Preamble
With the introduction of a unique national Health ID by our honorable Prime Ministry during
his Independence day speech, the need for such a training program for staff on EHR and
telemedicine usage has even more pronounced
Background
Digital India is happening. Digital health, especially Telemedicine and Telehealth are an
integral part of the Digital India campaign. A National Digital Health Blueprint (NDHB) was
released in 2019 wherein emphasis was laid out in the adoption of an Electronic Health
Record (EHR) system for all clinical establishments. Actual usage of EHRs is less than 5% and
computerized hospitals only use billing, inventory modules of HMIS solutions.
There are approximately five lakh MBBS doctors in India, to which one can add two lakh
specialists and another eight lakh from AYUSH. Most have little or no grounding in EHRs and
more importantly, no time to learn or understand it. The COVID epidemic has made
telemedicine part of regular clinical practice but there is lack of confidence, on whether it is
sustainable.
As of March 26th this , year the Telemedicine Practice Guidelines were released which tried
to give Telemedicine provision a formal legal basis. As part of the requirement for adoption
telemedicine, the guidelines have made it mandatory for doctors to learn and understand
the processes that telemedicine entails. Many organizations including SATHI having stepped
forward to train these doctors. An important component for better adoption for
telemedicine is having a running an EHR system. Over and above usage in telemedicine,
EHRs help doctors for long term care efficiency, management of chronic diseases, team
approach , reseasech public health as well as health strategy. The government has been
trying since long to make for widespread adoption of EHRs. Use of EHRs requires some
training and understanding which is not taught even now in medical schools. Even in the
USA where EHR use has become mandatory, there are many complaints that patient care is
getting effected rather than improved as the data entry in the computer takes too much
time.
Directly training doctors on EHRs has challenges of lack of time and willingness to learn. We
propose to provide trained manpower to these clinicians. Not only will there be much more
time for the patient, there will be all the benefits as outlined above.
Almost every clinic has a few clinic helpers, receptionists, dressers with many of them
multitasking. Nurses are expensive and unaffordable for an average clinic. Even those who
do have a trained nurse, very few can take up tasks such as data entry. They also do not
understand the technical aspects of telemedicine. Shortage of trained manpower is
affecting growth of EHR as well as adoption of Telemedicine. A huge untapped demand for
such grass root level health workers exists and can be tapped at the school level. It can
hone skills, and in turn, help build a career in health care.
Stakeholders
Ion Foundation ( taken from https://www.ionindia.com/aboutUs/csr.asp)
VISION
To empower the economically disadvantaged towards social equality and to refresh
our environment.
MISSION
Initiate
To create awareness for the need to uplift the underprivileged sections of society
To encourage employee involvement by creating opportunities for meaningful contact with
beneficiaries
Organise
To support project responding to ‘felt need’ and having long term impact relating to
education, health and hygiene
To offer specialised expertise as facilitators
Nurture
To provide assistance to first generation learners, drop-outs, talented needy children
To integrate through holistic support, the underprivileged and special population, into
mainstream society
SATHI
SATHI ( www.sathi.org ) is a registered Not for profit society under the Delhi Societies
registration Act 1860 (regn No 49774/2004). Our members constitute Doctors, Engineers,
Sociologists and Corporate leaders who want to provide technical expertise for public good.
Our chief patron and mentor Prof Sneh Bhargava is a former director of AIIMS and current
director of Sitaram Bhartiya Institute. SATHI has a successful track record of community
health and telehealth projects. The basis of our success has been the sincere belief that no
technology can work without direct engagement and creation of capacity within the
community where it is to be deployed.
Objective
Any person working in a healthcare establishment is frequently the first level contact for the
patients. When an emergency occurs some knowledge of what needs to be done should be
existing as there are lives at risk. Another issue in these days of rising costs of
hospitalization, many persons prefer to stay at home and utilize telecare for low grade
medical help. But telemedicine cannot perform medical procedures – even the most menial
ones like put on the BP cuff or a finger prick for home based sugar testing. Having a family member who knows.
These small procedures can be a great help.
Adolescent children can be taught these skills which will primarily be helpful while working
at a clinic. These will enable them to earn a decent living. SATHI will train these children in
various healthcare services as well as telemedicine and basic processes followed in a
healthcare establishment. This will help them earn a living to become net contributors to
their families and the economy.
