Scheduling Makes Everyone A Winner

We’ve come this far.
April 17, 2013
Takeoff
June 4, 2013

In this post, our chief clinical liaison Cherie Fathy details her experiences interning with UNRWA last summer, where she assisted the pilot of a new electronic medical record system.

Almost two years ago to date, I signed on to work with the UN Relief and Works Agency in Amman, Jordan. As is the standard in life’s unpredictable course, I came in charged to work on community-based initiatives and left having worked on something completely different.  Starting in 2010, UNRWA launched a comprehensive set of healthcare reforms that would transition its clinics from operating under a curative-based to a primary care-based health system. I was incredibly lucky to be there during some of the most exciting pilot projects.

I’ll never forget my first glimpse of the Marka Clinic – a place I would end up spending countless hours. It was packed with what felt like 99% of the camp’s residents: with children who turned the steps into a jungle gym, and with mothers who caught up on local gossip as they collected their children.

Morning line outside of Marka.

Morning line outside of Marka.

Marka Clinic opened at 8 AM every day, but that didn’t stop patients from lining up as early as 5 AM to ensure that they saw a doctor because of the first-come, first-serve policy. On top of that, the doctor saw over 100 patients a day, averaging two or three minutes with each of them. Burnt-out doctors, frustrated patients, and sub-optimal care followed. To put it lightly, it was like an incredibly inefficient factory system – and everyone knew this was unsustainable.

The healthcare reform introduced several interventions, but two of my favorites are the appointment system and queue system (maybe they’re why I’m on the Dunia Health team today!). The organized system allows the clinics to better manage patient flow (and gives patients the chance to sleep in!). The appointment system allows the clinic to triage patients and spread out appointments, decreasing crowds. Meanwhile, the queue system gives patients a sense of when they’ll be seen and eliminates any confusion about where they have to go within the clinic. Best of all, doctors are capped at seeing 80 patients a day, allowing more time for each patient to interact with the physician.

As with any successful reform, there’s always the question a big question remaining afterwards: what’s the next step? That’s where we come in! Currently, the appointment system requires patients to come in and schedule an appointment instead of being able to call or text from home. Our system will allow clinics to send out text messages to patients to let them know that they need to schedule an appointment and will, in turn, allow patients to either call or text in to schedule instead of walking all the way to the clinic.

Moreover, the text message serves as a second check for parents on what vaccinations their child still needs, and when these vaccines might be available at clinic. It also allows clinics to track demand of vaccinations on a larger scale. Identifying what vaccines are in highest demand at different clinics will allow UNRWA to catch potential shortages before they happen. With this data, they can either reallocate or plan a way to preemptively get those clinics the necessary vaccines before it’s too late.

It’s important to emphasize that this isn’t a problem (or solution) that’s only applicable to the UNRWA clinics! Busy clinics and people with access to cell phones are hardly a rarity anywhere in the world! We’re excited to see where this technology will go and the impact it will have on tracking vaccines, saving time, and stopping preventable drug shortages!

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