records for life presentation

Amanda Buck, Yu Chen, Nate Gulledge, Sally Maier

RECORDS FOR LIFE PROPOSAL

For parents the world over, the time following the birth of a child

is hectic and emotional. Numerous daily concerns eclipse the

responsibility to retain a child’s medical health record. Records

can be easily forgotten, lost, or ruined and vaccination dates can

be missed if parents do not understand the importance of the

vaccination process and record to their child’s health.



THEREFORE WE ASKED

How can we instill a sense of value and parental engagement in the vaccination process? How can we ensure the physical record remains portable and durable?



Another issue that exists globally is human error in record

keeping. Healthcare workers may misplace records, parents

may lose them, and purely digital systems may break down

with a loss of power or internet connectivity.



THEREFORE WE ASKED

How can we create redundancy in record keeping to ensure that records are accurate over time and across the spectrum of their use—for health workers, families, and survey-takers?



OUR APPROACH

Seeks to address these questions through a hybrid of high- and low- tech solutions.



Parents are responsible for the physical copy of each child’s

vaccination record, which is provided at birth. The record is

intimately connected to the child through the inclusion of

standard identification information as well as a photograph

taken of the child shortly after birth, which is adhered to the

front of the record.

PHOTOGRAPH

Digital image capture and printing can be facilitated

though inexpensive consumer products like the Polaroid

PoGo printer and a mobile phone camera. A custom

solution could also be designed allowing for greater

consistancy between locations and simplicity for users.

OUR APPROACH

gives records a sense of value

facilitates parental understanding and engagement

ensures record is durable and portable

creates record redundancy to prevent data loss

utilizes both high- and low- tech solutions



The photograph marks the beginning of their child’s journey

to complete immunization. Parents will note that the record

also includes a place for a second image of the child, which

will be taken upon completion of the vaccination schedule.

This photographic supplement to the record adds emotional

value and a keepsake incentive for families to return to the

health clinic.

INCENTIVES

Innovations for Poverty Action reports that small gift

incentives show evidence of success in increasing

immunization levels in a study conducted in Rajasthan. http://www.poverty-action.org/provenimpact/vaccines/highimpact

OUR APPROACH








The vaccination schedule itself is designed to clearly show

the progress made with each inoculation. The graphics subtly

reflect game mechanics to engage the caregiver and encourage

them to follow-through and fulfill the necessary vaccines on

schedule. Icons representing the stages of infant development

and vaccination descriptions are also included, which makes

the information accessible and understandable to families

and caregivers.

OUR APPROACH








The record fits perfectly into a sealable plastic envelope for

protection and durability. The front cover features the name

and photograph of the child taken at birth. The back cover can

also be seen through the plastic envelope. It includes contact

information for the local health clinic and prominently features

the date of the child’s next vaccination visit.

RECORD DIMENSIONS

5-panel accordion fold, 3.5" × 4.75" folded, 17.5" × 4.75" flat.

APPOINTMENT REMINDER

The date can be handwritten in by the health worker into

space provided on the form. Alternatively, stickers can be

written on with the specific date, and then layered on top of

each other with each new appointment.

OUR APPROACH








The record is designed to use optical mark recognition (OMR).

This allows it to be easily filled out by hand by the health worker,

understandable to the human eye, and easily digitized and added

to a database. The digital record can then be easily accessed by

scanning a small barcode on the paper record with a scanner or

smartphone. Including this technology ensures that a forgotten

or lost record can be easily reproduced from one of the other

backups. This creates a necessary redundancy in the process.

