Introduction

Health and Wellness Centers (HWCs) are a critical component of India's healthcare system, part of the Ayushman Bharat initiative. The following documentation outlines the key aspects of HWCs, their role in providing Comprehensive Primary Health Care (CPHC), and their contribution to Universal Health Coverage:

In February 2018, the Government of India announced the establishment of 1,50,000 Health and Wellness Cantres (HWCs) as a fundamental pillar of the Ayushman Bharat initiative. These HWCs are intended to transform existing Sub Cantres and Primary Health Cantres, bringing healthcare services closer to the homes of people. They aim to provide Comprehensive Primary Health Care (CPHC), encompassing maternal and child health services and the management of non-communicable diseases. Additionally, these centers offer free essential drugs and diagnostic services.

Objectives:

Health and Wellness Centers are designed to offer a wider range of services, addressing the primary healthcare needs of the entire population in their respective areas. The emphasis is on health promotion and disease prevention, empowering individuals and communities to adopt healthy behaviors and reduce the risk of chronic diseases and morbidities.

Universal Access:

By delivering Universal Comprehensive Primary Health Care, HWCs increase the health system's responsiveness to the people by making services more accessible to communities and addressing the needs of the most marginalized populations through a Primary Health Care team.

Pradhan Mantri Jan Arogya Yojana (PM-JAY):

In conjunction with HWCs, the Pradhan Mantri Jan Arogya Yojana (PM-JAY) seeks to provide financial protection for secondary and tertiary healthcare to approximately 40% of India's households. Together, these two components of Ayushman Bharat aim to achieve the aspiration of Universal Health Coverage.

Defining Health and wellness centre

HWCs are established by converting existing Sub Centers and Primary Health Centers in rural and urban areas. These centers follow the principle of "time to care," ensuring that care is provided within 30 minutes. They may also provide services through outreach programs, Mobile Medical Units, camps, home-based care, and community-based care, all of which should create a seamless continuum of care while upholding principles of equity, universality, and financial accessibility.

Sub health center and Health and Wellness Centre Team:

HWCs at the Sub Health Centre level are staffed by a trained Primary Health Care team, including multi-Purpose Workers (male and female), Accredited Social Health Activists (ASHAs), and led by a Mid-Level Health Provider (MLHP). This team delivers an expanded range of services, and some states have transformed Additional Primary Health Centers (PHCs) into HWCs.

Primary Health Centre/Urban Primary Health Centre-HWC Team:

The Medical Officer at the Primary Health Centre (PHC) ensures that CPHC services are provided not only at the HWCs but also at the PHC itself. The staff qualifications and numbers at the PHC are in accordance with the Indian Public Health Standards (IPHS). Strengthening PHCs to HWCs includes training for staff, provision of equipment for wellness rooms, IT infrastructure, and resources for laboratory and diagnostic support.

Key Principles:

The implementation of HWCs is guided by several key principles, including:

Transforming existing facilities for universal access to Comprehensive Primary Health Care services.
Emphasizing a people-centered, holistic, and equity-sensitive approach.
Delivering high-quality care using standard protocols and advanced technologies.
Promoting a team-based approach to healthcare.
Ensuring continuity of care through a two-way referral system.
Focusing on health promotion and public health action.
Incorporating flexible financing and performance-based incentives.
Integrating Yoga and AYUSH as per people's needs.
Utilizing technology for improving access and recording.
Involving civil society for social accountability.
Collaborating with non-profit organizations and the private sector.
Encouraging learning, feedback, and innovation.
Establishing robust measurement systems for accountability and performance improvement.

The establishment of Health and Wellness Centers is a significant step towards enhancing primary healthcare services, promoting preventive healthcare, and working towards the goal of Universal Health Coverage in India.

2.General Information

Health and wellness Centre web application is the digital platform used to provide Information, resources and also services related to health and well-being of the beneficiaries staying in vulnerable sections of the society. These applications are valuable for the beneficiaries who are looking to manage their health and wellness and healthcare providers or organization seeking to offer online support and services.

2.1 System Overview

The Health and wellness center has the following functionalities and modules which are as follows

Login Page
Registration Page
Nurse Module
Doctor Module
Lab Technician
Pharmacist

Login Page

This login page is the entry point for users to access the application. It requires users to provide valid credentials to gain access. This document outlines the key components and functionality of the login page.

