Metrix

Effectively securing, accessing and exchanging medical records in Low-to-middle income countries in Africa

We are trying to solve the problem of inaccurate and insufficient information regarding patient's health consequently leading to poor patient care and treatment management, wrong treatment options, inadequate documentation on medical prescriptions and poor planning options at hospital and government level due to insufficiency in available patient statistical data. 

Health information documentation is a document about healthcare services that is provided to an individual patient. If documentation doesn’t give a clear presentation of a patient’s history, it is termed improper documentation.

According to a research conducted by John Hopkins in the United States, approximately 250,000 patients are known to die from human mistakes, diagnostic errors, system failures, and preventable patient safety events each year making known medical errors the nation’s third leading cause of death in 2013. 

In Low-to-middle income countries(LMICs) with Uganda being inclusive and counties in the Sub-Saharan region, 15·6 million excess deaths from 61 conditions occurred in LMICs in 2016. After excluding deaths that could be prevented through public health measures, 8·6 million excess deaths were amenable to health care of which 5·0 million were estimated to be due to receipt of poor-quality care and 3·6 million were due to non-utilization of health care. Poor quality of health care was a major driver of excess mortality across conditions, from cardiovascular disease and injuries to neonatal and communicable disorders.

Our solution suggests the use and integration of blockchain-based architecture of a decentralized electronic patient record management system running through an application software and website with a database record containing the patient personal info, department lies-in, physician, tours, treatment and lab results. 

The system will operate through the blockchain with each patient having their own individual nodes and use of contracts to ensure the privacy of patients. This patient information is made available upon authorized privilege of patient to review their own medical records, authorize their own medical records, create/modify the authorized medical records and review the authorized medical records. 

Since the patient enters the hospital the workflow starts as the patient generates a patient-provider contract which works as a medical certificate. The contract is utilized to record the current situation of medical records, details of diagnosis and the access permission of different summary contracts. Sometimes other relevant information will also be included. All summary contracts must be licensed by the owner of the patient-provider contract to be made accessible. 

The provider can then enter the patient personal info and sends the record to assigned department; at this stage the nurse starts update the record by entering the physician comments, required treatment, and sends lab test when it is required. As well as information like Physician names, medicines,

Also there are can advance search that can help to make statistical reports and researches for the physicians. The system is considered time and cost effective to healthcare.

The solution targets towards serving patients who are on the verge of patient safety compromise and death due to inaccurate and insufficient information regarding their health leading to poor patient care and treatment management, wrong treatment options, inadequate documentation on medical prescriptions and poor planning options. 

Our solution aims to ensure patient safety and easy accessibility to well scripted and palatable medical records to cater for well-fashioned patient care.

This form of patient record management and gives direct benefit in certain terms, whilst avoiding any confusion that would jeopardize the quality of patient care.

We are a multi-disciplinary team of undergraduate health science students comprising 4 medical students, a physiotherapist and a biomedical engineer and have as well as a liaised with other individuals in support of the initiative i.e. two medical doctors, a project management team and a software engineer. Some of the team members include;

Raymond is a medical student with experience in research as well as development and management of community engagement projects where he has served in numerous capacities on top of his clinical skills. 

Nsamba Joseph is a medical student who has also participated in numerous projects as a leader and also volunteer. He has experience in lobbying.

Hellen is a biomedical engineer with knowledge in development of applications and systems but also coding in programming languages

Kisiriko Solomon is a physiotherapist who recently won a grant in innovation against antimicrobial drug resistance. He has volunteered in community projects and has good clinical skills and patient handling. 

Taking on the fact that our team constitutes of majorly medicine students studying and operating in hospitals with no/limited resources, it came to our notice that poor medical documentation was a detrimental problem that was causing most of the deaths in the hospitals due to some patients presenting with no past medical documents or when they are insufficient. 

On interacting with some of the patients, they said that they had lost the documents in some way or another and we asked them for what they think should be done to ensure proper medical record documentation. 

Some of the suggested hospital based systems to store for them their data while the majority suggested having the documents with them on their phones since most them were taken by the simplicity in the current social media wave of TikTok and Facebook.

With that in consideration, we decided to come up with an application software while guarantying patient records safety.

What makes our solution innovative is that it can automate patient information management while ensuring patient safety through the provision of use of individual patient nodes operating on the blockchain with use of contracts that the medical personnel will use to upload the diagnosis to patients' node. This gives direct benefit in avoiding any confusion that would jeopardize the quality of patient care. Purposefully, this helps to provide right information in the right place, in the right order, at the right time for the right person at the lowest cost.

Our impact goals are that our system is able to accommodate a minimum of 5000 people with well detailed medical records in the year 2023/2024. 

We plan to achieve by first of all developing the overall system in the first 3 months and thereafter come up with an implementation plan where we will reach out to different individuals and health care facilities that can accommodate the software.

The core technology of our system is blockchain technology where a patient, which an individual node on the blockchain is able to generate a patient-provider contract which acts as a medical certificate. The contract is utilized to record the current situation of medical records, details of diagnosis and the access permission of different summary contracts. Other relevant diagnostics, address information will also be included. All summary contracts are licensed by the owner of the contract. Medical personnel will be allowed to modify or read only based on the access right in the summary contracts after getting the permits. 

We haven't yet launched our solution, but we expect to serve up to 5000 people the following year.

Currently, we are experiencing limitations both financially and technically as well as a lack of support from indigenous organization who think that most of these ideas we come up with are a daydream and can't be implemented due to the political and economic discrepancies in Uganda.

Currently, we aren't partnering with any organizations but in talks with some of them.

Our path to financial sustainability is through revenue streams such as transaction fees, premium subscription to other subsidiary services and in-app advertisement.