A second wave of COVID-19 has spread rapidly in India, with more than 31.65 million people infected and more than 400,000 dead.1 As the world’s second most populous country battles the virus and tries to stem the tide of new cases, Cerner has helped clinics in India go digital to help them become more efficient.
In India, Primary Health Centers (PHCs) typically serve as the first point of access to a qualified doctor in the country’s public healthcare system, providing support for basic health needs for about 20,000 to 30,000 people.2 In 2018, India’s government announced a plan to update PHCs into health and wellness centers that could provide a range of preventative and curative services, rehabilitative services, palliative care and health education, as well as make them digital. Working with Karuna Trust, a Karnataka state-based non-governmental organization, Cerner helped digitize more than 35 PHCs with a suite of products, including the Cerner Millennium® electronic health record (EHR).
Digitizing these clinics required solving for unique challenges. Some PHCs are in areas where internet speeds are not adequate, so Cerner provided internet dongles with SIM cards to help boost the speed. Cerner also offered extensive training and support on computer functionalities and provided placards with translations of common chief complaints and medical terms in the local languages. Additionally, they helped reduce the amount of typing by enabling drop-down menus in solutions and reiterated those sections during training.
“Digitization of PHCs through Cerner products has empowered health staff to maintain EHRs of patients for ready reference. Our PHCs are now role models to other government centers,” said Hanumappa Sudarshan, MD, founder and secretary of Karuna Trust.
When COVID-19 cases first started to rise in India in April 2020, many of the PHCs were already using the Cerner EHR and were able to add new workflows for potential COVID-19-positive patients. The clinics created a digital COVID-19 triage form for patients to determine if they have symptoms and if they may be infectious. The registration clerk asks the questions and fills in the patient’s answers in the form during the registration process. The clinics also created a digital intake form for physicians to help determine if a patient was infectious and what to do from there.
Karuna Trust staff use a laptop while working with patients. (Source: Karuna Trust)
“COVID-19 risk categorization is an innovative product which Cerner introduced as a part of the EHR itself during the first wave of COVID-19. The patients were triaged into high-risk and low-risk categories for COVID-19 based on a self-assessment questionnaire. This helped minimize cross contamination and spread,” said Sudarshan.
Over the course of more than 13 months, the clinics triaged about 10% of the patients who came to the clinics.3
Cerner India also helped develop an app called CovSAFE for healthcare workers who were traveling door to door in remote areas to determine if families may be COVID-19 positive. The workers used the app to call a doctor who would talk to the families about dealing with symptoms and staying safe. It’s able to sync with the EHR to allow for data flow and can also generate daily consolidated reports. Additionally, the app served as a tool to help track the history of COVID-19 exposure in a community.
“The CovSAFE app helps our staff identify high-risk individuals or families during door-to-door visits. In addition to the early identification of patients with symptoms, it also allows for follow-up of these patients by our front-line workers. This helped enable early isolation of suspected COVID-19 cases and containing further spread,” said Sudarshan.
A healthcare worker goes door to door to speak with people about COVID-19 and to learn if they may be positive with the virus. (Source: Karuna Trust)
In 2021, with the second wave of COVID-19 spreading quickly, Cerner worked with Karuna Trust to set up large care centers and help with data capture. Cerner also assisted with financial support toward infrastructure setup as well as EHR support for the care centers. Additionally, Karuna Trust continues to use the CovSAFE app to reach rural populations and get them access to care through telehealth.
“Karuna Trust has a long-term partnership with Cerner. In the ongoing fight against COVID-19, Cerner has supported Karuna Trust with quick technological innovations," said Sudarshan.
Cerner India continues to work closely with clients in the country to further mitigate the spread of COVID-19.
“This is one example of how Cerner is committed to providing healthcare in India and modernizing India’s healthcare system while creating better health outcomes for India’s citizens," said Rama Nadimpalli, senior vice president and general manager of Cerner India.
1“India reports 41,831 new COVID-19 cases in last 24 hours - health ministry,” July 31, 2021, Reuters: https://www.reuters.com/world/india/india-reports-41831-new-covid-19-cases-last-24-hours-health-ministry-2021-08-01/
2“Indian Public Health Standards (IPHS) For Primary Health Centres,” March 2006, Directorate General of Health Services Ministry of Health & Family Welfare Government of India: https://www.iapsmgc.org/userfiles/4IPHS_for_PHC.pdf
3Based on clinic data from April 27, 2020, to May 21, 2021.