This is the welcome page of the HWC(Health and wellness center) application and to proceed further click on HWC Link

Spoke :- This is a concept used in healthcare systems where there is a central facility, often referred to as the "hub," which serves as a focal point for a network of smaller facilities, known as "spokes." The hub is usually a larger, more comprehensive healthcare facility, such as a hospital, while the spokes are smaller clinics or healthcare centers. This is a concept used in healthcare systems where there is a central facility, often referred to as the "hub," which serves as a focal point for a network of smaller facilities, known as "spokes." The hub is usually a larger, more comprehensive healthcare facility, such as a hospital, while the spokes are smaller clinics or healthcare centers.

Here select the Name of Hub and then click on Continue

Beneficiary consent – Beneficiary consent is a crucial step before proceeding with registration. It is essential to obtain consent from the beneficiary to store their data. Registration cannot be performed without the beneficiary's explicit consent.

Once clicking on "Accept" it signifies that the beneficiary has provided their consent for the storage of their data, which is a necessary prerequisite for registration. This consent ensures compliance with privacy and data protection regulations and guarantees that the beneficiary is aware of and agrees to their data being stored.

Registration

The Registrar Role is one of the available roles in the Registration Page. This role is mainly responsible for managing the registration of Beneficiaries who visit the Hospital

The “Registrar has following Subcomponents which are as follows

a) Registration

This role is specifically designed for registering the beneficiaries who visit the hospital. Registrar using the tab can enter and manage Beneficiary information.

b) Search

The "Search" bar is primarily used for searching and retrieving information about existing beneficiaries. It allows registrars to look up and access beneficiary records.

Here the Beneficiaries can be searched with Mobile number as well as Beneficiary ID as well as ABHA ID

Personal Information

In this section, essential personal details of the beneficiary must be recorded. These details are crucial in meeting clinical requirements and ensuring effective service. It is important to ensure that the following mandatory fields are correctly filled out:

It is important to complete the following mandatory fields to ensure comprehensive and accurate record-keeping:

a)First Name: Enter the beneficiary's first name in the designated field. Make sure to provide the accurate spelling and verify it for correctness.

b)Contact Number: Input a valid contact number where the beneficiary can be reached in case of need. Verify the number's accuracy to ensure effective communication.

c)Gender: Select the beneficiary's gender from the provided options. Ensure this information is accurate as it can be essential for tailoring healthcare services.

d)Age: Specify the beneficiary's age in years. Ensure the age provided is precise, as age can influence clinical assessments and care.

e) Age Unit: The Age unit is divided into Months, Days and year and after entering the Age and selecting the Age unit the Date of Birth will automatically reflect.

f) Marital status: Marital status is the field to know the status whether the person is Married or Unmarried

Location Information

Location information refers to specific details about where a person, place, or event is situated on the Earth's surface. It helps identify a particular geographical area, enabling accurate navigation, communication, and organization of various activities. The essential components of location information include:

a) State: The largest administrative division within a country, typically with its own government. States are further divided into smaller administrative units like districts, regions, or provinces.

b) District: A smaller administrative division within a state or country. Districts are often important for regional governance and are further divided into smaller units like taluks, counties, or municipalities.

c)Taluk: Also known as a tehsil or sub-district, a taluk is an administrative division within a district. It comprises several villages and towns and is headed by a tahsildar or a sub-collector.

d)Street/Panchayat/Village: These terms refer to progressively smaller and more specific geographical divisions.

e) Habitation -Here Habitation is the place where the beneficiaries’ house is located

Below is the screenshot for the reference

Other information

"Other Information" refers to supplementary details required during a registration process. This section typically includes two types of information:

1) Members of Family

Members of Family refers to the individuals connected to the registrant through familial ties. This may include their names, relationships, and other relevant details.

2) Other Details

There are other details in “Other Information” which has to be entered such as

Email -ID

Here E-Mail ID is referred to the Beneficiaries Email address .

Community

Community here refers to the caste of the Beneficiary such as SC,ST and OBC .

3) Bank Details

Bank Details consist of the financial information necessary for transactions or account setup. This information may encompass bank account numbers, branch information, and other pertinent financial data.

