Fondation Pierre Fabre

To deliver evidence-based, affordable, effective, safe and high-quality preventive and primary healthcare services

Main beneficiary country:
India

About the sponsor

Biocon Foundation

At Biocon, Corporate Social Responsibility (CSR) has been an integral part of business since inception. Biocon is engaged in providing sustainable solutions to address the myiad health challenges faced by the country through its CSR arm, Biocon Foundation. The Foundation is working towards empowering marginalized communities since 2005, with the vision of promoting social and economic inclusion of marginalized communities through impactful programs. The organisation is committed to innovation, affordability and access to healthcare. In line with this commitment, Biocon Foundation has, over the last 10 years, invested in various CSR programs for marginalized communities. Biocon Foundation is registered under the Indian Trusts Act of 1882, registration number is IV 410/06-07 dated August 9th, 2006. The trust is recognized under Section 80G of the Income Tax Act 1961. Registration under Foreign Contribution (Regulation) Act, 1976 on application dated 18th January 2011, Registration No. 094421528. The CSR Board approves the CSR strategies, budgets, plans, manage internal governance and play an oversight role with regard to compliance with the company’s policy. The CSR Committee identifies intervention areas based on the needs of the community, reviews policies, recommends budgets, monitors implementation of programs and reports the results to the board on a quarterly basis. Biocon Foundation has built a strong reputation for the quality of its programs and their impact in addressing the social, humanitarian and environmental challenges of India. To widen and deepen the reach of our programs, the Foundation is using technology as a force multiplier, and has embraced technology for healthcare delivery at various levels – through mobile phones, handheld diagnostic devices, digitized patient records, live dashboard and ICT-enabled smart clinics. The Foundation has also entered into public private partnerships (PPPs) with state governments to scale up various CSR programs. These initiatives have contributed to realizing the vision of empowering and integrating the underprivileged into the social and economic mainstream.

Activities :

- Delivery of preventive and primary healthcare through Primary Health Centres (PHCs), either directly or in partnerships with various state governments

- Information, Education and Communication to promote appropriate health-related behaviours in target population

- Use of ICT innovations in healthcare, which entails specific applications such as mHealth, Electronic Medical Records (EMR) system, state-of-the-art diagnostics and real-time dashboard

- Early detection through population-based screening and integrated management of chronic diseases like Diet-related NCDs, Cervical Cancer, Breast Cancer and Oral Cancer

- Maternal and child health services : ANC camps, Well women camps, Adolescent girl health education, Management of child under-nutrition

- Water, Sanitation and Hygiene (WASH) interventions : Sustained IEC alongside setting up community toilets, water purification units and sewerage treatment facilities

- Education: distribution of workbooks in government schools and construction/renovation of school buildings, school toilets and ladies hostel

- Environmental Sustainability : lake rejuvenation

- Rural Development : flood rehabilitation and rural infrastructure development

- Grant-in-aid to support social initiatives

Sector: Organizational: Communities, public authorities, NGOs, associations, foundations, etc.

Country of origin: India

The organisation has:

114
Full-Time Equivalents
114
Employees
0
Volunteer
1
Service provider

Initiative overview

Healthcare themes targeted

  • Mother and child health
  • Primary healthcare
  • Nutrition
  • Infectious diseases
  • Sexual and reproductive health
  • Chronic diseases
  • Cancer
  • Oral health
  • Mental health

Stage of development:

  • Routine project/operational

Area where initiative is utilised

  • National (in one country only)

Initiative start date

  • 07/10/2015

Financing

Financing method

  • Private (private investors, crowdfunding, philanthropy, etc.)

Economic model(s)

  • Donations

About the initiative

The ineffective primary healthcare system is an impediment to cater the healthcare demands in rural areas. An integrated eHealth platform like eLAJ has rarely been used at the primary healthcare level in India to collect information to improve health care processes and outcomes. The PHCs, supposed to provide the first line of defence against any disease in rural areas, is underutilized when secondary and tertiary centres are overburdened. Providing quality of care at the PHC level is crucial to reduce the patient movement by mitigating the burden of diseases at advanced stage. The Government of India has set up Indian Public Health Standards (IPHS) guidelines to help primary healthcare institutions in improving quality of healthcare. Unfortunately, only 14% Sub Centres (SCs) and 21% Primary Health Centres (PHCs) in India are working as per IPHS norms according to Rural Health Survey 2016. A study by USAID claims that only 45% of the public health facilities have ANMs and data entry operators who are trained to capture data on MCTS portal to track MCH indicators. The quality of healthcare services in PHCs and SCs are poor because the protocols and norms to dispense healthcare are not complied. In India, the disease prevalence also varies significantly, so it is crucial to collect sub-district level health information for local healthcare planning and implementation. Meaningful use of EMR/EHR can fill the gap of health information scarcity and medical compliance, and it can boost the competence of healthcare systems. Guidance in optimal use of the system, particularly in the effective use of data made available through electronic medical records, is needed to realize healthcare goals. The major barriers in the adoption of EHR/EMR in India are interoperability standards issues, lack of funds and shortage of suitable governance health policies. Biocon Foundation contributes to provide digital infrastructure for healthcare providers as well as patients. In doing so, the Foundation has initiated the evolution of health information technology in many States of India.

The solution supplements the bigger outpatient primary healthcare delivery system of the government. eLAJ as an eHealth model fits directly into the existing PHC infrastructure of the government with minimal modifications. The project aims to show the proof of concept to catalyse a movement for the adoption of eHealth at PHCs to practice evidence-based medicine. It has set the foundation on which different state governments are building EHR interoperability. 2 years from now, eLAJ should be integrated with various other health schemes and platforms including Telemedicine in order to synergize all the healthcare delivery platforms. Biocon Foundation is rendering support on several fronts to integrate eHealth applications functional in the health ecosystem of government with eLAJ in order to create a unified platform.

