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Both Bagalur Primary Health Centre and Baldev Medical & Community Centre have implemented the Early Detection & Prevention System (EDPS2000). EDPS2000, a software system developed by Dr. Abraham George (maintained and enhanced by eMedexOnline LLC) is designed to be part of a new approach to providing quality healthcare to the rural poor in India. It provides early diagnosis of a patient's health status by screening patients and identifying those who need prompt attention by qualified physicians, while recommending treatment for others with minor illnesses. The system is described in more detail under Health Projects.

Current Developments:

The Bagalur Primary Health Center has achieved 100% coverage of all pregnant women and children in 17 villages.

Three independent groups have evaluated EDPS 2000:

1. Kempegowda Institute of Medical Sciences assessed the diagnostic accuracy and treatment recommendations of EDPS2000.
2. St. John's Medical College evaluated the effectiveness of EDPS implementation at the Bagalur Primary Health Center.
3. Johns Hopkins, U.S.A. studied the validity, process of implementation, training needs and cost analysis of setting up EDPS2000 at Primary Health Centers.
   

From October 1999 through the end of March 2000, EDPS2000 was in beta test at three hospitals in Bangalore, India, for both accuracy and ease of use. Patients were initially screened and preliminarily diagnosed by the system. The patients were then seen by physicians at the hospitals, without the benefit of the system's analysis, and the diagnoses compared. The results of these tests, with over 10,000 patients, are summarized in Results of Field-Testing of EDPS2000.

In the summer of 2000 the government of Tamil Nadu asked The George Foundation to co-manage with it a clinic in Bagalur, a village in rural Tamil Nadu, using the EDPS2000 system. This clinic serves a population of 80,000 people. Since August 2000 EDPS2000 has been in use there, with excellent results. Starting in September 2000, one of the Bangalore hospitals assigned five doctors to review the system and look for omissions and improvements, and minor changes are continually being made.

In the spring of 2002 the government asked The George Foundation to co-manage three more clinics using EDPS2000, and this was accomplished in the fourth quarter of this year. At that point, EDPS2000 covered a patient population of 120,000 people.

At the suggestion of the World Bank, a study of the success of EDPS2000 at the Bagalur clinic was commissioned, and was performed by an independent medical institution in India and by the Bloomberg School of Public Health, Johns Hopkins University, Baltimore.

In addition, The George Foundation has completed the construction of a new medical center in Hosur Taluk, a rural area in Tamil Nadu. The "Baldev" project serves the rural population of eleven villages within a 10 km. radius in the Deverapalli block and was opened to patients in September 2001. This health care facility will eventually provide services to a population of over 25000 persons. It has also been designed as a prototype for the regional centers that will provide training, data collection and other resources to a group of five to ten PHCs/clinics serving the regional population and using EDPS2000.

A special focus at Baldev is on women and children. In addition to the routine health care provided at the center, clinics cater to pregnant women, infants and children. Mobile services will be provided to remote villages to ensure that all pregnant women and children receive essential care. Multi-specialty clinics will be held on a rotation basis at fixed intervals where visiting specialists will provide their expertise to the local community.

As in the case of the Bagalur clinic, the training of community level volunteers, traditional birth attendants, preschool (anganwadi) and primary school (balwadi) workers and other members of the community are part of the strategy to empower the community with the knowledge and skills to improve their healthcare and status.

Initial efforts focus on our experience with the system's use in India. In India it is estimated that technology to improve primary healthcare can be provided at these rural clinics for as little as twenty five US cents per year, per patient, using EDPS2000 and The George Foundation approach. The combination of these economics and the support of major development agencies should provide compelling reasons for the government to adopt the system.

Kofi Annan's Millenium speech to the United Nations listed improving the health of the world's poor and bringing the benefits of technology to them as two of the most important goals of that organization for this century. With the conversion this past August of the clinic in Bagalur, utilizing EDPS2000, we have a working model of a system that uses technology to improve the health of the world's poorest citizens.

Pilot study in a Bagalur PHC of Dharmapuri District.