Bank details includes the following Information

Bank Name
Branch Name
Account No
IFSC Code

ABHA ID

The ABDM initiative has empowered citizens to establish their Ayushman Bharat Health Account, commonly referred to as "ABHA," through a process that encompasses self-registration and assisted modes. Acknowledging the existence of geographic areas within the country where internet or mobile connectivity is either inaccessible or limited, ABDM has introduced an alternative method to facilitate the creation of ABHA (referred to by a specific number) via digital devices in an offline mode. The widespread adoption of ABDM is poised to enhance the accessibility, efficiency, and affordability of healthcare services in these particular regions of the nation.

The Ayushman Bharat Health Account (ABHA) Health Card, introduced as part of the Ayushman Bharat program, serves as an innovative healthcare solution. This card comprises a 14-digit identification number, which can be generated using either Aadhaar card or mobile number of the Individual, providing with a distinct health identity.

The Abha ID can be generated through 2 different modes which are

a) Biometric

b) Aadhar card

Below is the screenshot for the reference

Here is the process of Generating ABHA ID through Aadhar

Select the mode as “Aadhar” for generating ABHA ID

Enter Aadhar Number and click on Generate

Click on “OK” button to get the OTP

Enter the OTP sent to the registered Mobile number and click on “Submit”

After entering OTP enter the Registered mobile number

ABHA is generated succesfully and here is the screenshot for the reference

Advanced Search

This Functionality can also be used the search the existing beneficiary and there are mandatory fields to check such as

First Name
Gender
State
District

Nurse Module

The Beneficiary ID has to be selected which was done during Registration.

Reason for Visit

For any beneficiary it is important to capture Reason for Visit details and here there are 4 categories

1.Follow up

Follow up is done for existing beneficiaries and it can be any follow up can be done for any kind of symptoms such as Fever or cough

2.New chief complaint

New chief complaint is taken basically for new beneficiaries who are getting registered initially and medication is done accordingly

3.Referral

Referral is done basically if the nurse is unable to perform or cure patient’s illness then it will be referred to Doctor or higher center

4.Screening

Screening, in medicine, is a strategy used to look for as-yet-unrecognized conditions or risk markers. This testing can be applied to individuals or to a whole population.

Visit category

is indicates that for any follow up or any chief complaint what is the category that needs to be selected so if it is a follow up or chief complaint then for that purpose beneficiary is doing follow up or what is the purpose for that chief complaint .

Sub visit category

Sub visit category are selected based on the visit category for which beneficiary is given medication

For eg-If Beneficiary selects General OPD then the sub visit category could be

a)Basic Oral health care services

b)Care for Eye, Ear ,Nose and throat

c)Management of communicable diseased

Chief complaint

A chief complaint (CC) is a concise statement describing the symptom, problem, condition, diagnosis, physician recommended return or other factor that is the reason for the patient encounter. A CC is required for all levels of service.

a)SNOMED CT

SNOMED CT is one of a suite of designated standards for use in U.S. Federal Government systems for the electronic exchange of clinical health information and is also a required standard in interoperability specifications of the U.S. Healthcare Information Technology Standards Panel. The clinical terminology is owned and maintained by SNOMED International, a not-for-profit association.

Upload Files

Upload files is basically used to upload the Medical records of the beneficiary and it is basically saving the existing medical records of the beneficiary

Schedule for TM

When the beneficiary wants to connect with Doctor on video call at the place where Doctors are not available especially in villages then the schedule for telemedicine will be done

Past History signifies the medical history of the beneficiary and the history can be captured only for existing beneficiaries

It includes few points which are

a)Illness-Past illness

b)Duration-No of days

c) Time period ago-Time taken to fix the issue

There is also Add and Remove functionality and “Add” functionality will add the past illness and “Remove” functionality will remove the as it is not required

Below is the screenshot of list of illness

Past H/O Surgery

Past H/O Surgery indicates the history of the surgery which was done in the past and it includes the following points which are as follows

a)List of surgery

b) Duration-No of days

c) Time period ago-Time taken to fix the issue

Below is the list of H/O surgery

Comorbidity/Concurrent conditions also includes

a)Comorbid conditions

b)Duration

c)Duration of units

Medication history

It indicates the past medical history of the beneficiaries

Medication history has an additional Add functionality

Personal History(Habits/Risk factors)

It's essential to gather information about a beneficiary's personal history, including any risk factors or habits that might impact their health. Here's an outline of how you might delve into these categories:

Previous Tobacco History:

Smoking Habits: Record any previous smoking habits, including duration, frequency, and quantity. This involves cigarettes, cigars, pipes, or any other tobacco products.

Duration of Use: Note the period during which tobacco was consumed regularly.

