EHR As A Service

Enabling the bottom of pyramid through EHR (Electronic Health Records) and Radiology services on the cloud, OpenTok and Genome Link API, blockchain network and open source PACS and spreadsheet. EHR as a service aims at providing secure data storage, transparent data movement and data authenticity. . Ability to plan food and nutrition using OpenTok and GenomeLink API, EHR's medical report, medical data for better healthcare delivery can be devised and implemented.

Inspiration

EHR (Electronic Health Records) Need in India: The current status of the healthcare sector in India is associated with low public spending (1% of GDP), high out of pocket payments (71%), a high level of anemia among young women (56%), high infant mortality (47/1,000 live births), high maternal mortality (212/100,000 live births).

This highlights the need for major reforms in the healthcare sector. Though information and communication technology (ICT) cannot work as a panacea, it can provide a cost-effective solution to improve the quality and coverage.

Indian doctors are in the process of adopting electric health/medical records maintenance online. It not only gives complete information about the patient, about his previous medical history, and also saves time while providing treatment, as going through the medical record doctor can get in to fast conclusion on what treatment to provide immediately. Indian government is taking consideration into maintenance of health records online.

The proliferation of mobile phones and the availability of high-speed Internet offer the possibilities to provide healthcare services in rural, remote areas of the country.

Our Vision and Goals

Our vision is to carry out research on new EHR (Electronic Health Records) models that incorporate technology and which aims at revolutionizing the medical scene around the world. EHRs is a technology solution designed specifically to address the needs of the medical eco-system comprising of hospitals, medical laboratories, patients, diagnostic labs, R&D organizations and improve the operational efficiencies.

  1. Just in Time service Availability of patient’s medical records, genome data across different stakeholder through secure blockchain network.

  2. Record Management Quality documentation reduces the issues regarding prescription of incorrect medicines. Ability to plan food and nutrition using GenomeLink API, EHR's medical report, medical data for better healthcare delivery can be devised and implemented.

  3. Research Research laboratories can use the data for computer-aided diagnosis of diseases, suggesting personalized care to patients. Further, food and nutrition methods could be researched and devised for speedy recovery of the patient and prevention of diseases in patients' life after successful treatment.

  4. Web Application Cloud-based web application with OpenTok APis, a material design application linking to GenomeLink API for quick medical attention.

  5. Transparency Insurance agencies can utilize the data to provide customized health insurance plans to the customer. Personal dietary consultants can provide better food and nutrition plans for the speedy recovery of patients.

  6. Better Cure Journal of medical records covering complete patient history and Genome data using GenomeLink API improve the cure outcomes.

Technology

We engineered and developed cutting edge technology on ethereum blockchain network using NuCypher protocol, OpenTok and GenomeLink API, open source spreadsheet and open source PACS (Picture Archiving and Communication Systems) solution:

  1. Creation of radiology files in DICOM format, examination reports and patient’s medical records from hospital visits. DICOM stands for Digital Imaging and Communications in Medicine. This file format is created to distribute and view medical images using a standardized file format. We utilize GenomeLink API and integrate with EHRS platform for better understanding the genetic make-up of a person and suggest appropriate treatment.
  2. Cleansing and validation of in-bound patient data available as medical images and examination reports
  3. Authentication, authorization using unique SSN (social security number) for legitimately storing the medical records.
  4. EHR movement across different hospitals, laboratories, pharmacies on requirement basis using:

i) ORTHANC as an open source and light weight DICOM server for medical imaging, querying and retrieving patient’s data and radiology reports from a medical institution.

ii) An inbound web application and OpenTok APIs for viewing medical examination reports and patient records.

Purpose

Our blockchain solution, EHR as a service, can help in:

  1. Legitimate storage of medical records, invoices using open source PACS and IPFS for storage and react based spreadsheet application.
  2. Records movement in a secure way using NuCypher Re-encryption Protocol, OpenTok APIs, Query and Retrieve application on bootstrap and Orthanc DICOM open source solution.
  3. Preventive treatment and remediation by studying the Genome using the GenomeLink API and planning essential nutrients in the patients' meal, food and nutrition plan.

Enablement

EHRs can help in data cleansing, creating EHR, records legibility and coordination with hospitals, pharmacies, diagnostic clinics, in case when movement of records is needed. The EHR application can be accessible using Internet browser, all the data is on the cloud. Motivational benefits of our solution include -

  1. Patient information can be secured and shared anywhere at any time with help of EHR.
  2. Staff and clinicians can make the direct entry, reduces transcription cost.
  3. Quality documentation can be maintained (perceptible, readable, records, reports and charts).
  4. Reduce the issues of prescription of incorrect medicines. Ability to plan food and nutrition using GenomeLink API, EHR's medical report, medical data for better healthcare delivery can be devised and implemented.
  5. Complete patient history records improve the cure outcomes.
  6. These systems greatly enables the physician for immediate patient treatment by capturing the key records.
  7. EHR records are the key data for implementing the clinical decision support system.

Business Benefits

a. Patients

  1. Make instant appointments with a doctor and get quick access to e-records.
  2. Computer-aided detection will help in early prediction and diagnosis of diseases. Ability to plan food and nutrition using GenomeLink API, EHR's medical report, medical data for better healthcare delivery can be devised and implemented.

b. Doctors and Hospitals

  1. Prioritize and handle appointments better.
  2. Issue prescriptions
  3. Coordinate with specialists.
  4. Access to accurate records.
  5. Improved care.
  6. Better dietary feedback based on genomelink API

c. Administrator and Insurers

  1. Connect all stakeholders
  2. Personalize care treatment.
  3. Accurate and timely payments
  4. Reduce the cost of centralized systems

d. Employees

  1. Administer Benefit.
  2. Reduce healthcare costs.
  3. Reward employees
  4. Offer affordable benefit packages.
  5. Better diet and food programs at offices.

e. Research Institutions

  1. Computer-aided detection of diseases and development of prevention models.
  2. Personalized medicine and drug discovery practice.

Challenges we ran into

We wish to mention that integrating and sending medical reports using NuCypher protocol required lot of mentorship from Bogdan Opanchuk and Dr. Michael from NuCypher. They helped us at every step of implementing NuCypher whether it was installing the correct versions of requisite libraries and tools and helping us running the re-encryption protocol. We wish to thank the EthIndia community and fellow participant hackers, who helped us learn and implement our idea in a fine way.

Next steps

Our solution is useful only to the extent it is used by the medical eco-system and healthcare community. Thus, we are working with health specialists around the world to focus on these learning challenges:

  1. To make our project freely and readily available to learners everywhere
  2. To explore and share best practices
  3. To provide a forum for discussion and support for technology for learning
  4. To provide mechanism for evaluation and dissemination of results.

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