The Problem

Introduction

Ensuring a healthy life and promoting well-being at all ages is important to build prosperous societies. However, despite great strides in improving people's health and well-being in recent years, inequalities still persist. More than six million children die before their fifth birthday each year, and only half of all women in developing regions have access to the health care they need. Epidemics like HIV/AIDS thrive in places where fear and discrimination limit people to receive the services they need to live healthily.

From Paper Records to EHR to Hippocrates

Standard paper records can be compromised in two ways: by being misplaced or being stolen (in the unlikely event of a break-in). On the other hand, traditional EHRs are at risk due to the increasing prevalence of cyber attacks. Hippocrates distributed technology stores an immutable version of the latest patient´s passport in a block of the Ethereum Public Ledger, which does not give any opportunity of compromising the sensitive data without reverting the entire Ethereum blockchain.

One of the biggest gripes against traditional paper records is that they are incredibly tedious to access and share. Obtaining a paper record involves, firstly, having to find it — possibly within a mound of files — and then, either mailing, faxing, or scanning the copies. On traditional EHRs, patients and medical staff can access information electronically. Hippocrates uses the best of both systems in a decentralized environment by establishing a private offline network using IPFS, managing the state of the medical records through smart contracts and granting access through a physical paper (with a QR code) without the need to use any technology resource.

A practitioner’s penmanship is often tough to read and decipher, and very easy to misinterpret. Paper records are also notorious for not providing enough space for a practitioner to write everything down legibly. Using Hippocrates, notes can be typewritten without regarding space and legibility.

Insight of a specific case

Holiday camps for disabled people of all ages in Chabrouh, Lebanon

The Lebanese Association of the Order of Malta (LAKM) is the primary health provider via 4 mobile clinics for more than 200,000 individuals, including up to 40,000 in Akkar. The large majority of users (95%) are Syrian refugees, a disadvantaged and vulnerable group with highly complex medical and psychological needs - but have limited medical documentation.

This makes it challenging for camp volunteers to provide the best possible health care. The service faces several operational challenges:

• Patients with complex medical needs.
• Limited resources and limited links to specialist care.
• Reliance on paper records.
• Difficult to monitor clinical activity and expenses, and to produce reports.

Paper Records | Challenges

Logistics:

• Organising records for transport takes 1 hour each day.
• It takes 3 hours to transcribe clinic activity into a separate database for subsequently reporting and analysing.
• Management must prepare reports manually.
• Finding or creating new medical records for patients onsite is a time-consuming and manual process.

Limited Data:

• Paper records capture limited clinical information.

Paper records are only able to capture very limited medical information. Getting a patient’s complete medical record from their notes is difficult, and records do not have a ‘summary’ page. These factors slow down medical care and have an impact on the quality of the care they are able to provide. Low-resolution data also affects the Order of Malta’s ability to track medical activity, costs and demands on the service. When data are transcribed, the information is grouped into broad categories only.