Med Intelligence

User Roles and Access

• The Med Intelligence application is configured to support the following user roles:
  1. Clinician (Doctors & Nursing staff)
  2. Clerical
  3. Diagnostic Technician
  4. System Administrator
• Screen level access and functional permissions can be specified using the user role administration functionality.

Security and Confidentiality of Information

• Med Intelligence software deals with highly private and confidential medical data pertaining to patients which may be regulated by specific legislation in the country deployed. There may also be issues or concerns related to movement / transportation of medical data within national and across international borders.
• Med Intelligence software will need to be deployed within secure client infrastructure environment. The end client will own and all medical data within the system and will be responsible for ensuring
  appropriate information security policies and practices and put in place to secure the clinical data stored within the system.
• Use of 128 bit (or 256 bit) encryption for data movement inside and outside the DMZ firewall is under consideration.

Application Performance and Usage Load

• Application performance and response time for the initial deployment release will be optimised for 10 hospital sites with a maximum 500 users.
• The software deployment is expected support about 10 to 50 users in the proposed 10 hospital locations.
• The application will be architected to for optimal software performance with up to 100 concurrent users within the above deployment scenario of maximum 500 users.
• The enterprise version of the application will be scalable and capable of supporting up to 10,000 users in about 700 to 1,000 clinical locations.

Usability Engineering Features

• The Clinical Management component of the software deals with the effective and efficient support of the diagnosis, treatment and management of diseases such as HIV / AIDS, STI, TB and Malaria leveraging information technology based systems.

Key usability features of the Med Intelligence software include:

• • Ease of use through intuitive, user friendly and efficient User Interface. Intuitive screen / works flows will increase efficiency and ease of use.
  • Calendar / Diary scheduling functionality for medical appointments.
  • Context Sensitive “Help” functionality to aid user training and ease of use.

Multi-Language Support Capabilities

• The application will support English and French user interface for multi-language capabilities.
• Reporting and Analytical Capabilities

The Medical Intelligence component deals with software capabilities such as:

• Reporting of individual patient data pertaining to diagnosis and treatment outcomes captured using the system
• Aggregated reporting of data pertaining to diagnostic and treatment outcomes by demographic slicing to support analysis and pattern recognition

Reporting & Analytical Capabilities:

1. By Geography, location, postal code, etc.
2. Demographic slicing for analytics by:
   • Age
   • Racial group
   • Sexual Behaviour / Preference
   • Socio Economic Distribution
   • Education / Profession
   • Employment Status
   • Marital Status
   • Alcohol Consumption / Abuse
   • Recreational Drugs Consumption / Abuse
3. Analytical Reports to support prevention strategies and related pattern recognition
4. Historical success and failure rates, and related reasons, correlations etc.
5. Analytical Reports to support Treatment Strategies and related  pattern recognition.

1. Log-in and Security
   Log in: Password protected.
   Enables you to keep track of the clinician who made the entry
2. Main Menu
   Enable you to choose the 4 main user roles and related functionality.

1. Clinical details
2. Diary
3. Clinical report
4. Maintenance

Clinical detail:

• • Provides Easy & quick access to individual Patient Record

Diary:

• • Daily clinic activities
  • All clinics for the day are clearly identified
  • Patient flow through the clinic from arrival to discharge is highlighted by different symbols, which helps to locate patient within the clinic.

Clinical Reports:

• • Most of the relevant information is recorded from “drop down” boxes — helps to create many reports valuable to clinicians and administrators.
  • Essential reporting facilities are programmed thereby enables the health care team to obtain report with a click of a button.

Maintenance:

• • All essential tools to run this programme is accessible to add new information. E.g. A new drug could be added to the list of drugs.
  • Different user levels give different access to programme.
    This helps to prevent “interference” by healthcare professionals with individual records.
  • Enables one to nominate selected individuals to have administrative rights so that new information can be added.

3. Patient Record:
Every patient will have a unique sheet with multiple subheadings, designed in a very user friendly way following a standard method of how a patient journey will take place. Separate sheets are designed for male & female.

4. Patient Details
Obtain patient demography and other relevant information essential in patient management.

5. Current Entry – History
Current: enables one to record clinic visits in the order a medical consultation will take place.

