Day 2 :
Keynote Forum
Michelle Black
University of Queensland, Australia
Keynote: Combatting compassion fatigue: Th e care professional’s resilience program
Time : 9:30-10:15
Biography:
Michelle Black is a Consultant, Educator and EAP Practitioner. She is an Advocate for leveraging the evidence to solve industry problems. She developed Australia’s fi rst evidence based program to combat compassion fatigue among community care professionals and has more than 20 years’ of experience in leading organizational
development and change in the commercial, government and not for profi t sectors. She is a Registered Counsellor and a Fellow of the Australian Institute of Training and Development. She has a Master of Counselling and a graduate certifi cate in Corporate Management. As an Advocate for people thriving in the workplace, she has
presented research on Compassion Fatigue at a number of national and international conferences and published peer reviewed articles in the Counselling Australia Journal and the Australian New Zealand 17th International Mental Health Conference papers. She is a PhD student at the University of Queensland and continues to advance
the research on Compassion Fatigue.
Abstract:
Articulated as the cost of caring for clients that have experienced trauma (Figley, 1995), the phenomenon of compassion fatigue (CF) also known as secondary traumatic stress (STS), is presented from a study of empirical research relating to CF among care professionals. Th e research uncovered, the symptoms, prevalence, risk
factors and best practice interventions identifi ed to alleviate individual experiences and symptoms of CF. Populations explored include; nursing, counselling, social work, hospice care, residential care, mental health and military health care professionals.The research informed the development of an evidence based program, combatting compassion fatigue; the care professional’s resilience program. The program incorporates a combination of best practice interventions to educate, develop selfcare, and develop emotional intelligence and problem solving capability to foster resilience, reduce the risk and alleviate experiences of CF. An independent pilot study of the program facilitated using the Eagala Model, occurred with a purposeful sample of 10 community care professionals (CCPs) working in residential care facilities in northern new south wales who self-nominated to participate in the program. Pre and post assessment occurred using the professional quality of life (ProQOL) scale (Stamm, 2010), as a screening tool and the Genos emotional intelligence self-test (Genos, 2015) to understand emotional intelligence factors. An analysis of the variance between the pre and post tests revealed ProQOL scores for compassion fatigue and burnout decreased whilst compassion satisfaction scores increased. Th e Genos emotional intelligence analysis found a statistically signifi cant improvement in overall emotional intelligence (p>0.05) and statistically signifi cant improvements (p>0.05) in the emotional intelligence factors of emotion self-management, emotional expression, emotion self-control and emotion awareness of others. Understanding the increasing demands, high staff turnover and limited capacity to release care professionals from their workplace, further research has commenced to undertake a clinical trial of the Combatting Compassion Fatigue. Care professionals resilience program facilitated in a blended learning mode using workshops, online learning and support resources to optimize access and engagement in the program for nursing healthcare professionals in highly demanding, high stress and high stakes environments
- Epidemiology and Public Health | Chronic and Infectious Diseases | Obesity and Health Risks | Gynecological Health and Disorders | Mental Health and Mental Disorders | Healthcare and Management
Location: Vasco de Gama 2
Chair
Amelia Sarmento
Universidade Fernando Pessoa, Portugal
Co-Chair
Usha Dane,
LIC, India
Session Introduction
Aline Ferreira Placeres
University of Sao Paulo | Brazil
Title: The relation between anxiety and depression and the loss of the occupational roles of people with spinal cord injury
Time : 11:20-11:55
Biography:
Aline Ferreira Placeres is an Occupational Therapist with a Master's Degree in Health Sciences from the University of Sao Paulo - USP Ribeirao Preto, Post Graduation in Physical Rehabilitation by the Multiprofessional Residency Program of the Medical School of Sao Jose do Rio Preto - FAMERP and Improvement in Occupational Therapy in the Hospital neurology at the School of Medicine of Sao Jose do Rio Preto- FAMERP. Regina Celia Fiorati holds a degree in Occupational Therapy from the Federal University of Sao Carlos, a Master's Degree in Psychiatric Nursing and a PhD in Sciences from the Postgraduate Program in Psychiatric Nursing at the Ribeirao Preto College of Nursing, University of Sao Paulo. Post-doctorate at the Faculty of Medicine of the Autonomous University of Madrid, Spain. He is currently teaching at the Undergraduate Course in Occupational Therapy at the Medical School of Ribeirao Preto, University of Sao Paulo. Accredited in the Postgraduate Program in Psychiatric Nursing at the Ribeirao Preto College of Nursing and the Interunit Program for PhD in Nursing at the School of Nursing at the University of Sao Paulo EE-USP and at the Ribeirao Preto College of Nursing EERP-USP. Acts in the following areas of knowledge: mental health, public health, collective health collective and social fi eld.
