What is NIROG?
HAEFA’s custom-made EMR known as NIROG is probably the only comprehensive EMR in the FDMN camps and also in Bangladesh.NIROG is a fully paperless system and stores patients’ medical records that can be retrieved by the scannable barcode of the digital health card.It is solar-powered and can function without internet. It is run by a local Wi-Fi router.
NIROG is an entirely paperless and digitized record-keeping software uploaded onto tablets using fingerprint identification and barcoded photo ID cards for patients. This system tracks and records encrypted patient data under unique identifiers that give doctors a high technology resource to provide accurate follow-up care. By mastering technological tools, HAEFA has increased by four to five times the number of patients treated compared to using handwritten notes that need to be later transcribed .Follow up of the NCD and other chronic and pregnant patients have become very simple for HAEFA due to this EMR.
NIROG was originally created to track and improve the health of Bangladesh factory garment workers, but with the escalation of the Rohingya refugee crisis in 2017, the tablets have been further optimized to use solar powered batteries and to function without constant internet connection. This makes NIROG accessible in remote and rural locations like the Rohingya refugee camps, where the tablets are used offline to collect patient information and are then brought to a nearby town to upload data onto a secure and password protected database that authorized healthcare providers can reference. NIROG provides role-based (layered) access to health professionals for added security. From the health care centers in the Rohingya refugee camps and in the mobile clinics of the garment factories, NIROG securely sends their patients’ medical data to the databases of the Directorate General of Health Services (DGHS), a division of Bangladesh’s Ministry of Health and Family Welfare (MOHFW). This data collection is particularly significant for the Rohingya population, as their health data collection ended in 1982 when Myanmar stripped the ethnic group of citizenship and legal identity (Lifespan).
NIROG’s built-in systems prevent drug-interaction by making suggestions for contraindicated drugs, making the technology uniquely safe in emergency situations. NIROG is capable of having two-way communication between the health care providers (using handheld tablets) and patients (using their cell phones) for follow-ups and treatments of chronic diseases.
On the EMR tablets, the NIROG software uses the WHO’s current medical classification, the Tenth Revision of the Internal Classification of Diseases (ICD-10), to diagnose and standardize treatment and management protocols for non-communicable diseases. In particular, HAEFA focuses on treating patients suffering from hypertension, diabetes, malnutrition, chronic obstructive pulmonary disease, high-risk pregnancy, anemia, infectious diseases, and cancer.
Empowered with NIROG, HAEFA’s medical teams have provided health screenings, diagnoses, treatments and follow-ups to more than 25,000 RMG factory workers since 2013 and 130,000 Rohingya refugees since October 9, 2017.
NIROG also helps to understand the prognosis of the patients and helps doctors find the efficacy of the medicines that were prescribed by HAEFA. The encrypted, HIPAA-compliant, medical records can only be accessed by authorized health professional from anywhere in Bangladesh, if needed.
How do we operate?
Nirog Uses Icd- 10 Code Of Disease.When HAEFA’s team arrives on-site, all workers or patients are given an initial screening. This confidential screening includes basic identification (date of birth and gender) and health information (height, weight, vital signs such as blood pressure, blood glucose levels, hemoglobin levels, and heart rate). A medical professional will ask about their health histories including chronic conditions, traumas, illness, infection, injury, and reproductive information. Patients are screened for health behavior patterns, such as smoking and dietary habits, and are also asked about an extensive list of symptoms that can alert our healthcare professionals to conditions such as tuberculosis, typhoid, and heart failure that would require treatment or careful monitoring.
Patients are then given a confidential physical exam, and any impressions and diagnoses are recorded along with treatment recommendations. Our mobile team for initial on-site screening consists of 12 healthcare workers and paramedical staff and 6 physicians. Every hour, 40 workers can receive an initial screening. Afterwards, 2 health workers and 1 physician perform monthly follow-up visits to monitor patients with diagnoses and pregnancies. These patients are scheduled for appointments with healthcare professionals as needed. Pregnant women receive check-ups once a month and then, after reaching weeks 24-26 of the pregnancy, once every two weeks. If complications arise, patients can visit healthcare workers more frequently.
Because this is not a “one and done” program, each patient receives a healthcare card and unique ID number linked to their confidential electronic medical record (EMR), stored in our data servers. Our physicians are able to access these records to help diagnose, monitor, and treat patients remotely. Factory employers are able to monitor treatments and prognoses and can also communicate with our healthcare professionals and health workers through email or mobile phone.