6. Sexual History:
Drop down boxes for all relevant questions.

7. HIV Risk Assessment:
Drop down boxes for all relevant questions which will alert the clinician of potential risks.

8. Medical History:
Free text to record relevant details.

9. Examination:
Drop down boxes of relevant examination sites are displayed with space to write free text.
Diagrams for male and female genitalia are provided with facility to mark abnormal physical signs.

10. Tests:
Drop down boxes are provided to indicate tests carried out. This enables clinicians to access upto-date test results while the patient is in consultation.

11. Diagnosis and treatment:
A list of diagnoses is provided with appropriate treatment.

12. Management:
Overall management plan can be recorded

13. Follow up:
Provides sheets for free text to add during patient follow up visits

14. HIV – History Sheet 1:
Records date of diagnosis, route of transmission and other relevant medical and social factors.

15. HIV – Antiretroviral Therapy Sheet 2:
Record of all antiretroviral therapy, date of initiation, date of discontinuation and the reason for stopping therapy.

This information is important in the decision process for future line of therapy

16. HIV Review:
Records HIV markers and other relevant investigation with free text for follow up notes.

17. Booking History
Patients’ entire visits can be viewed.

User Friendly:

• Various levels of healthcare workers can use it without much difficulty.
• Users with administrative capability can add new lists without assistance from IT personnel

Paperless System:

• No loss of notes
• Significant savings on time to prepare clinical notes
• Records always available when seen in the Clinic
• Easy to Audit and monitor clinical governance

Recording Notes:

• Frequently asked questions as drop down boxes. This helps quality of information.
• Prompts appropriate history taking, examination & investigation.
• Diagnosis of each episode recorded correctly by all users.
• Standard treatment for each diagnosis as per guidelines provided as drop down boxes.
• Prompts to record full management plan.

Reporting:

• Essential reports are predesigned and tailored to the requirement of the users.
• This enables the user to produce various reports within minutes.

Infrastructure Requirements and considerations at Client Deployment Sites

• The MED Intelligence software is a client server application and requires (as a minimum) at each hospital site where the software is deployed, a secure Local Area Network (LAN) infrastructure.

Considerations for Deployment at Multiple Client Sites

• For the 1 database model to work for 2 (or more) geographically dispersed hospital sites there should be secure network connectivity between the 2 (or more) hospitals and the main hospital where the database and application server is hosted. They will need to have a Virtual Private Network (VPN) between all the hospitals and the location where the database server and application server is hosted.
• For example, in an implementation scenario where the software is to be deployed at 10 different hospital or clinic sites. If no VPN / secure network connectivity is available, then we would need to
  install 10 instances of the database and application at each hospital site that uses MED Intelligence software. The downside here is then there won’t be a consolidated database of all 10 hospitals
  clinical data.
• However, in this scenario we can look into software design alternative and/or other client manual processes that enable consolidation of clinical information for reporting purpose. A software solution by MedGlobal Health will require additional design and development effort and must be priced separately (not part of current contract proposal) based on the client specific infrastructure scenario at the hospital deployment sites.

It is not recommended deploying the software using an unsecure public internet cloud (without a secure VPN) to access the application / database due to privacy, confidentiality and security considerations and concerns related to STI / HIV / AIDS related data, general medical and private patient information.

Local Area Network (LAN)

• A Local Area Network (LAN) is a secure computer network that interconnects application server hardware, database servers, storage devices, personal computers and mobile laptops and notebooks in a limited area (generally not exceeding 1 km) using network media and connectivity devices. LANs are used in homes, schools, computer laboratories, office buildings and hospitals. The defining characteristics of LANs, in contrast to Wide Area Networks (WANs), include their usually higher datatransfer rates, smaller geographic area, and lack of a need for leased telecommunication lines.
• Ethernet over twisted pair cabling and Wi-Fi are the two most common networking technologies currently used to build LANs. However, ARCNET, Token Ring and other technology standards have been used in the past.

Virtual Private Network (VPN)

• A Virtual Private Network (VPN) is a secure network that uses primarily public telecommunication infrastructures, such as the Internet, to provide remote offices or traveling users an access to a
  central organizational network.
• VPNs typically require remote users of the network to be authenticated, and often secure data with firewall and encryption technologies to prevent disclosure of private information to unauthorized parties.
• There are two types of VPNs; remote access VPNs and site-to-site VPNs. Remote access VPNs are for individual users who are not in a fixed location (e.g. remote or roaming users like doctors or
  medical staff working in the field). Site-to-site VPNs are for multiple users in a fixed location (e.g. like regional offices or hospitals.