IEEE Technology and Society Magazine - March 2015 - 48

Patients pay INR 3 ($0.06 U.S.) per head per visit,
and the NGO pays another INR 7 ($0.11 U.S.). The costs
include consultation, medication, treatment, etc. A patient
may be referred to a government hospital for tests, after
which they must submit receipts for a 50% reimbursement by the NGO. Serious cases are referred to government hospitals and the NGO deals with them on a case by
case basis (with expensive cases sometimes considerably
draining resources). Medicines usually cost INR 70008000 (USD 110-130) per month. There is no insurance,
but the patients are entitled to the below poverty line card
used in government hospitals. However, only 30% of the
patients have the card, as others are unable to prove their
cases due to lack of documentation. Government provides no direct support to the NGO at this stage.
Figure 4. The server in place at the clinic at the Manav
Sadhna operated community center in Rama Pir No Tekro slum
community. The system is monitored and maintained by the
resident IT manager.

arrival, some patients' body temperatures are taken by
helper if needed, and the reading is given to the patient
on a paper slip. However, the medic is responsible for
performing blood pressure and other measurements.
Prescriptions given by the medic are in numbers only,
coded for the helper.
A community health worker performs field visits,
and is trusted within the community, referring individuals to doctors and hospitals, and providing medication
where appropriate. He has no immediate link with the
medic, and is largely self-trained. Field visits are done as
often as possible, perhaps around three times a week,
usually in slots between 14:00 and 16:00 hours. The
visits are targeted checks, i.e, for elderly patients living
alone, patients with monthly medication packages, and
patients with chronic diseases.

Figure 5. A medic uses notebooks to keep basic records of a
patient's visit. Notebooks may be misplaced, memory can fade,
and mistakes may occur.

Solution Overview
Structure
The ITRM system solution serves slum clinics and provides outreach through community health workers (see
Fig. 6). The system's main active server is located in
Ahmedabad, India, and a mirror cloud server in located
in Dubai, UAE. The ITRM solution includes a records
management system based around an SQL 2008 R2
server, and serves both the clinic and community health
workers. The Microsoft Dynamics NAV 2009 is an industry standard Enterprise Resource Planning (ERP) package, and provides the clinical side of the software
residing on the server and accessed via laptop computers. Mobile devices run various operating systems, and
use database interface software to sync with the SQL
database and display data. RFID identification cards are
printed using specialized printer and software linked to
the SQL back-office.
Fig. 7 depict the procedure of registration, while other
system procedures include consultation, follow-up, and
administration. There are two possible procedures for
consultations: either the worker will enter data on the
system directly, or they will make handwritten notes to
be transcribed at a latter stage. Follow-up and Administration staff monitor appointments and medicines discharge, and generate patient and clinic reports.
Simple Object Access Protocol (SOAP) is a specification for exchanging structured information in the implementation of web services in computer networks [3].
The RFID-ITRM solution allows a SOAP note format as
required by the end user.
Health Level 7 (HL7) enables interoperability of
healthcare information, providing standards for the
exchange, management, and integration of electronic
healthcare information [4]. The RFID-ITRM system has
the facility to allow HL7 compliance while interfacing with
other healthcare systems via the Iguana HL7 software.

IEEE TEchnology and SocIETy MagazInE

∕

MARCH 2015

Table of Contents for the Digital Edition of IEEE Technology and Society Magazine - March 2015