FDHS Application Requirements for Handset

Revision History
Date Version Change Author
Sep. 7, 2008 0.1 Initial draft Ravi Nistala
Sep 30, 2008 0.2 Updated after demo Ravi Nistala
to Dr Balaji
Sep 31, 2008 0.3 Updated after Ravi Nistala
internal review

Introduction to FDHS
Fixed Day Health Service is a rural health program aimed at reaching out to villages so
far unconnected to basic health services. This service is being started from Andhra
Pradesh, India.

The service is delivered via Vans equipped with tools and workers skilled at providing
basic health services. Focus is on care for pregnant woman, infants and people with
chronic diseases.

The Process flow diagram below presents a simple view of the system. Each of the solid
boxes in the diagram is mapped to a manned counter in the real world situation.
Functions of these counters are described below.
 All patients
enter here
Registration

Weight-Height

Pregnant Woman
Chronic Diseases
and Infants Care

All patients
exit here
Lab Tests Medicines

Registration
All patients first get registered with their information at the registration counter. A
photograph is taken and thumb impression scanned. The thumb impression is used at late
occasions to establish and retrieve identity of the patient if required. At this counter all
patients are initiated to receive service. An OP Form is initiated here. This form travels
through the remaining counters. The longest queue of patients is seen at this counter.

Weight-Height
At this counter all the patients get their weight and height measured. The OP Form is
updated. Patients are directed to the next counter based on the patient type – Pregnant
woman, infant, child, chronic disease etc.

Pregnant Women and Infants

At this counter, measurements specific to pregnant woman, infants and children less than
five years old are taken. If any diagnostic tests are required, the patient is directed to the
Lab Tests counter. For any medicines to be dispensed, the patients are directed to the
medicines counter. The OP Form is updated.

Chronic Diseases
Chronic diseases are diagnosed and treated at this counter. A new form is started here
capturing details of illness in addition to generic patient information. Patient is directed
to the Lab or the Medicines counter as needed.
Lab Tests
Samples are collected at this counter. A new form is initiated capturing patient details
and details of the test performed. Patient is sent to the medicines counter as indicated at
the earlier counter.

Medicines
This is the last counter. All the forms created till this point, are collected here.
Information of medicines dispensed is captured in a log here. All the information is later
keyed into the PC to be submitted to the central database. Medicine is dispensed at this
counter.
Objectives
The above described system is being analyzed for automation opportunities with the
following goals:
• Low cost
– To develop and deploy
– To monitor and manage
• Efficient
– Number of patients handled per hour
• Scalable
– Can be expanded or contracted based on local needs
– Can adjust to spikes in certain kinds of patients
• Dignity
– Multiple ways to recognize the patient
– Short Queues
• Reliable
– Accuracy in Information management
– High degree of system availability

The above objectives shall be achieved by replacing paper forms in the current system
with smart phones. These phones shall carry applications designed to perform the counter
tasks electronically. This document describes requirements for the applications running
on the handsets. Application specific screen shots provide further clarity on the role of
each counter.

Glossary of Terms
1. Registration – New patients coming to the FDHS location for the first time undergo
Registration and receive a Patient ID card.
2. Sign-in – Patients arriving at the FDHS location Sign-in to the system on each visit to
receive service.
3. Sign-out – Patients after receiving service are formally released from the system by
being Signed-out.
4. Counter – Manned by an FDHS worker, a counter provides a specific service.
5. Counter Type – The service provided at a given counter is defined by the Counter
Type. At present the following Counters Types are defined in the FDHS system –
Registration, Height-Weight, Pregnant woman, Chronic Diseases, Lab tests and
Medicines.
6. Patient ID – A numeric ID issued to each patient upon registration.
7. Patient List – A list of patients waiting to be serviced at a given counter.

Registration, Patient-List, Sign-in and Sign-out

All Patients are registered into the FDHS system with their personal information,
photograph and thumb impression. A Patient ID card is issued to the patients after
registration. The Patient ID printed on the card helps in quickly identifying the patient.
Repeat patients are entered into the system using their patient ID. Patients who do not
bring their Patient ID card are identified based on their thumb impression and name.

