Problem list


Optimizing management of multiple hospital operating theatres in a large hospital is a complex problem. A large hospital can have a number of different procedures per day and theatres need to be scheduled several weeks in advance. Each procedure requires gathering a different team and specific equipment/medicine. A delay of a procedure, breakdown of equipment, unavailability of required team, etc can affect the life of the patients and cost to the administration. Lack of information on the current status of an operation theatre (Unoccupied, start of procedure, cleaning, etc.) affects the efficiency of usage. Further, an operating theatre has number of equipment and instruments where the management and inventory is controlled on paper.

Intensive care units, premature baby care units and high dependency units have multipara monitors attached to each patient. These patients need continuous supervision of care rather than periodic visits in ward set up. Remotely observing system for these patients along with alerting function to the responsible consultants will have a huge benefit. This system can be improved with robotic science so that distant commanding and adjust doses by remotely seen specialist.

Currently, a significant portion of time of a hospital visit is being spent in queues at pharmacies while obtaining prescribed medication. Pharmacists have to spend a significant amount of time to count , pack & label medicines.

Delivering of blood samples collected from a ward to the laboratory and obtaining test results from the laboratory and deliver to the ward involves human intervention and thereby met with unnecessary delays.

Hospitals are complex buildings and have new visitors coming there for the very first time every day. Patients and visitors are usually in a heightened state of anxiety and are thus worried about finding their way to their intended destination. Indoor navigation assistance inside a hospital reduces the stress of the visitors and patients and reduce interruptions of medical staff being asked for directions.

Hazardous health care waste can be categorized as Sharps waste (e.g.: needles, syringes), Infectious waste (Waste suspected to contain pathogens and that poses a risk of disease transmission), Pathological waste (Human tissues, organs or fluids; body parts; fetuses; unused blood products), Pharmaceutical waste, cytotoxic waste (Pharmaceuticals that are expired or no longer needed; items contaminated by or containing pharmaceuticals Cytotoxic waste containing substances with genotoxic properties), Chemical waste and Radioactive waste. Technology can be incorporated in to monitoring, record keeping and waste treatment activities to increase the efficiency and effectiveness of the waste disposal process. Introducing automation into this process will reduce labour cost as well. (Source: Safe management of wastes from health-care activities, Second edition of published by World Health Organisation)

"A new form of chronic kidney disease of unknown etiology (CKDu), which has emerged over the past two decades, has become a public health issue in Sri Lanka. Previous studies have identified exposure to organophosphate pesticides, presence of ochratoxin in food supply, presence of heavy metals such as Cadmium and Arsenic in the environment of dietary system and hard water and elevated fluoride levels, as factors likely to cause CKDu. However, the exact cause still remains unclear. Early detection of the disease, dialysis process and proper after care are required to effectively treat the many sufferers. Lack of affordable water purification methods will also have a huge impact on people living in affected areas."

Diabetes mellitus (High blood sugar in common terms) is a common disease condition which contribute to 4% of deaths of all ages in Sri Lanka and above 8% of individual's of both sexes are said to have blood sugar levels above expected. This condition needs not only medications by doctors but adaptation of healthy life style, modification of other risk factors and regular attention by many disciplines. A person will not know whether they are suffering from Diabetes mellitus or not. If they are suffering from diabetes, general public is not well aware on how to maintain a healthy life style and keep the disease under control.

Detect composition of exhaled air, micro organisms in sewerage, urine, etc. can result in early detection in diseases. This will allow health care professionals take necessary precautions and treatments more effectively and efficiently.

Most of the elderly people and people who have undergone through immediate surgeries have problems in expressing their pain verbally. They might suffer from excess pain when the others try to take care of them as well (like trying to feed and trying to move). It would be helpful for both the patients and the caregivers if their brain signals can be detected and to give notification when he/she is in excessive pain.

Strengthening of surveillance is one of the main control strategies for Dengue Fever and other communicable diseases proposed by the Epidemiology Unit of the Ministry of Health Sri Lanka. A report published by the Ministry of Health states that the surveillance mechanism includes monitoring and deriving preventive measures from data collected manually from affected areas. This information is not readily available for the public or organizations to engage in an effective prevention control. Furthermore, the data captured is not sufficient as it is only taken from limited sources.

Currently, Sri Lanka do not have any emergency medical support service networked with nearest hospitals and ambulance services digitally. If a person meet with an accident when driving alone in a underpopulated area or a person suffers from cardiac arrest and he/she will not be even conscious enough to dial 119 or reach his/her mobile. Even when someone find such person who needs immediate medical assistance, there will be a delay in getting medical assistance which will reduce the chances of survival of the patient.

