Inspiration

Although this project can serve all displaced populations across the world, the inspiration for this project came from the Syrian Refugee Crisis. One of our team member’s work with very sick refugees in poor camps in Lebanon made us think about the future that faces these people as they get relocated to a new country, without access to their medication or health records. According to UNHCR, the war in Syria has resulted in 1.8 million displaced refugees who came across the open-Lebanese borders. Recently, these refugees have been resettled in big masses with Europe allowing to take more than 200,000 refugees over the next year. These vulnerable displaced groups, whose suffering has had a big impact on their health, will need access to their medical records in order to ease the process of linking them to proper treatment.

The second part of the project, consisting of access to services around relocated refugees, was inspired by an email that this same team-member got through this week from a Lesbian Refugee in Germany seeking help to reach out to LGBT organizations in Germany. This woman, who has longed for the sense of belonging to a new community, couldn’t have easy access to services and organizations around her who would be welcoming to her and ease her suffering.

How it works

iRefugee is a website that will allow refugees to access their medical records across borders. The portal will have three branches to it:

1) Health Care Workers (HCW) access: HCWs will apply to become part of the portal and enter basic information about themselves (names, specialty, nationality, position, clinic where they work, registry number in order of physicians). After background check and approval, they will be granted access to the portal through their fingerprint. This will allow them to: a) Access and Edit patient's medical records if the patient gives their own fingerprint as well. b) Upload information onto Name and reference number for patient (without having access to full medical records). This will be used to upload diagnostic test results that have been used and that can be uploaded as a pdf. or a photo.

2) Refugee/Patient Access: Any refugee will be able to access (and not edit) their own medical records through their fingerprint. They will also be able to approve the upload of diagnostic tests (when they attend the clinic), to avoid false uploads into a patient’s system.

3) General Visitor Access: This portal will allow any refugee (or any other visitors) to localize services, clinics and NGOs that particularly serve refugees around the place of resettlement.

The portal is authenticated through a fingerprint reader and allows access accordingly. Fingerprint reader devices can be plugged to computers, phones or tablets and are not hard to purchase. Simprints has already begun a pilot study using such devices for access of medical records in Bangladesh.

How did we do it

The website doesn’t use any pre-built framework and is made from scratch. The front end uses HTML, CSS, Javascript, and JS Libraries. The backend uses PHP and MySQL as well as AES Encrypting system. All patient’s data is encrypted based on their passwords as of right now, but will later be encrypted based on their fingerprint. We used Google Maps API, for enabling visitors look and find nearby clinics.

Finances

Refer to attached Budget image

Challenges

Implementation of this device at every point through the journey of a refugee and through different transition countries will be a challenge. That is why we decided to pilot the study at two sets of clinics in Lebanon (starting point) and Germany (end point), with the plan to expand this project to different countries at a later stage.

Another important challenge is wide adoption of this program by health care workers. We will have a basic training video available to learn how to use the portal. We will also have in-person training available, if needed. Seeing how refugee health services are concentrated in few free clinics, with many of those bound to big agencies like the UNHCR other local NGOs, the link between the two parts is there.

We are committed to protecting patient privacy at all levels. There is limited access to patient data without patient authorization through their fingerprints. Contact on the same device through fingerprints could be a challenge for hygiene and infection control between patients; insisting on using sterilizer after the patient gives their fingerprint in clinics is a necessity.

Regarding database size, since the Syrian refugee population is estimated at about 2-3 million displaced individuals worldwide, the storage space that is needed initially does not have to be very big, which reduces costs significantly.

What’s next?

We are looking to apply for government or private donor funding for piloting the project and then taking iRefugee to the next level. Once funding is obtained, we will apply trainings to 13 clinics in Lebanon on one side and in Berlin and its surrounding areas(Germany is the European country that hosts the biggest number of refugees). We will then purchase the devices and implement them in different clinics. Since the refugee population is condensed in one place, we will implement these devices, at a later stage, within the refugee camps (1 or 2 per site of relocation) with the presence of 5 smartphones per camp site. This will allow refugees to access, through a lending system, these phones opening the door to look for services around them and knowing how to access them.

iRefugee has a promising future, not only in its application to medical records and facilitation of access to services, but also potentially with research regarding refugee health. (i.e. a pop-up message could come on each patient’s portal asking them for consent of giving out their anonymous data to researchers who want to improve healthcare dedicated to these patients).

Finally, this could be a very useful tool for health care workers themselves, who could have, next to each disease they enter into the patient’s medical record, a link directing them to the current guidelines of treatment (in case they feel the need to refer to that).

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