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
    1. To install the EDPS2000 system in 2 additional PHCs in Dharmapuri district.
    2. To train and orient selected PHC staff to use the EDPS2000 system.
    3. To ensure registration of the complete population of the selected primary health centers into the system
    4. To monitor and supervise the EDPS2000 system in all selected PHCs through a central system located at the Baldev Health Centre.
    5. To provide necessary health information systems documents at regular intervals.
    6. To track disease patterns including epidemics within the entire population.
    7. To provide supportive training and supervision services to selected PHCs.

  • Long Term:
    1. 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).
    2. 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:

  1. Basic infrastructure improvements are made at 2 additional PHCs.
  2. EDPS is installed on new computers, and are operational at the PHCs.
  3. Trained staff is appointed at the PHCs.
  4. Patient history is obtained and recorded in EDPS.
  5. PHCs remain functional even in the absence of doctors.
  6. Workflow at PHCs becomes efficient, and management reports are generated.
  7. Both patients and staff are motivated.
  8. Quality of healthcare delivered is significantly improved.
  9. 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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