Human capital shortages
Poor skill levels of staff
Unavailability of diagnostic tests
Stock out of essential medicines
Poor quality of infrastructure
Absence if connectivity and digitized data
Poor systemic accountability
Poor availabilty of care
12 services
1. RMNCH+A
2. Communicable Diseases
3. Non-communicable Diseases
4. Expanded Services
5. Linkages to specialty care
Innovations
1. Tele-health
2. Electronic Health Records
3. E-Rx and medicine vending machine
4. Large range of diagnostics through POCDs
5. Essential NCD screenings
6. 24-hour access
7. Digitized Inventory management
Results
1. Improved Access
2. Reduced out-of-pocket expenses
3. Improved quality of care
4. Reduced burden on secondary & tertiary level healthcare facilities
Human capital shortages
Poor skill levels of staff
Unavailability of diagnostic tests
Stock Out of essential medicines
Poor quality of infrastructure
Absence if connectivity and digitized data
Poor Systemic accountability
Poor availabilty of care
12 services
1. RMNCH+A
2. Communicable Diseases
3. Non-communicable Diseases
4. Expanded Services
5. Linkages to specialty care
Innovations
1. Tele-health
2. Electronic Health Records
3. E-Rx and medicine vending machine
4. Large range of diagnostics through POCDs
5. Essential NCD screenings
6. 24-hour access
7. Digitized Inventory management
Results
1. Improved Access
2. Reduced out-of-pocket expenses
3. Improved quality of care
4. Reduced burden on secondary & tertiary level healthcare facilities
The d-HWCs are completely aligned with Indian Public Health Standards (IPHS) 2022 Guidelines, and the centers are modeled as per the National Health Policy (NHP) 2017. Our model of d-HWCs addresses preventive, promotive, basic curative, and rehabilitative healthcare needs
LEHS|WISH operates 100 d-HWCs across 4 states i.e. Rajasthan, Madhya Pradesh, Uttar Pradesh & Assam wherein the division demonstrates and positions this universal solution clubbed with unique learning across primary healthcare structures. The model leverages the Government’s existing deployed Manpower, Supplies, and Infrastructure. The d-HWCs deliver twelve essential primary care services to the last mile. Systemic gaps are addressed by leveraging innovations in technology and service, including telehealth, EHR, e-Prescribing and medicine vending machines, essential point-of-care diagnostics, digital inventory management tool to reduce stock-outs and pilferage, and linkages to India’s universal insurance scheme (PMJAY).
The telehealth solution demonstrates a twin approach i.e. beneficiary-to-provider as well as provider-to-provider interface for tele-consultations with general and specialist RMPs thereby creating triaged referral resulting in reduced burden on the secondary and tertiary healthcare facilities as well as enhanced access to assured services as envisaged under Ayushman Bharat.
The SWASTHYA ATM, an Automatic Medicine Dispensation system through QR code on e-prescription provides for enhanced drugs as per the EDL mandated for the primary health care even at the sub-centers even in the absence of the pharmacist fulfilling legal adherences as well as resulting in reduced OOPEs across communities.
The EHR integrated with POCDs provides diagnostics as well as screening mechanisms within the primary health care system across services as well as at the hub for informed decision making thereby further enabling provisional diagnosis significantly impacting the OOPEs of the Bottom of the pyramid (BoP) population as well as enhanced access to appropriate cure. EHR is equally a robust system capturing the patient socio-demographic and clinical history creating a beneficiary electronic record. This helps in generating the epidemiological profile for the population and has the potential to be linked to higher healthcare research needs for futuristic health sector planning and management creating an impact on healthcare financing.
The d-HWCs have a structured support mechanism for geo-time tabbed digitized supervision by district officers at a pre-defined / need-based frequency assuring critical clinical, SCM, product, and operational quality assurance within facilities are reviewed on a real-time basis at state & national level.
The Health Care Providers through a digital ticketing system are able to raise concerns/issues within facilities on real time. These tickets are then directed based on category for immediate resolve. Analysis on TATs, and pendency’s with factors/reasons provide insights for mid-course correction as well as optimal operations within facilities.
| Sr. No | Measurable Progress/Performance | Since Inception to YTD |
|---|---|---|
|
1 |
Total Consults (Since Inception:) |
395935 |
|
2 |
Specialist Consultation |
34.2% (135376) |
|
3 |
Episode Status(repeat patients within the d-HWCs) |
15.7% (62345) |
|
4 |
Referrals (referred to higher facilities through tele consults) |
4.2% (16,491) |
|
5 |
Diagnostic(beneficiaries were prescribed diagnostic tests) |
11% (43,598) |
|
6 |
Access Equity (females are accessing teleconsultations) |
54% (2,14,444) |
Consultations access disaggregated by age:
| Age groups accessing facility services (in percentage) | ||
|---|---|---|
|
0 to 5 years: 8.9 |
6 to 9 years: 5.4 |
10 to 14 years: 8.1 |
|
15 to 19 years: 7.6 |
20 to 24 years: 7.7 |
25 to 29 years: 8.7 |
|
30 to 49 years: 26.9 |
Above 50 years: 26.7 |
|
1. Out-of-Pocket Expenditure: 6%-point reduction can be seen at CHCs indicating a reduction of burden i.e. crowding at higher facilities as well as impacting OOPE’s.
2. Acceptability:
3. Effectiveness: 87% of the tickets generated were resolved (operational efficiency) as per the mandated TATs across the states.
4. Service Utilization
