Background: The District Emergency Operations Center (DEOC) of Ernakulam District is operating a tele-medicine system which is physically hosted at the Indian Medical Association. At present there are 10 doctors and 5 moderators who are manning the systems. The workflow is as follows
General Public has many points of reach into the Healthcare system such as their family doctor, a hospital doctor, DEOC Hotlines numbers, Primary Health Care Center, Palliative Care Nurses etc.
The calls which are received by the above stakeholders are filtered by the stakeholders themselves who try to see if a solution can be done by themselves.
If they are not able to provide a solution, then the Name and Mobile Number of the Patient is passed on (by sms/whatsapp/webportal) to the TeleMedicine System where a moderator enters the details into a web portal.
The moderator then places a call to the patient and registers the patient into the system which includes Name, Age, Sex, # of Old People at home, District, Panchayat, Ward, Whatsapp Mobile Number and the difficulties faced.
The moderator them sends a message to the patient informing them of their Patient Registration Number and sets up a time for a call from the doctor.
The doctors places a whatsapp Video/Audio/ telephone call to the patient depending on what is feasible.
The doctor prescribes the medicine over the phone. If the patient requires hospitalisation, then the doctor informs the DEOC and Ambulance Systems to pick up the patient.
If the Patient requires a follow up, then the tele-medicine system doctor calls back to review the patient at predefined times and enters the update into the system.
The distribution of medicines has to be integrated into the Emergency Food and Medical Logistics Network.
The Ernakulam District is split into four areas for distribution. Mrs Louvya, Public Relations Officer is the person coordinating with the four coordinators who are looking at each area in Ernakulam district.
The doctor’s prescription is written in a white book,entered with the Doctors Medical Registration Number and then put on a seal.
This prescription copy is then whatasapped to the Pharmacist at the PHC in the Panchayat.
The Delivery Volunteer then picks up the medicines and delivers it to the patients.
Integrating the existing Telemedicine System into the CoronaSafe Network
We need a platform where a large number of initial calls from the healthcare stakeholders are to be filtered based on two options that they pick
This is not an emergency and thus should this go to the telemedicine call-back system.
This is an emergency, please connect to Doctor Hotline.
Checklist of things to do:
In EKM War Room add Dr Athul who will then add Dr Sajith.
Dr Sajith will share the list of volunteers to Aisha
Aisha will help the volunteers register into the Corona Safe Network.
The Names of PHC in each Panchayats, Name of Pharmacist and Mobile should be send by Mrs Honey, Public Relations Officer to Aisha
These Delivery Volunteers need specific training (which can be made with small videos on mobile phone) which has to be made by Dr Sajith
Aisha will ensure that the Volunteers are trained in these Protocols
We need to create the Hotline Doctor calls back/gets connected to the Healthcare ProfessionalWhen the call goes back from Doctor to Healthcare professional, there should be an operator who listens into the call and decides based on doctors advice
This call needs an ambulance so connect to the ambulance network
This call needs a medical prescription so that can be send over whatsapp.
This call needs a follow-up so mark the details and time for follow-up.
When the deaths increase in the system, we expect the portal to get heavy loaded so scaling should be thought through.
A large number of doctors needs to be on the same page.
The government doctors and private sector doctors operate in two different settings. We need to help the private sector,