Cessation Attempts: Explore if there have been any attempts to quit smoking and their success.

Previous Alcohol History:

Drinking Patterns: Understand the frequency and quantity of alcohol consumption.

Duration of Use: Note the duration over which alcohol has been consumed.

Alcohol-related Issues: Inquire about any related problems such as dependency, accidents, or health complications.

Previous Allergy History:

Known Allergies: List any known allergic reactions to specific substances, foods, medications, or environmental triggers.

Severity: Gauge the severity of allergic reactions experienced in the past.

Treatment and Management: Explore how allergies have been managed or treated previously.

Additional Considerations:

Dietary Habits: Enquire about the typical diet patterns, including preferences, any specific diets followed, and nutritional intake.

Exercise Routine: Gather information about physical activity levels and exercise routines.

Medical History: Include any past medical conditions, surgeries, or chronic illnesses that might impact their health.

When collecting this information, it's crucial to maintain confidentiality and create an open and non-judgmental environment to encourage honest disclosure. This data is essential for healthcare professionals to understand and manage potential health risks and tailor appropriate interventions or guidance for the beneficiaries' well-being.

Family History

Family medical history is a comprehensive record detailing the health conditions and illnesses experienced by the relatives of the Beneficiaries. This historical data is crucial in understanding and assessing potential health risks and genetic predispositions among family members. The family medical history is divided into several key categories:

1) Disease Types:
Family members have encountered various health conditions, including but not limited to:

Asthma

Diabetes Mellitus

Epilepsy (Convulsions)

Hemiphelgia (Stroke)

Hypertension

Infant and Congenital Anomalies

Ischemic Heart Disease

Multiple Pregnancy (Nil)

2) Affected Family Members:
Details regarding specific family members who have been afflicted by the aforementioned diseases:

Brother

Sister

Father

Mother

Daughter

3) Past Family History:
Accessing the previous medical history of the Beneficiary's family members involves clicking on an icon, which prompts a pop-up display presenting the relevant historical medical information.

4) History of Genetic Disorders:
This section delineates any disorders or diseases prevalent among the family members of the Beneficiaries. It includes a dropdown selection:

Yes

No

Once clicking yes on H/O Genetic disorders then a free text for Genetic disorders appear on the screen.

5) Consanguineous Marriages:
Refers to unions occurring within the same family or blood relations. It is divided into dropdown selections:

Yes

No

Add and Remove Button

Within this system, several crucial components demand the inclusion of additional information regarding a patient's health. Each of the following aspects: Further Illness or Surgery, Comorbidity or Concurrent Conditions, Medication History, Personal History (Habits/Risk Factors), and Family History necessitates thorough documentation. To facilitate this, an 'Add' button is incorporated across all functionalities. This button serves the purpose of capturing any additional details pertaining to these areas. If there are new instances or updates related to any of these categories, users are required to click on the 'Add' button to ensure comprehensive data capture.

Upon clicking the cross symbol associated with any added field, the system will initiate the deletion process for that particular entry. This action effectively removes the additional field from the interface, streamlining the information and ensuring a cleaner, more organized display of data."

After clicking on next it goes to Anthropometry screen

Anthropometry

Anthropometry is the scientific study of the measurement and proportions of the human body. It involves taking accurate measurements of various body parts and dimensions to understand human physical variation, growth, and development. This field is utilized in various disciplines such as anthropology, ergonomics, medicine, nutrition, and sports science.

Categories of Anthropometry:

Anthropometry encompasses various crucial measurements that shed light on human body composition and structure. These measurements include:

Height (CM): The vertical measurement from the base to the top of an individual, providing insights into growth patterns and stature.

Weight (kg): The quantitative assessment of body mass, crucial for understanding health, fitness, and nutritional status.

Body Mass Index (BMI): A calculated index using an individual's weight and height, aiding in categorizing weight status and health risks.

Waist Circumference (cm): Measurement around the narrowest part of the abdomen, significant in assessing abdominal fat and associated health risks.

Hip Circumference (cm): Measurement around the widest part of the hips, contributing to assessments of body shape and potential health implications.

Waist-to-Hip Ratio: Calculated ratio between waist and hip circumference, offering insights into body fat distribution and associated health risks.