OMR TECHNOLOGY

OMR technology is easy to implement. Several

companies offer OMR solutions, and there are

examples of the technology’s successful use in

a variety of environments:

Case study of proprietary OMR system use in a pediatric

care environment:

http://scantron.com/~/media/Scantron/Files/products/docuscan/

casestudy_LakeForestPediatric.ashx

Case study of a system using non-proprietary forms

with barcodes to create an OMR system:

http://www.gravic.com/remark/Office-OMR-Scanning-Software/pdf/

Case%20Study%20-%20University%20of%20Arizona.pdf

OMR also has a history of successful implementation in

record-keeping in developing regions:

Paper from IKP Centre for Technologies in Public Health (ICTPH)

evaluating OMR use in Rural Health Data Collection:

http://www.ictph.org.in/downloads/Optical%20Mark%20Recog-

nition%20Technology%20for%20Rural%20Health%20Data%20Collection.pdf

OMR SCANNING

the record is designed at a size that can be simply scanned

on standard-sized scanning beds. Also, if the technology is

available, it is fairly simple to implement a scanning feature

using smartphone applications, i.e.:

http://www.appxy.com/tinyscan/

OUR APPROACH








If families have access to a mobile phone, they will also receive a

text reminder shortly before the date of the next immunization.

Where technology allows, the message will include the child’s

photograph from birth—an additional emotional incentive.

Health workers will encourage parents to share the digital photo

and immunization information with family and friends, creating

a dialogue within the community. By leveraging the personal

value of the photographs and encouraging open discussion

about immunizations, we create the possibility for bringing

about new vaccination advocates as a result—within families,

villages, communities, and the world.

TEXT MESSAGING

This text messaging technology is widely used and realistic

to implement; companies already using the technology

include: http://medicmobile.org/

and

http://www.cell-life.org/systems/communicate/

It would be an effective way to send reminders about next

vaccination dates, allow caregivers to send keywords in or-

der to receive more information (about a specific vaccine),

and even provide location-based services for caregivers

(to point them to the closest health clinic, for example).

This approach is supported by pilot programs in the devel-

oping world finding that use of text-based interventions

increase efficiency in healthcare implementation:

http://www.ncbi.nlm.nih.gov/pubmed/20495253

OUR APPROACH








VACCINE SCHEDULERECORDS FOR LIFE

Complete the chart to protect your child!

BIRTH 6 WEEKS

DATE OF VACCINES: DATE OF VACCINES:

10 WEEKS

DATE OF VACCINES:

14 WEEKS

DATE OF VACCINES:

9–12 MONTHS

DATE OF VACCINE:

15–18 MONTHS

DATE OF VACCINE:

Penta DOSE 1 OF 3 Penta DOSE 2 OF 3 Penta DOSE 3 OF 3

HepB DOSE 1 OF 1 RV DOSE 1 OF 3 RV DOSE 2 OF 3 RV DOSE 3 OF 3

PCV DOSE 1 OF 3 PCV DOSE 2 OF 3 PCV DOSE 3 OF 3BCG DOSE 1 OF 1

OPV DOSE 2 OF 4 OPV DOSE 3 OF 4 OPV DOSE 4 OF 4OPV DOSE 1 OF 4

HEALTHWORKER WILL FILL OUT FORM WHEN YOUR CHILD IS IMMUNIZED

MR DOSE 2 OF 2MR DOSE 1 OF 2

BCG protects your child

from Tuberculosis.

HepB will fight off Hepatitis

B, which if untreated, is a

lifelong disease.

OPV protects your child

from debilitative Polio.

Penta is a superstar vaccine. It protects your child

against Diphtheria (heart and nerve damage),

Tetanus (lockjaw, spasms, and seizures), Hepatitis B

(again!), and Haemophis Influenza (attacks many

parts of the body).

PCV protects against ear

infections, sinus infections,

and pneumonia.

RV prevents severe diarrhea.

MR helps your child fight off the fever, cough,

and skin rash brought on by Measles and Rubella.

Text the vaccine name (example: “MR”) to 2345 for more information.

NAME:

CONGRATULATIONS!Your child received all of the vaccines.

You’ve earned a new photo!

At the time of the child’s birth, the parents will be given the child’s Records for Life. The physical health record will include:

A PHOTOGRAPH OF THE NEWBORN, ADHERED TO THE FRONT OF THE RECORD.

