I am interested in cost effective and accurate patient identification in a health center. Bahmni’s photos on the patient dashboard are a great addition, but not sure how that helps to identify patients thru the workflow.
Here are some questions for Team Bahmni:
Could you describe the workflow?
If cards are only printed at the time of the first visit, what happens when the cards are lost?
Is it tricky to find the patient record at checkin and clinical visit?
Do patients have other IDs (ie. bank cards, national ids, drivers licenses) with photo and printed names?
Is the camera stationary? Is there a special spot where photos are taken?
Cost and model of cameras?
Does it prevent patients pretending to be someone else?
How are the paper IDs used?
Are they printed on a regular printer or a special card printer?
Perforated or cut with scissors?
Laminated?
Thanks to Emerson and Pradipta for answering some preliminary questions.
When a patient visits the hospital for the first time, he is registered in the system and given a ID card. This ID card is printed from Bahmni and has patient’s photo along with his/her Name, ID, Age, Gender, Village etc. It is given to patient to be taken home with him/her and he/she is asked to bring it for every subsequent visit to the hospital. When patient comes for a return visit to the hospital, he/she shows his/her card at the registration and clerk sitting there enters patient’s ID in the system to start the visit.
If a card is lost, patient reports it to the registration and the clerk searches for the patient by his Full Name and Village. If there are more than one search results, the clerk can verify by matching patient’s photo in the system to the patient standing on the counter and a new ID card is issued to the patient. In case there is no photo in the system (which happens for the patient who were already registered in hospital before Bahmni was installed) and patient can’t be identified in the system from the search results, the patient is registered again and a new ID card is issued although this does create the problem of not being able to access patient’s past data of earlier visits. So having patients photo in system does help in identifying the patient from a list of search results, in case the ID card is lost.
As you can guess, if the patient has brought the hospital ID card, there is no problem. If the card is lost or patient has come without card, searching by full name and village works most of the time. In few cases, matching patient’s face with the photo of search results might be needed. In rare cases, a new ID has to be issued if search doesn’t give satisfactory results.
So far, the kind of hospital settings that we have seen Bahmni working in, patients seldom have any other IDs (with or without photo). Even if they have one, there is no expectation that they will carry it to hospital.
The camera should be stationary. Ideally it should be placed at a such location where every patient is going to be standing even if camera wasn’t there. From what we have observed, most convenient place is registration window. So, while the patient is standing on the window waiting for his ID card to be made, the clerk can just asks him/her to look at the camera and click the button in registration screen. If for some reason (crowd at the window, lighting etc) the photos are not clear, the patient can be asked to go and stand somewhere else where camera is placed. If patient’s height & weight is also captured at registration (which we do in one of our implementations), the photo can be taken when the patient is standing at weight machine. However, we’ve also observed some registration clerks being more comfortable with webcam in their hand and they just call the patients after their height & weight is measured and hold the webcam by hand in front of them and take photo.
To some extent yes. If the photo is on the card and in the system, the registration clerks can surely check for the authenticity. But it depends on how diligently the registration clerk tries to match a photo with patient’s face for every patient. If the photo is not in the system (for old registered patients), it will be hard to prevent if someone tries to use somebody else’s card.
Patient is supposed to carry it with him every time he/she comes to hospital so that registration clerk can quickly know the ID and start a new visit for the patient in Bahmni. Since paper ID is the only thing that patient is supposed to take home and bring back to hospital for every visit, the ID is also used to remind patient of information like next visit date by writing such information on the back of ID.
A regular printer can be used with a small sized paper setup.
Cards are printed individually for each patient, so we don’t need perforation or scissors.
It’s not exactly laminated but simply put in a small polythene envelope of the approximate size of ID and given to patient. It’s not laminated because that’s expensive and also because the ID needs to be taken out from time to time to write something on it’s back.