Mandatory requirements - computers, classrooms, faculty and other basic infrastructure.
This program is a long-term commitment from SATHI. We will manage the program for an
initial period of 2 years. Includes cost for content development and course materials which
can then be rolled out at many more locations through a Train the Trainers (TOT) program.
Cost of the program will expectedly come down later.
Future prospects for the students who participate in this
Better health support for their own family – like taking BP and pulse, giving injections, doing
a minor dressing, along with communicating live with doctors for remote support
Jobs at existing local health and dental clinics as medically trained help
Jobs as emergency medical technicians
Perform Life support and first Aid during local accidents and emergencies
May start their own telehealth supported centres in extremely remote areas ( A franchise
system will ensure quality)
Motivation to take up further training in Health sector like going for Medical and Nursing
careers
Curriculum
Items 1-4 are ready, work in progress for the rest
1. General and Health related applications (Assuming minimal basic knowledge of
computers)
1.1. Use of telemedicine software
1.2. Troubleshooting networking problems
1.3. Making a Hard copy/printing and hardware /software maintenance
2. Basics of data entry
2.1. Components of EMR/EHR
2.2. Understanding common Medical terms and acronyms
2.3. Importance of EMRs
2.4. EHR Standards (basics only)
3. Telemedicine
3.1. Online appointments
3.2. Video Consultation
3.3. Audio consultation
3.4. Capture basic patient data
3.4.1. Name, Age, Sex, History
3.4.1.1. KYC and Personal data protection
3.4.1.2. Anonymization protocols
3.4.2. Entry of Specialised measurements (e.g. Height weight. Temperature, SPO2)
3.4.3. Photographs & Address
3.4.4. Specialty oriented forms
3.5. Prescription approval and storage
3.5.1. Explaining the prescription- Frequency, duration, dose
4. Getting reliable information from the internet
5. Front Office Basics- Online offline Q Management doctor/ specialty wise
5.1. Reception management
5.2. Managing appointments
5.3. Crowd management
6. Basic Clinical procedures
6.1. Finger prick test for Blood sugar
6.2. Blood Pressure
6.3. Handling Biomedical waste
6.4. Basics of wound and dressings
6.5. Rationale behind Sterility and no touch technique
6.6. PPE and self- protection against hospital acquired infections
6.7. Assisting with plaster application and cutting
6.8. Assisting with suture application and removal
6.9. Putting ear drops/ eye drops
6.10. Understanding signs& symptoms of collapse
6.11. Lifting and shifting of patients
6.12. Managing wheelchair and stretcher patients
6.13. Bandaging and other first aide measures
6.14. Applying slings and splints
6.15. Managing clean and sterile consumables
6.16. Awareness about Handling spills. Sharp injuries
6.17. Basics of Decontamination of used instruments
6.18. Cleaning guidelines
7. Inventory upkeep and accounting of all assets, consumables and other items
8. Public Good Samaritan
8.1. Emergency management - road accidents
8.2. Basic Life Support including CPR
8.3. Maintaining helplines
8.4. Triaging patients
Training Plan
1. Batch size – 30
2. Consecutive Batches -2
3. Batches/year -4
4. Course duration- 25 weeks
5. Online training for 2 hours each day, 5 days a week
6. Practical face to face training for 3 days on each subject
7. Kit for each student
8. On the Job Training (Internship) for every student – 4 weeks
a. Need to identify locations
9. Certification by skill sector council (NSDC)
Responsibilities
Partner Agency
1. Fund the program
2. Participate in meetings with the local health centre/school management
3. Monthly review of progress
4. Publish report and findings on organization website
5. Sign MoU with SATHI
SATHI
1. Training Platform
2. EMR and Telemedicine Software to be used for training
3. Develop Content
4. Check for basic infrastructure, student profile, number of students, connectivity,
computers etc.
5. Register and Train students
6. Arrange medical kits
7. Hands on Practical Training
8. Evaluate students and get them certified by the sector skill council
9. Support Placement - Register trained students with Government and Private
Enterprises for employment
10. Regulatory and Compliance Requirements
Jointly
1. Identify school /health centre for pilot
Financials
1. Total number of students– 240
2. Cost/Student - Rs. 26000.00
3. Taxes as applicable
4. Includes out of pocket expenses
5. Cost is based on project site being in New Delhi – but can be shifted as long as TA DA
can be arranged