SPACE FOR THE CHILD’S NAME TO BE HANDWRITTEN.

PROMPT FOR PARENTS TO USE TEXT MESSAGE-BASED INFORMATION SYSTEM.

VACCINE DESCRIPTIONS

CHART SHOWING VACCINATION PROGRESS ICONS REPRESENTING CHILD GROWTH PROVIDE SUBTLE VISUAL REMINDER OF

NEXT VACCINATION DATE

FINAL PHOTOGRAPH OF CHILD TAKEN AFTER VACCINATION

SCHEDULE IS COMPLETE.OPTICAL MARK RECOGNITION BUBBLESTO BE FILLED IN BY HEALTHCARE WORKER

FRONT VIEW



REMEMBER THE DATE

LOCAL CLINIC

IDENTIFICATION ADDITIONAL VACCINES

THE NEXT IMMUNIZATION DATE IS

Text “HELP” to 2345 with urgent questions.

NOTES

CLINIC NAME

CHILD’S FAMILY NAME

CHILD’S GIVEN NAME

MOTHER’S FAMILY NAME

MOTHER’S GIVEN NAME

FATHER’S FAMILY NAME

SCAN FOR DIGITAL RECORD

CHILD’S NAME DATE OF BIRTH

CELL PHONE NUMBER

ADDRESS/VILLAGEMOTHER’S NAME

FATHER’S NAMEADDRESS

PHONE NUMBER

VACCINE NAME DATE GIVEN

3

At the time of the child’s birth, the parents will be given the child’s Records for Life. The physical health record will include:

FAMILY IDENTIFICATION INFORMATION. BY USING THESE BOXES OPTICAL CHARACTER RECOGNITION WITH CAREFUL HUMAN SUPERVISION CAN BE USED TO DIGITIZE RECORDS

NEXT IMMUNIZATION DATE IS WRITTEN OR PLACED AS A STICKER HERE

PROMPT FOR PARENTS TO USE TEXT MESSAGE-BASED INFORMATION SYSTEM OR RECIEVE DATE REMINDER

FIELDS FOR ADDITIONAL VACCINES TO BE RECORDED

BAR CODE CAN BE SCANNED TO ACCESS AND UPDATE DIGITAL RECORD

ROOM FOR ADDITIONAL NOTESCLINIC INFORMATION, EITHER HANDWRITTEN OR PLACED AS A STICKER

BACK VIEW



A digital record-keeping system would also be available to caregivers and health workers. The solution could be implemented in whole or in part depending on available technology:

IMMUNIZATION RECORD DATABASE ACCESSIBLE VIA DESKTOP COMPUTER OR MOBILE APP



REMEMBER THE DATE

LOCAL CLINIC

IDENTIFICATION ADDITIONAL VACCINES

THE NEXT IMMUNIZATION DATE IS

Text “HELP” to 2345 with urgent questions.

NOTES

CLINIC NAME

CHILD’S FAMILY NAME

CHILD’S GIVEN NAME

MOTHER’S FAMILY NAME

MOTHER’S GIVEN NAME

FATHER’S FAMILY NAME

SCAN FOR DIGITAL RECORD

CHILD’S NAME DATE OF BIRTH

CELL PHONE NUMBER

ADDRESS/VILLAGEMOTHER’S NAME

FATHER’S NAMEADDRESS

PHONE NUMBER

VACCINE NAME DATE GIVEN

3


ANALOG TO DIGITAL TRANSITION

A barcode on the physical record can be scanned to access the patient’s digital medical record




PHOTOGRAPHS ADD VALUE

The medical center or the app would also be equipped to take a digital photograph of the child to be attached to the digital record for additional verification

A portable photo printer would be used to output a physical copy of the photograph to attach to the physical record, adding emotional value and personalization and providing an incentive for timely completion of the vaccination schedule.



Thank you for your time!

records for life presentation

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