When a medical officer prescribes a drug he/she should be aware of the patient's other diseases, previous medications and allergies which can occur. In current situation medical officers prescribe drugs considering only the data given by the patient regarding any allergy condition. Most of the time because of the absence of proper communication of the patient, doctors do not get to know about the drug allergies that the patient might have. Neither they will be able to find out the drugs currently taken by the patient for other diseases. However considering the facts illustrated by the patient, medical officer decides himself with his knowledge whether to proceed or not with the prescription. But when a person is suffering from multiple diseases it is difficult even for the medical officer to sort out probable allergies which can appear due to interaction between different drugs. Even though they can verify drug interactions, there is no proper way to predict an adverse drug reaction due to a particular drug without giving it to the patient. 70,000 preventable medication errors, causing 9,250 to 23,750 deaths has been found by recent surveys conducted by Canadian adverse study. These are resulted due to the lack of concern regarding the probable conflicts between drugs. These conflicts between drugs increase when the person is having several diseases. In that case medical officer has to consider multiple things including patient profile and his/her multi-morbidity condition when prescribing medicines.

Doctors prescribe several drugs for the patients and pharmaceutical companies are selling the same drug in different brand names, different colours, different forms( tablets/capsules) & in different prices. But there is no central platform to get an updated list of drugs with their descriptions, prescribing information, prices, side effect, etc. for the drugs registered in Sri Lanka.

Sri Lanka is in the top of death rate due to poisoning in the world. Identification of poison is a challenge to the doctor if patient does not give any evidence of poison. Some patients coming unconsciously or without any evidence will lead to delay in specific management if the poison is unidentified. A chemical analyser which is capable of find common poisons in Sri Lanka using patients’ gastric juice or vomitus will be make it easy for the doctor to take early measures for the poisoning.

According to World Health Organization's records of 2017, Sri Lanka is ranked #1 in a list of suicide rates by country and social and economic issues are the major reasons behind. (https://en.wikipedia.org/wiki/List_of_countries_by_suicide_rate).

Due to the less number of doctors around the island and some of them not preferring to stay in rural areas, the patients in rural areas are facing difficulties in getting specialized medical services. Further, it is not affordable to have specialists in rural hospitals which leads to difficulties in travelling and delays in patients getting medical care. This might also lead to death in emergency situations.

Lack hospital beds is a rising problem in hospitals with the Dengue epidemic situation in Sri Lanka. Monitoring of non-critical patients remotely by continuously acquiring their physiological parameters will enable providing medical care at their homes, which increase access to care and decrease healthcare delivery costs. Further, it significantly improves an individual's quality of life.

There are cardiac patients who are not necessary to hospitalization but require great care at the home. But according to current Sri Lankan economic situation it would be quite difficult for everyone to have a dedicated care giver for frequent observation of such patients and decisions for future home treatments and actions based on the visual observations and will heavily depend on care giver's prior experience. Average care givers are average people and they do not have proper medical knowledge and they may not either relatives or friends of the patient.

Availability of affordable point-of-care diagnostics and mobile diagnostic capabilities for local health care employees in the field, at home or in an ambulance will allow rapid treatment to the patients. This will have a significant positive impact on health care delivery and address the challenges of health disparities.

Unavailability of a method to check blood glucose level, platelet level and other frequent blood related check-ups without pricking the patient and taking blood out.

Every 6s a person dies from tobacco use which results 6 million deaths around the world annually and 600,000 of that are non-smokers who were exposed to second-hand smoke (passive smoking). According to National Dangerous Drug Control Board of Sri Lanka over 250,000 youth of the country are addicted to drug where closely 50,000 out of that are addicted to heroin alone. Improving assistance to the addicts with the right game plan tailored to their needs, they can break the addiction, manage their cravings, and join the millions of people who have overcome the addiction.

