The legacy system existed as a simple database system which allowed for recording of patient related data and simple display. The idea was to initially migrate the application data into a CMS based system that would make basic features related to data entry, notifications, centre specific visibility seamless. The focus was also speed as migration from a simple database to advanced CMS system could lead to site being slow.
We proposed Drupal due to its robustness and its ability to extend using modules. Migration API helped us a great deal in ensuring successful migration. We worked on several caching mechanisms, finally zeroing on APC caching as it was a simple installation and configuration and provided great speed benefit. We started plugging in various features once the normal operation of work became seamless. Features like Document Management, Inventory, Quality Assurance System, Incidence Management, Outcome Analysis, Competence Management, Support desk, Event Management, Todos, Forum were added in iterations to make the system truly comprehensive.
As of February 2014, over 2400 patients have been registered and 112 BMTs have been performed with outcomes comparable to international standards, but at a fraction of the cost. The tool contributes to local healthcare strengthening and competitiveness thereby minimizing medical emigration.
Scientific Papers and Presentations
- Our paper "A prospective international cooperative information technology platform built using open-source tools for improving the access to and safety of bone marrow transplantation in low- and middle-income countries" has been published in The Journal of the American Medical Informatics Association(JAMIA)
- Our paper "Hematopoietic stem cell transplantation quality management support through a dedicated web-based application" has been chosen for oral presentation at the "40th Annual Meeting of the European Society for Blood and Marrow Transplant"
- Enrolment : Enables capturing enrolment data, general medical evaluation, disease-specific summary, notes, socio-economic profile etc.
- Selection: Tracks the process of identifying and screening potential donors.
- Preparation: Enables and tracks the process of scheduling, conditioning and preparing patient for transplant.
- Transplant: Daily clinical forms allow monitoring through pre and post-transplant phases including vital signs, lab reports, transfusions, medications, complications, nursing notes, as well as, consultant's notes.
A clinical form with tabular display of essential daily parameters (weight, maximal temperature, blood counts, liver and renal function tests) to be monitored during the critical phase of BMT enabled at-a-glance clinical assessment. The system also offers charts plotting height and weight z-scores based on 'The WHO Child Growth Standards', which is very relevant for both pre-transplant and follow up assessments. Enables consultants and other professionals, including multidisciplinary experts who may not be available locally, from various collaborating centers to share knowledge and provide general as well as patient-specific advice.
Notifications and Alerts
- Generates statuses related to relevant parameters such as lack of critical pre-BMT tests, requirement for an evaluation within a defined time from BMT or relevant alerts, e.g. allergies, hepatitis or HIV positivity.
- The system warns of any critical enrolment data missing, tracks BMT preparation status, monitors post-transplant critical parameters and highlights any abnormalities including missed labs.
- Follow-up height and weight according to standard growth curves is monitored.
- Each time there is a change the concerned individuals are immediately notified by email.
- Periodic emails are sent to the concerned individuals indicating the status of the patient on all parameters that need attention.
- The tool enables development, implementation and assessment of quality system in accordance with FACT-JACIE. It systematically highlights the areas where progress is being made and opportunities for improvement.
- Enables status tracking of the organisation on the compliance to each standard listed in the accreditation checklist
- Automatic triggers for standards that need to be re-evaluated
- Enables distribution of responsibility and accountability for maintaining a quality assurance scheme.
- Provides both high and low level view of areas that need attention on a real time basis.
- Records personnel’s name and employment related information
- Job descriptions for all personnel including their responsibilities, authorities, and position requirements (e.g. degrees, skills, experience, training) - periodic review of same.
- Periodic competency evaluation target critical job functions
- Mechanism to document and to provide opportunities for continuing education related to job position
Inventory and Costs
- Tracking, monitoring and storage of materials and reagents
- Automatic alerts when stocks reach configurable reorder level
- Enables tracking and prevention of expiry
- Provides insight into patient wise, vendor wise, date wise and item-wise costs
- Provides option to maintain multiple store locations
- Supplier details, agreement and service history.
- Invoice generation
Private, Confidential and Reliable
- The electronic records offer accuracy, integrity, identity, and confidentiality.
- Fast retrieval and review of critical information for emergency intervention.
- Limited access to only authorised program personnel based upon user and role specific permissions.
- Multi level back-up and option to restore old records. (Backup at remote servers included)
- Enables change tracking and records identity of users making changes
- In-built support desk and in-line system documentation
- Designed for minimise faults by using submission validation, preview etc.
- The platform can operate in a stand-alone or a multi center mode.
- Multi-center mode allows for usage of common protocols, procedures, quality management systems, and review of clinical results and regular interaction.
- Allows for involvement of remote professionals for consultation and monitoring.