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 childs 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 childs health.

Amanda Buck, Yu Chen, Nate Gulledge, Sally Maier

RECORDS FOR LIFE PROPOSAL

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?

Amanda Buck, Yu Chen, Nate Gulledge, Sally Maier

RECORDS FOR LIFE PROPOSAL

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.

Amanda Buck, Yu Chen, Nate Gulledge, Sally Maier

RECORDS FOR LIFE PROPOSAL

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 usefor health workers, families, and survey-takers?

Amanda Buck, Yu Chen, Nate Gulledge, Sally Maier

RECORDS FOR LIFE PROPOSAL

OUR APPROACH

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

Amanda Buck, Yu Chen, Nate Gulledge, Sally Maier

RECORDS FOR LIFE PROPOSAL

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

Parents are responsible for the physical copy of each childs 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.

Amanda Buck, Yu Chen, Nate Gulledge, Sally Maier

RECORDS FOR LIFE PROPOSAL

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 childs 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

Amanda Buck, Yu Chen, Nate Gulledge, Sally Maier

RECORDS FOR LIFE PROPOSAL

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 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.

Amanda Buck, Yu Chen, Nate Gulledge, Sally Maier

RECORDS FOR LIFE PROPOSAL

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 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 childs 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.

Amanda Buck, Yu Chen, Nate Gulledge, Sally Maier

RECORDS FOR LIFE PROPOSAL

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

OMR TECHNOLOGY

OMR technology is easy to implement. Several companies offer OMR solutions, and there are examples of the technologys 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/Ofce-OMR-Scanning-Software/pdf/ Case%20Study%20-%20University%20of%20Arizona.pdf

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 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%20Recognition%20Technology%20for%20Rural%20Health%20Data%20 Collection.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/

Amanda Buck, Yu Chen, Nate Gulledge, Sally Maier

RECORDS FOR LIFE PROPOSAL

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

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 childs photograph from birthan 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 resultwithin 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 order 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 developing world finding that use of text-based interventions increase efficiency in healthcare implementation:
http://www.ncbi.nlm.nih.gov/pubmed/20495253

Amanda Buck, Yu Chen, Nate Gulledge, Sally Maier

RECORDS FOR LIFE PROPOSAL

At the time of the childs birth, the parents will be given the childs Records for Life. The physical health record will include:
FRONT VIEW

SPACE FOR THE CHILDS NAME TO BE HANDWRITTEN.

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

VACCINE DESCRIPTIONS

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

RECORDS FOR LIFE

NAME:

VACCINE SCHEDULE
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.

HEALTHWORKER WILL FILL OUT FORM WHEN YOUR CHILD IS IMMUNIZED

Text the vaccine name (example: MR) to 2345 for more information.
MR helps your child fight off the fever, cough, and skin rash brought on by Measles and Rubella.

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 Penta
DOSE 3 OF 3

DOSE 1 OF 2

MR

DOSE 2 OF 2

Penta

DOSE 1 OF 3

Penta

DOSE 2 OF 3

BCG

DOSE 1 OF 1

PCV DOSE 1 OF 3 RV DOSE 1 OF 3 OPV DOSE 2 OF 4

PCV DOSE 2 OF 3 RV DOSE 2 OF 3 OPV DOSE 3 OF 4

PCV DOSE 3 OF 3 RV DOSE 3 OF 3 OPV DOSE 4 OF 4

HepB OPV

DOSE 1 OF 1

DOSE 1 OF 4

BIRTH
DATE OF VACCINES:

6 WEEKS
DATE OF VACCINES:

10 WEEKS
DATE OF VACCINES:

14 WEEKS
DATE OF VACCINES:

912 MONTHS
DATE OF VACCINE:

1518 MONTHS
DATE OF VACCINE:

CONGRATULATIONS!
Your child received all of the vaccines. Youve earned a new photo!

Complete the chart to protect your child!

CHART SHOWING VACCINATION PROGRESS OPTICAL MARK RECOGNITION BUBBLES TO BE FILLED IN BY HEALTHCARE WORKER

ICONS REPRESENTING CHILD GROWTH PROVIDE SUBTLE VISUAL REMINDER OF NEXT VACCINATION DATE

FINAL PHOTOGRAPH OF CHILD TAKEN AFTER VACCINATION SCHEDULE IS COMPLETE.

Amanda Buck, Yu Chen, Nate Gulledge, Sally Maier

RECORDS FOR LIFE PROPOSAL

At the time of the childs birth, the parents will be given the childs Records for Life. The physical health record will include:
BACK VIEW

NEXT IMMUNIZATION DATE IS WRITTEN OR PLACED AS A STICKER HERE

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

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

FIELDS FOR ADDITIONAL VACCINES TO BE RECORDED

REMEMBER THE DATE

THE NEXT IMMUNIZATION DATE IS

IDENTIFICATION
CHILDS NAME
CHILDS FAMILY NAME

ADDITIONAL VACCINES
DATE OF BIRTH VACCINE NAME DATE GIVEN

NOTES

CHILDS GIVEN NAME

CELL PHONE NUMBER

Text HELP to 2345 with urgent questions.

MOTHERS NAME
MOTHERS FAMILY NAME

ADDRESS/VILLAGE

LOCAL CLINIC
CLINIC NAME

MOTHERS GIVEN NAME

ADDRESS

FATHERS NAME
FATHERS FAMILY NAME

PHONE NUMBER SCAN FOR DIGITAL RECORD

CLINIC INFORMATION, EITHER HANDWRITTEN OR PLACED AS A STICKER

BAR CODE CAN BE SCANNED TO ACCESS AND UPDATE DIGITAL RECORD

ROOM FOR ADDITIONAL NOTES

Amanda Buck, Yu Chen, Nate Gulledge, Sally Maier

RECORDS FOR LIFE PROPOSAL

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

Amanda Buck, Yu Chen, Nate Gulledge, Sally Maier

RECORDS FOR LIFE PROPOSAL

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:
ANALOG TO DIGITAL TRANSITION A barcode on the physical record can be scanned to access the patients digital medical record

EMEMBER THE DATE

THE NEXT IMMUNIZATION DATE IS

IDENTIFICATION
CHILDS NAME
CHILDS FAMILY NAME

ADDITIONAL VACCINES
DATE OF BIRTH VACCINE NAME DATE GIVEN

NOTES

CHILDS GIVEN NAME

CELL PHONE NUMBER

ELP to 2345 with urgent questions.

MOTHERS NAME
MOTHERS FAMILY NAME

ADDRESS/VILLAGE

LOCAL CLINIC

ME

MOTHERS GIVEN NAME

FATHERS NAME
FATHERS FAMILY NAME

UMBER SCAN FOR DIGITAL RECORD

Amanda Buck, Yu Chen, Nate Gulledge, Sally Maier

RECORDS FOR LIFE PROPOSAL

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:
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 verication 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.

Amanda Buck, Yu Chen, Nate Gulledge, Sally Maier

RECORDS FOR LIFE PROPOSAL

Thank you for your time!