Oral diseases are one of the most frequently treated conditions by people of varied ages. World Health Organization states 60–90% of school children and nearly 100% of adults have dental cavities worldwide. Some of the general practices that could lead to this are, 1) One in four adults admit they don’t brush twice a day, including a third of men. 2) One in ten admit they regularly forget to brush their teeth. 3) Brushing only once a day means you are 33% more likely to develop tooth 4) More than a quarter of adults only visit their dentist when they have a problem. 5) A quarter of adults admit they have not visited a dentist in the past two years. (Source: National Institute of Dental and Craniofacial Research, Mouth Cancer Action Survey, British Dental Health Foundation, 2013) As the statistics point out, a majority of population brush only once a day and 10 percent completely forget to brush at all. Only brushing once increases the likelihood of getting deceases significantly. Also note that people tend to go to dentists only after acquiring a condition and not before or not regularly. We might need to look into the reasons for this in children too. 1) A third of all children starting school each year have signs of tooth decay. 2) Tooth extractions are the biggest reason children are admitted to hospital for general aesthetics in the UK. 3) Sugar makes up 15% of the daily calories consumed by four to ten year olds. 4) There has been an almost 20 per cent (19.6) increase in children being admitted to hospital with tooth decay between 2010 and 2015. 5) But roughly 40% of children still do not visit the dentist each year. (Source: National Smile Month Organization) We could see similar patterns in children as that of adults, through these statistics. Children too have high likelihood of developing deceases and they too go to dentists after acquiring conditions. This problem is prevalent in Sri Lanka too. In Sri Lanka, 67% of the population has a lower than average dental health and reason being lack of dental knowledge or awareness.

As per World Health Organization, Non Communicable Diseases are estimated to account for 75% of total deaths in Sri Lanka. In October 2015 the United Nations Interagency Taskforce on NCDs conducted a mission to Sri Lanka and concluded that the epidemic of NCDs has now become a serious economic as well as public health issue in Sri Lanka and is fuelled by tobacco use, unhealthy diet, harmful use of alcohol and physical inactivity. The number of people suffering from cardiovascular diseases (like heart attacks and stroke), cancer, chronic respiratory diseases (such as chronic obstructed pulmonary disease and asthma) and diabetes is rising each year. (Source: http://www.who.int/beat-ncds/countries/sri-lanka/en/).

Live medical image transferring mechanisms during surgeries for expert opinions will have an immense benefit to the health sector of the country. Improvement in this aspect of health care will benefit the patients of hospitals in remote areas as well.

Indigenous medicine has a rich history of over 3,000 years with 4 specialisations including Ayurveda, Unani, Siddha and Paramparika. Over 3 mn patients in Sri Lanka are treated annually at 438 Ayurvedic hospitals and dispensaries island wide. It is noted that 60%- 70% of rural population prefer Ayurvedic medicine treatment. Sri Lanka has been designated as a World Bank Global Environment Facility (GEF) zone as a biological hotspot, with 1,500 species of plants of the 8,000 known medicinal plants in the world. Lack of awareness in the fields of indigenous medicine has limited people in using them. (Source: https://www.rvo.nl/sites/default/files/2016/01/Health%20sector%20in%20Sri%20Lanka.pdf).

A considerable amount of valuable lives meet tragic deaths due to lack of knowledge of first aid and basic health care at home, school or work place. Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. People with low health literacy lack the skills needed to manage their health and prevent disease resulting in higher rates of hospitalization and less frequent use of preventive services.

As per the Department of Census and Statistics, there are 137,000 employees have been working in the Human Health and Social Work Activities sector of Sri Lanka in 2015. Continuous training is required for these employees where latest technologies (e.g.: Augemented Reality, Virtually Reality, etc.) can be incorporated in making the training programs more productive and encourage continuous on the job learning.

Nutrition of its citizens is important for a country's economic development. Given the environmental pollution and current market conditions in Sri Lanka, it is becoming more important to have mechanisms to detect the quality level of food. e.g.: Detect heavy metals and poisonous chemicals in food, detecting freshness/moisture content in fruits and vegetables, etc.

Sri Lanka has a legislation in place protecting the rights of persons with disabilities. Both the Government and private sector encourages them to be in their work force. But it is a struggle for them to lead a normal life style and move along with society. Technology has the capacity to create wonders in enhancing their quality of life.

Bad posture and imminent disorders leads to many occupational health issues. These are common in people who do repetitive movements like carrying loads and the people who stay in the same position for a long time period (e.g.: people who work in front of a computer all the day, people who keep standing for long hours). With easy and affordable methods to monitor these postures and movements, people can be reminded to change the posture after some time or they can be warned if there is any risk for their health due to that.

In 2030 Sri Lanka is expected to have 22% of its population aged over 60 years. Accordingly, affordable facilities should be improved in hospitals and nursing homes as well as households in taking care of elders, rehabilitation and improving their quality of life. (Source: http://www.suwasariya.gov.lk)

Rehabilitation is a treatment or treatments designed to facilitate the process of recovery from injury, illness, or disease to as normal a condition as possible. Monitoring the improvement of the treatments is critical for doctor's decision making and achieve the goals.

Sleep deprivation and lack of exercise can be cited as two major causes for many health issues. Many people are not aware that they are having such issues in their life style.



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