Note:-Weight(kg) is checked with the help of Device called as Healthcube

Vitals

Vital signs indeed play a critical role in assessing an individual's health status and are fundamental in various medical evaluations and treatments. These measurements encompass several key physiological parameters that indicate the body's overall functioning. The primary vital signs typically include:

Temperature (°F):

Temperature measurement is essential in gauging the body's heat balance and detecting potential signs of fever or hypothermia. It is typically recorded in degrees Fahrenheit (°F).

Pulse Rate (Per Min):

Pulse Rate

Pulse rate refers to the number of heartbeats per minute (bpm) and reflects the heart's functioning. It's commonly measured at arterial points and is an integral component of cardiovascular assessment.

SPO2% (Oxygen Saturation):

SPO2%(Oxygen Saturation):

SPO2, or peripheral capillary oxygen saturation, denotes the oxygen saturation level in the blood. It is a measure of how much oxygen the blood is carrying, usually expressed as a percentage.

Blood Pressure (BP):

Blood Pressure (BP)

Blood pressure is the force exerted by circulating blood against the walls of blood vessels. It comprises two measurements:

Systolic BP (mmHg): The pressure in the arteries when the heart contracts.

Diastolic BP (mmHg): The pressure in the arteries when the heart relaxes between beats.

It is represented in millimeters of mercury (mmHg) and is critical for assessing cardiovascular health.

Respiratory Rate (min):

Respiratory Rate(Min)

Respiratory rate signifies the number of breaths taken per minute. It is a vital parameter in assessing lung function and overall respiratory health.

Random Glucose Test

RBS test is a simple blood test used to measure the amount of glucose present in the bloodstream at a given time, regardless of when the individual last ate. Elevated blood sugar levels beyond the normal range can indicate various conditions, with diabetes being one of the primary concerns.

Random Glucose test is divided into following categories

RBS Result(mg/dl)

The result of RBS is typically measured in milligrams per deciliter (mg/dL).

RBS Test Remarks

The remarks or interpretation of RBS (Random Blood Sugar) test results can vary based on the measured glucose level in the blood. Here are some possible remarks or interpretations

Examination

General Examination

The general examination is a visual and manual examination to collect, in a reasonably short time, information that can be combined with the signalaient, history, and general impression to guide the problem formulation and give direction to further examination.

General examination is divided into following categories which are as follows

1.Consciousness

Consciousness is a complex and multifaceted phenomenon that refers to the state or quality of being aware of and able to perceive both internal and external stimuli. It involves subjective experiences, sensations, thoughts, feelings, and perceptions. While it is a fundamental aspect of human experience, the exact nature and mechanisms of consciousness remain a topic of ongoing debate and exploration in various fields such as philosophy, psychology, neuroscience, and cognitive science

It is divided into three categories

a) Conscious

Conscious is a person having mental faculties but not dulled by sleep ,faitness or stupor.It also includes perceiving, apprehending or noticing with a degree of controlled thought or observation

b) Semiconscious

Semiconsciousness refers to a state that lies between full consciousness and unconsciousness. It implies a diminished level of consciousness where a person may have some awareness of their surroundings or internal experiences but is not fully alert or responsive.

c)Unconscious

When someone is unconscious in a medical context, it means they are not responsive to stimuli and cannot be awakened. This state can result from various causes, such as trauma, medical conditions, intoxication, or underlying health issues.

All these are in the form of Dropdowns

Cooperation

Cooperation in the medical context refers to the collaborative relationship between healthcare providers (such as doctors, nurses, specialists, therapists, and other professionals) and patients or their families. It involves mutual understanding, communication, and shared decision-making to achieve the best possible outcomes in healthcare.

Cooperation is divided into following categories

a)Cooperative

Cooperation in the medical context refers to the collaborative relationship between healthcare providers (such as doctors, nurses, specialists, therapists, and other professionals) and patients or their families. It involves mutual understanding, communication, and shared decision-making to achieve the best possible outcomes in healthcare.

b) Irritable

Irritable" in a medical context often refers to a symptom or condition related to increased sensitivity or a tendency to react strongly to stimuli.

c)Restless

Restless typically refers to a state of agitation, unease, or the inability to stay still or relax.

