded PHC Coverage and the "Surveillance Centre" at Baldev:
- Short Term
- To install
the EDPS2000 system in 2 additional PHCs in Dharmapuri district.
- To train
and orient selected PHC staff to use the EDPS2000 system.
- To ensure
registration of the complete population of the selected primary
health centers into the system
- To monitor
and supervise the EDPS2000 system in all selected PHCs through a
central system located at the Baldev Health Centre.
- To provide
necessary health information systems documents at regular intervals.
- To track
disease patterns including epidemics within the entire population.
- To provide
supportive training and supervision services to selected PHCs.
- Long Term:
- To improve
the quality of life in a rural community in Dharmapuri district
of Tamil Nadu, South India through essential, affordable and accessible
primary health care services including health education (Baldev
Medical Centre Programme).
- To set up
a central co-ordination centre that will train, implement and manage
the data of EDPS2000 spanning several primary health centers in
Tamil Nadu (EDPS2000 Project).
The George Foundation plans to involve other NGOs who serve other communities.
We plan to work with rural hospitals and physicians. EDPS system will
be continually improved by eMedexOnline LLC, based on the feedback from
patients and staff. Major medical establishments such as Johns Hopkins
will be involved with the project to assure quality.
The fundamental
concepts upon which PHC and Baldev projects have been established have
already been outlined. The benchmarks of success are as follows:
- Basic infrastructure
improvements are made at 2 additional PHCs.
- EDPS is installed
on new computers, and are operational at the PHCs.
- Trained staff
is appointed at the PHCs.
- Patient history
is obtained and recorded in EDPS.
- PHCs remain
functional even in the absence of doctors.
- Workflow at
PHCs becomes efficient, and management reports are generated.
- Both patients
and staff are motivated.
- Quality of
healthcare delivered is significantly improved.
- Surveillance
of diseases and health problems of the population served is carried
out.
These changes
in health status will be brought about within a period of 18 months starting
from April 2002.
The communities
of beneficiaries are participants from the planning, implementation, monitoring
and evaluation stages of the project.
Results
of Field-Testing of EDPS2000
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