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 HWCs:
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.
SHC-HWC 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.
PHC/UPHC-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.
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