The e-healthcare model of ‘eLAJ Smart Clinic’ is an integration of preventive and outpatient primary healthcare services. The primary healthcare approach, early detection and case management, is effective in reducing morbidity and mortality from infectious and non-communicable diseases. It also involves a data driven approach with the help of an in-house Electronic Medical Record (EMR) system which enables our clinics to digitally record the patient encounter. A Multi-Parameter Monitoring (MPM) device records essential vital parameters and can be remotely accessed through a live dashboard. The EMR system helps in maintaining continuum of care, public health surveillance and disease profiles of different communities. It also empowers the decision makers to lead and manage more effectively by providing timely and useful evidence based interventions. The data is also amalgamated with the health delivery model to address the growing need of basic preventive and primary health concerns in the areas of Communicable Diseases, Maternal and Child Health (MCH), Diet-related Non Communicable Diseases (NCDs) and prevention of cancers (Cervical cancer, Breast cancer and Oral cancer) through special health camps. In the interest of fulfillment of proposal prerequisites, the literature will emphasize more on the component of Information and communication technologies (ICT) used in the healthcare delivery hereon.

Health Information System : eLAJ was launched in the year 2015, to harness the potential of Information and Communication Technology (ICT) tools, in order to transform the quality of primary healthcare. The idea behind ‘eLAJ Smart Clinic’ innovation project in the PHCs is to promote adoption of eHealth, health data exchange and interoperability. Under this initiative, Biocon has converted primary health centres into a comprehensive single point treatment facilities to provide systematic clinical consultation and essential diagnostics services. eLAJ Electronic Medical Record (EMR) system maps every patient with a unique identity and it allows to capture, manage and store vital parameters, diagnoses, lab tests, medications and other relevant clinical information on a secure server.

A few of the many standards of eLAJ system are as follows:

• Standardization of ICT tools and implementation specifications to enhance the interoperability, functionality, utility and security of health information

• Patient identifiers including Aadhaar (unique identification of Indian residents) with algorithms to match records

• Clinically valid and reliable architecture and functionality

• Accumulation of medical data of clinically relevant events and encounters

• Immutability to keep the original data intact; provision of editable version with audit trails

• Digital archiving and retrieval of medical records

• Strong security and data encryption to protect personal information from any unauthorized access and tempering

• Ownership of records with service provider on the behalf of the patient

• Disclosure of sensitive information only on patient’s authorization.

 

There are three interconnected workstations in the eLAJ system which includes Registration, Medical Consultation and Diagnostics:

• Registration : demographic details, addiction profile, past medical history and vital parameters (blood pressure, pulse, blood sugar, weight and pulse oximetry) recorded with the help of Multiple Parameter Monitor (MPM) device and stored at the local server

• Medical Consultation: identification of symptoms, provisional diagnosis, drug prescription, patient follow-up and referrals

• Diagnostics : more than 50 tests including cell count and biochemistry investigations performed at the primary health facility level, which are otherwise not available below secondary care The eLAJ system helps in the integration of workstations, and also commands process and flow of duties between these stations connected through an intranet. The one of its kind highly integrated PHC aid the patient in deriving the best experience from and organised framework of healthcare services. eLAJ is predominantly built using web technologies and the system integration with various devices is done using C++. The registration system, also acts as local server on which all the tools/services and the application are installed, is connected with Multi-parameter patient monitor (MPM620) device and store encrypted data. The doctor and Lab stations (clients) only require a browser to connect to the server system and not store any data. The devices used for eLAJ set up are MPM620, Computers, Biochemistry Analyser, Cell Counter and accessories. Once the data is synchronized to a secure cloud server, various analytics is done through dashboard.

Live Dashboard: The live dashboard is a distinctive feature of the eLAJ system, which organises data on a real time basis and presents at-a-glance as well as minute views of systemic statistical analytics with graphical display. The dashboard allows to monitor facility utilization, quality of care and disease trends. The disease trends also give an insight needed to plan a response in case of any disease outbreak and personalize the treatment for a patient.

Utility:

• Evidence-based clinical interventions and practices

• Improved overall quality and safety of care

• Improved clinical compliance

• Opportunistic screening

• Targeted health camps

• Optimized personal care

• Continuum of care

• Increased patient participation

• Disease surveillance and outbreak management

Extend : Biocon implemented the eLAJ project at four eLAJ Smart Clinics run exclusively by Biocon Foundation in Karnataka. The model has also been applied at the five Government PHCs in Rajasthan and 15 Government PHCs in Karnataka under Public Private Partnerships (PPPs). The intervention is serving a population of more than 6 lakhs living in rural areas, peri-urban areas and slums.

Fields of application:

Information, education and communication for behaviour change (IEC) - Patient monitoring and medical data

Target audience

  • Healthcare professionals and structures (hospitals, healthcare centres/clinics, health networks)
  • Sick people
  • Pregnant women
  • Children - adolescents (ages 6-18)
  • Young children (0-5 years)

Initiative objectives

  • Decreased mortality
  • Decreased morbidity
  • Reduced suffering
  • Improved treatment

Key figures

111964 Number of beneficiaries since launch

21000 Number of users per Month

Materials used

  • Computer
  • Connected objects

Technologies used

  • Internet

Offline use

Yes

Open Source

No

Open Data

No

Independent evaluation

Yes
evaluated independently

Partners

Department of Medical, Health & Family Welfare, Government of Rajasthan

Health: Healthcare professionals and structures

Department of Medical, Health & Family Welfare, Government of Karnataka

Health: Healthcare professionals and structures

National Health Mission, Karnataka

Health: Healthcare professionals and structures

Partners

Collaborators

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