On-site healthcare professionals update EMR automatically through cellphone-based technology. They can also capture and send images and messages concerning symptoms, enabling remote physicians to review files, monitor treatment results, and change treatment regimen in real-time, if needed.
What do we provide?
Health Screening and Treatment
INFECTIOUS DISEASES: HAEFA provides confidential on-site health screenings and treatments that include the following infectious and transmittable diseases:
- Tuberculosis
- Typhoid
- Malaria
- Dengue
- Hepatitis
- Respiratory infection
- Skin lesions
- Sexually transmitted diseases
NON-COMMUNICABLE AND CHRONIC DISEASES
HAEFA provides confidential on-site health screenings and treatment for:
- Diabetes
- Hypertension
- Trauma and injuries
- Arthritis
- Urinary tract infection
- Respiratory infection
- Skin lesions
- Cancer
- Gynecological conditions
- Asthma and chronic lung conditions
- Anemia
- Mental health conditions
- Substance abuse
Maternal Care
By providing high quality ante-natal care, we can reduce the risk of neonatal deaths and decrease the infant mortality rate. HAEFA also provides child day care, nutrition education, childhood immunizations and tetanus vaccinations for adults along with its program.
OUR ON-SITE HEALTH CARE DELIVERY SYSTEM INCLUDES:
- Ante-natal care
- Routine ante-natal visits and screening for high-risk pregnancy (preeclampsia)
- Screening and treatment for diabetes
- Screening and treatment for hypertension
- Screening and treatment for anemia
- Screening and treatment for STDs
- Screening and treatment for injury or trauma
- Health education and nutrition of pregnant mothers
- Health screening and immunizations
- Safe-delivery practices
- Post-natal care for mother and child
- Family Planning
Feminine Health and Education Hygiene
Our health care team provides on-site feminine health and hygiene education and materials.
WE DISCUSS:
- Importance of clean toilets and washing hands
- Factual menstrual information versus myths
- Role of proper feminine and menstrual hygiene in overall health and wellness
- Adequate sanitation and proper disposal of menstrual management cloths
WE PROVIDE:
- Alternative menstrual management products
- Family planning education and materials
- Health and nutrition education for pregnant mothers
Nutrition and Health Education
Through education and better health, we intend to break the cycle of poverty, uplifting living conditions for industrial workers and slum dwellers. By making small improvements through nutrition and health education, HAEFA is making sustainable improvements in the lives of garment workers.
Our health care team provides on-site Health and Nutrition education discussing issues like: drinking water safety, nutrition, occupational safety, personal and feminine hygiene, relief and rescue.
On-Site Training Workshops and Programs are arranged for:
- Local medical, emergency, and paramedical workers and volunteers
- Health educators
- Community Health Workers (CHW)
- Medical and emergency workers
- Administrative and management authorities
The topic of the trainings include :
- Health education on breastfeeding exclusively for 5 months, weaning food at 6 months
- Growth monitoring for children under age 3
- Vitamin-A capsule & deworming tablet distribution for children under age 5
- Family planning support and information
- Immunization for children under age 1
- Ante-natal care
- Immunization for pregnant women and adolescent girls
- Post-natal care
- Vitamin-A capsule distribution for post-natal period
- Safe delivery methods and protocols
- Nutrition education focusing on pregnant and lactating mothers
- Water, sanitation and hygiene education
- Health screening methods for anemia, hypertension, diabetes, asthma, high-risk pregnancy, and tuberculosis
Immunization Program
HAEFA promotes the immunization of children against illnesses that prevent healthy growth and development. Adults also require immunization against tetanus, influenza and pertussis (whooping cough).
Our on-site health care delivery system includes providing immunizations on the recommended schedule for:
- Tetanus toxoid
- Pertussis/Whooping Cough
- BCG
- Mumps
- Measles
- Rubella
- Chicken Pox
- HPV
- Flu
Supplements and Deworming
HAEFA recognizes that parasitic infestations are very common problems in conditions of poverty and unsanitary facilities.
Our on-site health care delivery system includes:
- Deworming
- Iron tablets
- Folic acid supplements
- Pre-natal supplements
- Vitamin A supplements