FDHS_REQ_1. All patients arriving at the FDHS location shall be put in a

patients-list. This is called Signing-in. They stay signed-in until they are completely
processed and Signed-out.
FDHS_REQ_2. Patients carrying their patient ID can be added to the patient-list
from any of the counters.
FDHS_REQ_3. Each counter shall have a view of the patients-list showing names
of the patients due at that counter.
FDHS_REQ_4. Each entry in the Patient List shall include – Patient Name,
Photograph, and Form data relevant to the counter.
Note: Size of photograph needs to be small to ensure fast transmission over BT.
FDHS_REQ_5. Selecting a patient from the patient list opens up the patient record
and forms as applicable to the counter.
FDHS_REQ_6. Each counter shall be able to select the next counter-type for the
patient to go to.
FDHS_REQ_7. A patient selected for a given counter type shall be assigned to an
actual counter based on the load at each of the available counters of the same counter
type.
FDHS_REQ_8. A list of counters is available to each handset to send the patient to.
FDHS_REQ_9. Each counter shall be able to sign-out a patient after service has
been completely delivered.

Counter Specific Requirements

FDHS_REQ_10. Each handset shall be able to assume role of any of the service
counters.
FDHS_REQ_11. Each handset registers with the laptop when it assumes a counter
type.
FDHS_REQ_12. Forms shall be presented at the handset based on the assumed
counter type.
FDHS_REQ_13. More than one handset can assume the role of a counter type.
FDHS_REQ_14. Each counter shall be able to update the patient information as
applicable at the counter. The data can be immediately committed to the database on
the laptop.
FDHS_REQ_15. Personnel at each counter can record voice and store special
remarks for each of the forms.
FDHS_REQ_16. Each counter can retrieve data entered the same day and edit it.

Language Requirements
FDHS_REQ_17. The application interface language can be localized.

Maintainability Requirements
Each counter uses forms to receive patient information. These are actual paper forms at
present. After the automation, the paper forms shall be replaced with electronic forms.
The content of the forms shall be contained in the central application residing in the
computer. There is no form content on the handset application.

FDHS_REQ_18. Application shall be independent of the form content at each of the

counters. It shall be able to present new questions if they are added to any of the
forms.
FDHS_REQ_19. Form versions used on the handset application shall be reported by
means of a simple version query.
FDHS_REQ_20. Handset application shall be updated with the latest versions of the
forms when the handset registers with the laptop.
NOTE: If some questions are deleted or modified in any of the forms, those shall be
reflected in the application after it registers with the laptop. There is not user action
required to update the forms.
NOTE: The laptop application shall be provisioned and updated over the network.

Performance Requirements
This system is being designed to handle a large number of patients very efficiently.
Ability to handle a large number of patients very efficiently is key requirement.

FDHS_REQ_21. The application shall be able to handle up to 100 patients in the

system at the same time.
FDHS_REQ_22. Latency of data transfer between the handset and central database
application shall be less than 5 seconds.
FDHS_REQ_23. The system shall scale to handle up to 16 simultaneously operating
handsets connected to one laptop computer.
FDHS_REQ_24. When multiple handsets assume the role of the same counter, the
counters act in a load balancing way such that patients are automatically transferred
to the counter with fewer patients.
FDHS_REQ_25. Total time spent by each patient between Sign-in and Sign-out
shall be recorded. The handsets shall share the timing information with the laptop
application for every sign-in and sign-out.
FDHS_REQ_26. Handset application shall record time when the patient is selected
from the Patient List and when the patient is sent to the next counter. The time
information shall be sent to the laptop application for record keeping.

Offline Requirements
There maybe situations where the laptop is unavailable. The handsets must be ready to
continue to provide service in the absence of the laptop. Following requirements capture
requirements of the handset application when the laptop is not available.

FDHS_REQ_27. Handset application shall launch in Offline mode when Bluetooth

connectivity is not available.
FDHS_REQ_28. In the Offline mode, Patient List is limited to the patients
registering at the handset.
FDHS_REQ_29. All data associated with forms and performance monitoring shall
be stored locally in the handset.
FDHS_REQ_30. All data stored locally in the Offline mode shall be uploaded to the
laptop application when the laptop becomes available.

NOTE: The laptop application shall be responsible for collating and correctly assembling
data from all the handsets before submitting to the database.

Reporting Requirements
Reports can be generated from the Internet Portal for FDHS. They can also be generated
from the laptop application. Certain reports shall be made accessible to the handset as
well. Below requirements apply to reports that can be viewed on the handset. A special
reporting application on the handset will provide all the reports as listed below. This
application maybe linked with the other handset applications as well.

FDHS_REQ_31. Patient history can be viewed by entering a patient ID. This report
will include details of patient condition, medicines given, dosage, allergies, etc.
Details of this report will be provided by HMRI.
FDHS_REQ_32. Availability of a particular medicine can be queried by entering the
medicine name or ID.
FDHS_REQ_33. Overall availability of all medicines can be queried.