Executive Summary

The primary objective of this project is to develop a reliable, efficient and easily deployable remote patient monitoring system that can play a vital role in providing basic health services to the remote village population of Pakistan at their door step. This project is proposed inline with the Millennium Development Goals (MDGs)* planned by the United Nations Development Program (UNDP).

The aim is to design a generic remote health care system with a focus on antenatal care, and use advancements in Information and Communication Technology (ICT) to develop a monitoring system that could enhance the quality of health care provided by the lady health workers. The proposed system will be able to gather the physiological data, transmit it, record it, find any abnormality and then assist the doctor in the decision making process.  The lady health worker is required to attach the data gathering module to the patient’s body using wearable straps etc. provided with the module. The module (consisting of medical sensors) will record the patient’s data and forward it to the PDA through a wired channel (e.g. USB or serial port). The PDA will contain an application for local monitoring of patient’s data that would display the current readings. When all the readings have been taken, the PDA will connect to a remote server and transfer the data to it. The remote server will process the data, invoke the Clinical Decision Support System to perform analysis of data, invoke the Electronic Medical Record service to record the readings in the patient’s history and provide feedback to the PDA screen notifying the decision given by the Clinical Decision Support System. The PDA carried by the lady health worker acts as a base station for transmission of patient’s data to the main server in the hospital. Its software part consists of a device driver for detecting and handling data gathering layer, and a local application interface which displays the gathered data for local monitoring and sends it to the main server for medical analysis. The feedback from server is displayed on the PDA. The PDA also provides an interface for entering patient’s data manually or reading it automatically using the patient identification system.  

The whole system cannot be efficiently developed without its deployment in a practical scenario. This practical deployment will also help in regular evaluation of the system and will lead to its further improvement. For this specific purpose, a controlled population group of pregnant ladies will be setup along with the expert advice of doctors from a teaching hospital. For this purpose, the evaluation framework has a setup based on following two organizations: Human Development Fund (HDF) and Rawalpindi General Hospital (RGH).

To evaluate the performance of the proposed system, performance indicators have been defined. The evaluation framework will evaluate the system deployed in the controlled population group on the basis of these indicators. These performance indicators include increase in lady health workers’ capacity, number of correct referrals, reduction in complexities in birth process through timely preventive measures, amount of correct information available during emergency cases; and ultimately reduction in infant and maternal mortality ratios in the controlled population group.

The rationale of this approach is to provide low-cost and reliable solution to the problem of provision of expert health care to patients in remote areas of Pakistan. The development of the project is focused on the health sector’s needs.

The venture will have the following advantages:

• Quality of life of majority of Pakistan’s population living in rural areas shall improve as a result of this project as health care services will be provided to them at their doorsteps.

• Health Care Organizations and hospitals will be able to deploy this low cost and highly reliable infrastructure in the areas where there is none at present. This would result in an increase in the quantity as well as quality of service of the overall health service being provided in the country.

• By taking advantage of this newly designed system based on technological revolutions in the field of communications and embedded systems, the government of Pakistan would be able to realize its vision of providing medical facilities to all of its citizens in a cost efficient manner.