Comprehensive Cost/Benefit Analysis and Business Case for IoT and ICT-Based Solutions for Critical Laboratory Results Communication at eHA Clinics

Introduction

Effective communication of critical laboratory results is essential to timely clinical interventions, patient safety, and adherence to international healthcare standards. The KPI for this process is 100% effectiveness of critical result communication, which aligns with JCI's International Patient Safety Goals (IPSG 2.1) and ISO 15189's Process Requirements (7.4.1.3). This analysis explores the potential for ICT and IoT technologies to streamline critical result communication at eHA Clinics and other PHCs in Nigeria, enhancing timeliness, efficiency, and quality of care.

Health Care Quality Benchmark: Critical Laboratory Results Communication

Key Areas:

  1. Immediate Notification: Automate notifications for critical lab results.
  2. Real-Time Monitoring: Track the time between result discovery and doctor acknowledgment.
  3. Improved Traceability: Maintain detailed logs for audits and continuous quality improvement.

Current QA/QC Processes:

  • Critical values are communicated via Google Hangout.
  • A tracking sheet records discovery time, communication time, and acknowledgment time.
  • Staff physically deliver results if no acknowledgment is received within 5 minutes.

Automation Potential: High

  • Automating notifications and integrating with existing systems like Odoo and EMR can significantly reduce delays and manual workload.

Proposed IoT and ICT Solutions

  1. Automated Notification System:
    • Product: Twilio Notify or Pushover API.
    • Functionality: Sends real-time critical result notifications via SMS, email, or app alerts to doctors.
    • Benefits: Ensures immediate delivery and acknowledgment tracking.
  2. IoT-Enabled Critical Result Alert Devices:
    • Device: Zigbee Smart Buttons integrated with Home Assistant.
    • Functionality: Allows lab staff to trigger critical result alerts directly to physicians’ devices or kiosks.
    • Benefits: Reduces manual processes and improves timeliness.
  3. Integration with Odoo and EMR:
    • Features: Integrate critical values into the EMR and enable highly sensitized alerts for flagged results.
    • Customization: Add an acknowledgment feature to Odoo’s Lab Invoicing and Communication modules.
    • Benefits: Provides traceability and reduces reliance on third-party apps like Google Hangout.
  4. BLE or LoRaWAN-Based Acknowledgment Devices:
    • Device: Adeunis LoRaWAN Buttons or BLE beacons.
    • Functionality: Doctors can acknowledge results via portable devices, triggering an update in the lab system.
    • Benefits: Tracks response times automatically.
  5. Centralized Monitoring via Home Assistant:
    • Functionality: Use HA for real-time dashboards displaying pending critical results, acknowledgments, and timelines.
    • Applicability: Suitable for large facilities with multiple care providers.
  6. Smart Displays for Audiovisual Alerts:
    • Product: Raspberry Pi Smart Display integrated with Home Assistant.
    • Functionality: Provides visual and auditory alerts for critical results in common areas like nurses’ stations.
    • Benefits: Ensures results reach physicians promptly.

Cost Analysis

  1. Initial Investment:
    • Automated Notification System: ~$1,500 for integration and initial setup.
    • IoT Alert Devices: ~$50 per Zigbee button. For 20 buttons: ~$1,000.
    • LoRaWAN Devices: ~$150 per device. For 10 devices: ~$1,500.
    • Smart Displays: ~$200 per unit. For 5 units: ~$1,000.
    • Odoo Integration Development: ~$5,000 (one-time).
    • Home Assistant Setup: ~$1,000 for hardware and configuration.
  2. Operational Costs:
    • System Maintenance: ~$750 annually.
    • Notification Service Fees: ~$500 annually for platforms like Twilio.

Total Estimated Initial Cost: ~$11,000

Annual Operational Cost: ~$1,250

Benefit Analysis

  1. Quality Improvement (QI):
    • Improved Timeliness: Reduces the communication timeline from 30 minutes to under 10 minutes.
    • Streamlined Workflow: Automates result delivery, reducing staff burden.
  2. Quality Assurance (QA) and Quality Control (QC):
    • Real-Time Monitoring: Tracks each step in the result communication process for accountability.
    • Standardized Reporting: Ensures consistent adherence to communication protocols.
  3. Operational Efficiency:
    • Reduced Delays: Eliminates manual steps like physical result delivery.
    • Enhanced Collaboration: Integrates communication channels directly into the EMR and Odoo.
  4. Financial Benefits:
    • Cost Savings: Reduces time spent on manual result communication by up to 50%.
    • Optimized Resources: Frees up staff for other critical tasks.
  5. Compliance and Reputation:
    • Global Standards Alignment: Meets JCI and ISO benchmarks, enhancing accreditation prospects.
    • Patient Confidence: Ensures timely interventions, improving patient outcomes and satisfaction.

Return on Investment (RoI) and Marketing Language

ROI Messages:

  • Efficiency Gains: Automating critical result communication saves 5-10 hours per month per facility.
  • Cost Reduction: Reduces manual workload and associated costs by up to 20%.
  • Timely Interventions: Faster communication directly improves patient outcomes and reduces liability risks.

Marketing Language: "Revolutionize critical result communication at eHA Clinics with intelligent IoT solutions. Our real-time alerts, automated tracking, and EMR integration ensure timely interventions, safeguard patient safety, and enhance operational efficiency—because every second counts."

Industry Best Practices and Innovations

  1. Automated Escalation Systems:
    • Leading hospitals use multi-channel escalation systems to ensure critical results are acknowledged promptly.
    • Applicability: Twilio or Pushover can replicate this process for eHA Clinics.
  2. AI-Driven Critical Alerts:
    • AI algorithms analyze lab results to identify critical values and prioritize communication.
    • Applicability: Can integrate with Odoo and EMRs for advanced decision support.
  3. Wearable Acknowledgment Devices:
    • Wearables like smartwatches notify physicians of critical results and track response times.
    • Applicability: Ideal for large facilities with mobile care providers.
  4. Cross-Platform Integration:
    • Systems like Epic integrate lab alerts with clinical workflows, reducing response times.
    • Applicability: Odoo and Home Assistant can provide similar functionalities with proper customization.

Viability in the Nigerian Context

  1. Cost-Effectiveness: Affordable solutions like Zigbee buttons and Twilio ensure high RoI with minimal investment.
  2. Scalability: Modular systems allow gradual rollout across facilities.
  3. Infrastructure Compatibility: IoT technologies operate effectively in both urban and semi-urban settings.
  4. Ease of Adoption: Integration with Odoo simplifies staff training and reduces resistance to new systems.

Conclusion

IoT and ICT-based solutions for critical laboratory result communication offer a high-priority investment opportunity for eHA Clinics. By automating notifications, integrating with existing systems, and leveraging IoT devices, eHA Clinics can significantly enhance timeliness, compliance, and patient safety. These technologies are scalable, cost-effective, and adaptable to Nigeria’s healthcare landscape, ensuring a high RoI while meeting global standards.

Next Steps

  1. Pilot Program: Implement the automated notification system and IoT-enabled devices in a single facility.
  2. Integration Development: Customize Odoo for critical result alerting and tracking.
  3. Staff Training: Train lab and clinical staff on the use of new tools and workflows.
  4. Evaluate Outcomes: Monitor reductions in communication timelines and improvements in critical result acknowledgment rates to guide broader adoption.