Database

A blockchain and cloud based low-cost database solution for small health centers in Uganda.

Record keeping a major challenge in healthcare. This is a news article by the daily monitor written in 2016 and last previously updated in January 2021. The use of paper has persisted for so long as the main method of data storage. These are easily lost by by the patients and are lost for long time frames. 

Some health facilities have implemented semi-electronic data management systems centered at the hospital. These end up to be costly as they require a dedicated software team for handling the data and often this is data only needed byh the hospital. Its there fore not patient centrist. 

In 2021, My grand father was diagnosed with a rare condition where his intestine coiled preventing food flow. After surgery, He was never able to use his lower body. We were referred to nearly five hospitals and for each we would accumulate an A5 sized envelope of documents to the extent that we couldn't keep track which is which. I recall having paid for an MRI scan twice.

A lack of easily transferable records between clinics further discourages treatment. Most clinics in Uganda still rely on decentralised paper records, and this adds another challenge to tracking patients as they change clinics.
Without records of how a patient responded to certain drug, doctors are much less effective and may start them at the beginning stages of therapy (ART) again and again. Inconsistent use of drugs can also lead to drug resistance, which can create a more dangerous virus.

Dr Hillary Bitakaramine, district health officer for Kalangala, says lack of a unique identifier for each client is one of his district’s biggest challenge. He is advocating for a computerized system interconnected at the district level so that treatment can migrate with the populations they are meant to serve.\

A study about patient records at kabale hospital revealed that  88% of the total interviewees express the need for their information to be kept secret from untrusted parties while 12% of the total interviewees didn’t express the need for their information secrecy from untrusted parties. When asked what they feel about what should be done to stop information disclosure to untrusted parties ,

20% of the Interviewees expressed concern for keeping their information in closed rooms, 60% of the Interviewees expressed concern for information
storage in the computer with passwords and 20% of the respondents expressed concern for hiring external authorities to store their information. The
study concluded that privacy of patients’ records was vital to the patients and recommended that security measures be implemented. 

To combat both low-cost patient data keeping that is secure and could easily be accessed by doctors from different hospitals, An Idea of connecting to a cloud database service comes to mind as with a web application, doctors can access information regards a particular patient with the database creating a unique identifier linking to each patient. 

Security is add dressed by having a blockchain security system onthe hyper-ledger framework ensuring that records are tamper proof and can only be edited by the rightful doctors. Each entry would show what was changed and by who. Also hyper-ledger allows for user right levels thus patients will have only viewing rights. It being a private blockchain network is a plus as ensures more security.

In conclusion, with this solution patient records should transit safely between referrals from hospital to hospital.

My solution serves mainly patients but also the nurses.For patients, theyshould be able to get medication depending on their body acceptance rare and avoid any medication that has proven harmful in the past.This can in time save time and money

For doctor having ample knowledge about the patient medical history makes diagnosis easy and eliminates some unnecessary tests. Recommendation of medicines becomes more spot on.

For nurses, this implies reduced toll in searching for patient records as this is a few buttons away rather than checking stacks of books.

Volunteering in organisations like red-cross has given us an edge benefit to experience first hand the record keeping situation in Uganda. However a few solutions have been implemented though largely ineffective and require a huge shift from the norm. Its from the analysis of such systems that gives us insight to implementation of the solution. 

Having taken courses in Python,AWS and blockchain, furthermore attending meetups regards hyper-ledger,python,blockchain and AWS tech talks, We have the needed know how to implement the solution with the right resources.

After attending the Camtech Med-tech hackathon in western Uganda. e presented our solution to A couple of medical personnel and insights given helped shape the solution. We had to consider issues regards how easy would it be to use or integrate. How do we reduce the toll on nurses. Such is partly why we had to forgo decision like optical character recognition for converting the hand writings to text then summarise them as this would mean increased work load for nurses. Currently we would have to develop our solution then implement it to find out how to bend it more to the specific use cases.

The use of blockchain to provude extra security and immutability.

The use of cloud computing to reduce on compute and networking hardware required.

The use of a web application to update and view data which ensures use even on cheaper devices

To have a working solution and prototype the solution

Using the solution in at-least 5 health centers. Experimenting of integration of the blockchain with existent semi auto databases.

Blockchian to secure and make data tamper proof

Cloud computing to reduce hardware cost and labour cost

Web application implementing access for devices with relatively older softawre

We aim at a total of 5 health centers including at-least one of the larger health facilities. Our customers for this testing phase would range a few thousands.

Currently the technical personell to handle such a project is low. Also funds to smoothly facilitate activities are rather not enough. This has put out speed only next to that of a snail.