Kindly find the screenshot in which it is in the form of dropdowns

Built and appearance

The classification of body types based on build or appearance can vary. While there isn't an exact standard classification universally adopted, general terms might be used to describe different body builds. Here's an overview:

a)Thin Build: Individuals with a thin build typically have a lean and slender physique. They tend to have smaller frames, less muscle mass, and lower body fat compared to other body types. Some medical conditions or lifestyle factors might contribute to being thin, such as a high metabolic rate, certain illnesses, or genetic factors.

b)Moderate Build: This category usually refers to individuals who have an average or moderate body size and composition. They neither fall into the thin nor heavy build categories. They might have a relatively balanced proportion of muscle and fat, without being notably lean or overweight.

c)Heavy Build: This term is often used to describe individuals who have a larger or heavier body size. They might have a higher percentage of body fat or a more substantial muscular build. It's important to note that a heavy build doesn't necessarily equate to being unhealthy .It’s more about a larger physical presence or higher body weight compared to thin or moderate builds.

The General examinations encompass several additional features, crucial to their comprehensive nature. Some of these key components include

1)Coherent

Coherent refers to the quality of being logical, consistent, and interconnected. It describes a state where different pieces of information, symptoms, or findings fit together logically, forming a unified and understandable picture or explanation. In medical contexts, coherence often relates to the consistency of symptoms, test results, and the overall clinical presentation of a patient, aiding healthcare professionals in making accurate diagnoses and treatment decisions based on a cohesive understanding of the situation.

There are two dropdowns in coherent which are

a) Yes

b) No

2) Comfort

Comfort assessment is a critical aspect of evaluating the well-being of an individual following a comprehensive examination. It involves the categorization of the beneficiary's state into comfortable or uncomfortable conditions, which further helps identify specific discomfort indicators.

Comfort Categorization:

a)Comfortable: Refers to a state where the beneficiary exhibits signs of being at ease and without evident discomfort.

b)Uncomfortable: Signifies a condition where the beneficiary shows signs or indicators of discomfort, requiring closer attention and further assessment.

Uncomfortable Subcategories:

When assessing discomfort, various indicators or subcategories may manifest in the beneficiary. Some of these discomfort indicators include:

Danger Signs: Observable indications that suggest an immediate threat to the beneficiary's health or well-being.

a)Fast Breathing: Increased respiratory rate beyond normal ranges, signaling potential respiratory issues or distress.

b) Chest Indrawing: Visual inward movement of the chest during breathing, often a sign of breathing difficulties.

c)Stridor: Audible high-pitched breathing sounds resulting from narrowed airways, indicating respiratory distress.

d)Grunt: Audible sound produced during expiration, commonly associated with breathing difficulties, especially in infants or young children.

e)Respiratory Distress: General difficulty in breathing or inadequate oxygen intake, leading to visible distress.

f)Cold and Calm Peripheral Pulses: Abnormalities in peripheral pulses characterized by coldness and calmness, potentially indicative of circulatory problems.

g) Convulsions: Involuntary and sudden muscle contractions, often associated with neurological issues or seizures.

h) Hypothermia: A dangerously low body temperature that can indicate a critical health condition requiring immediate attention.

Below is the screenshot for the reference

3) Gait

In medicine, gait refers to the pattern of movement and manner of walking. It encompasses the way a person walks, including their posture, rhythm, speed, stride length, and the coordinated movement of various body parts involved in walking. Assessing a person's gait is an important part of a physical examination because changes or abnormalities in gait can be indicative of various medical conditions, injuries, or neurological issues. Observing and analyzing someone's gait can provide valuable information to healthcare professionals in diagnosing or monitoring certain disorders affecting the musculoskeletal system, nervous system, or other body systems.

Gait is divided into following categories

a) Normal Gait:

Normal gait refers to the typical, smooth, coordinated, and efficient walking pattern exhibited by individuals without any apparent impairment or abnormality in their walking pattern.It involves a rhythmic and coordinated sequence of movements involving the legs, hips, and feet, allowing individuals to walk comfortably, with balance and stability.

b) Limping:

Limping, also known as an abnormal gait, is characterized by an uneven or irregular walking pattern due to pain, injury, weakness, or other underlying medical conditions affecting the legs, hips, or feet.

It involves an altered gait pattern, where the individual may favor one leg or exhibit an uneven distribution of weight while walking, often resulting in a noticeable limp or asymmetrical movement

4) Danger signs

"Danger signs" in a medical examination refer to specific indicators or symptoms that suggest a severe or life-threatening condition requiring immediate attention or intervention. These signs are crucial in identifying patients who are critically ill and in need of urgent medical care. Some of the common danger signs include the following dropdowns

a) Yes

b) No

Once clicking on Yes there appears another fields known as Danger sings and it is following into following dropdowns which are in the form of checkbox which are

a)Fast Breathing

b)Chest Indrawing

c)Stridor

d)Grunt

e)Respiratory distress

f)Cold and calm peripheral pulses

g)Convulsions

h)Hypothermia

i)Delirium

j)Uncontrolled Breathing

k)Hematemesis

l)Refusal of feeds

5)Pallor

"Pallor" refers to an unhealthy pale appearance of the skin. It's a clinical observation that can be noted during a physical examination of a patient. Pallor can be present or absent based on whether the skin appears pale or not.

Pallor is divided into following dropdowns

a)Present

If the skin appears notably paler than usual, it could indicate various underlying conditions such as anemia, shock, reduced blood flow, or decreased oxygenation of the blood.

b)Absence

If the skin color appears normal, without any significant paleness, it suggests that the patient doesn't exhibit this particular sign of pallor.

6)Jaundice

Jaundice is a condition produced when excess amounts of bilirubin circulating in the blood stream dissolve in the subcutaneous fat (the layer of fat just beneath the skin), causing a yellowish appearance of the skin and the whites of the eyes.

There are two types of Jaundice which shows whether Patient is undergoing Jaundice oe Not

a) Yes

b) No

7)Cyanosis

Cyanosis is a medical condition characterized by a bluish discoloration of the skin, mucous membranes, or nails. It occurs when there is a decreased level of oxygen in the blood. This bluish tint is most noticeable in areas where blood vessels are closer to the skin's surface, such as the lips, fingertips, nails, or the skin under the eyes.

There are two dropdowns in Cyanosis

a) Present

b) Absent

9)Lymphadenopathy

Lymphadenopathy refers to the enlargement or swelling of lymph nodes. Lymph nodes are small, bean-shaped structures that are part of the lymphatic system, which plays a crucial role in the body's immune system. They are distributed throughout the body and act as filters for harmful substances, such as bacteria, viruses, and abnormal cells.

There are two dropdowns in Lymphadenopathy

a) Present

b) Absent

10)Edema

Edema refers to the swelling caused by excess fluid trapped in the body's tissues. It occurs when small blood vessels leak fluid into nearby tissues, leading to an abnormal accumulation of fluid. This buildup can happen in various parts of the body, such as the hands, arms, feet, ankles, and legs, or it can affect other areas, including the lungs or abdomen.

There are two Dropdowns in Edema

a) Present

b) Absent

Head to Toe examination

A head-to-toe examination is a comprehensive physical assessment conducted by healthcare professionals, such as doctors, nurses, or physician assistants. It involves systematically examining all parts of a patient's body, starting from the head and progressing down to the toes. The purpose of a head-to-toe examination is to assess a patient's overall health, identify any abnormalities, evaluate the functioning of various body systems, and detect potential health issues.

Under Head-to-toe examination select

a) Normal or

b) Anormal

After selecting Abnormal enter the following details in the screenshot such as

Head
Eyes
Ears
Nose
Throat
Oral cavity

Now click on Submit

Doctor Module

Select the Beneficiary from the Doctor list

After clicking on the Beneficiaries, the details which was entered in Nurse Module will be displayed in Doctor Module

The chief complaints entered by Nurse will be displayed in the Nurse Module

Next go to CDSS (Clinical decision support system and Doctor will check whether all details are entered correctly by Nurse and if any changes required then it can be edited from Doctor end

Next upload the files if any files relating to Beneficiary previous history or any other information

Click on Next and proceed to case Record section

Next Move to History section and Doctor will check the past history of the Beneficiaries

Now click on Next and enter Anthropometry details

Now enter the two details which are

Anthropometry details
Vitals

Click on Next and enter the Examination details

After entering the examination details click on Next move to Case record section

Case Record section

Here there are following sections in Case Record section

Previous Significant findings will include the past clinical findings of the Beneficiaries

"Next, click on 'Previous Visit Details' to view a comprehensive overview of past visit records for all beneficiaries. This section includes information on current vitals and blood pressure readings."

Next click on Finings and select the following things such as

a) Chief complaint-Select the following chief complaint from the card such as Fever or cough and also enter Duration , Unit of Duration and Description

b) Clinical Observation-Search the clnical observations from the algorithms

c) Significant findings- Search the significant findings from the algorithms

d) other symptoms: - Enter any other symptoms if applicable