Abstract:
The study aimed to investigate the correlation of anxiety and depression symptoms with the incidence of loss of occupational roles in people with spinal cord injury, as well as the strategies adopted by health professionals to promote mental health for this population. It is a correlational cross-sectional study, with a predominantly quantitative approach, being a qualitative step. The
study included 30 people with traumatic spinal cord injury aged 19 years and 72 years and 10 health professionals who attended the population. The following instruments were used: Identifi cation Sheet; Beck Depression Inventory; Trait-State Anxiety Inventory; Role Checklist and Semi-Structured Interviews with health professionals. For the statistical analysis of the quantitative step, we used the IBM SPSS Statistic version 25 program, and in the qualitative step, the Bardin Content Analysis. A positive relation was identifi ed between anxiety, depression and occupational role losses, so that those who experienced more losses presented more symptoms of anxiety and
depression, and negative relation with continuous roles, in which those who continued to exercise more roles after the injury had fewer symptoms of anxiety and depression. The strategies adopted by health professionals for the promotion of mental health for this population are still limited, given
the lack of specialized services, the diffi cult referral to professionals in the area and the lack of more benevolent social positions towards this population accentuates the diffi culty to ensure accessibility and more egalitarian opportunities, thus contributing to the loss of the roles of this population.
Helena A. Ferris
HSE South | Ireland
Title: Challenges of managing an outbreak of tuberculosis in an immunocompromised setting
Time : 11:55-12:30
Biography:
Helena A. Ferris is a Specialist Registrar in Public Health Medicine and is a graduate of Trinity College Dublin.
Abstract:
Background: The management of an outbreak of Tuberculosis (TB) poses many challenges, particularly in the immunocompromised setting. The authors outline an outbreak of TB where two transplant recipients with sputum positive pulmonary TB attended a renal outpatients department in an acute hospital,
Methods: Interferon Gamma Release Assay (IGRA) has a higher sensitivity and specifi city (53%, 69%) than the Tuberculin Skin Test (TST) (31%, 63%) in immunocompromised individuals . IGRA was the primary screening test employed for immunocompromised contacts. Immunocompetent contacts were screened using the Mantoux TST. Results: A total of 13 cases of LTBI were identifi ed out of 138 screened contacts. Of these, 9 cases were identifi ed out of 38 immunocompetent close contacts (detection rate 23.7%) and 4 cases were identifi ed out of 100 immunocompromised hospital contacts (detection rate 4%). No further active cases of TB were identifi ed. Conclusion: It was anticipated that a greater rate of LTBI would be found in immunocompromised individuals. The true LTBI rate may well be higher; however, this could not be accurately assessed owning to the poor sensitivity and specifi city of screening
tests in immunocompromised individuals. Thus, all immunocompromised contacts with negative IGRA require chest x-ray follow up over a two year period.
Vineet Kumar Pathak
All India Institute of Medical Sciences | India
Title: Rural, Indian community-implication for insurance programme
Time : 12:30-13:05
Biography:
Vineet Kumar Pathak has completed his MBBS (2013 batch) from MGM, Medical College, MP, India with distinction Gold Medal in Paediatrics. Then he joined All India of Medical Sciences, New Delhi in 2015 as post-graduate student in Centre for Community Medicine. Currently he is working as Senior Resident in
department of Community and Family Medicine at All India Institute of Medical Sciences, Chhatisgarh, India.
Abstract:
Almost 8.6% of India’s 1.2 billion population are elderly, who spent considerable money from out-of-pocket (OOP) for healthcare. Any policy for elderly should encompass fi nancial protection from illness expenditure. However, lack of comprehensive information on OOP expenditure and its determinants, precludes such action. We studied a sample of 400 community-dwelling elderly in rural India, to assess cost incurred on outpatient and inpatient services, along with information on socio-demographics (individual-characteristics), morbidity (motivation for seeking-care), and social-engagement (healthseeking). Lubben Social Network Scale (LSNS) was used to assess the degree of social isolation. Multimorbidity was measured by Cumulative Illness Rating Scale for Geriatrics (CIRS-G). Mental health status was measured by the SF-12 mental component summary (MCS) score. The mean (95%CI) annual OOP expenditure was USD 156.3 (IQR, USD 103.0-209.5) with a median of USD 35.7 (IQR, USD18.2 -90.3), being explained signifi cantly by sex, statuses of morbidity, social engagement, and mental
health. In developing countries like India, information regarding different sub-headings of out of pocket expenditure on health (expenditure during visit to a formal doctor / non-formal doctor, over the counter purchase of medicine, medical aid purchase) is the basic input of targetted policy intervention whose evidences are provided in the present study. We recommend that the policy
for health of elderly persons in India should take into account of fi nancial protection. The policy should consider pre-payment mechanism like health insurance, as one of the components for providing fi nancial protection.
Maria Sheilla Cataluna Membrebe
Community College of Baltimore County, USA
Title: Service learning: Community involvement for CCBC nursing students
Time : 15:00-15:35
Biography:
Maria Sheilla Cataluna Membrebe is an Assistant Professor at the Community College of Baltimore County School of Health Professions. She has obtained her Master’s degree in Nursing Education at University of Phoenix and Bachelor of Science in Nursing from University of Santo Tomas. She served in the United States Army Reserve Nurse Corps. She was the recipient of the 2017 Clinical Practice Award from the Academy of Medical Surgical Nurses. She was also one of the recipients of the 2018 Excellence in Nursing Educator) Award from Baltimore Magazine.
Abstract:
Service learning is an impressive educational tool that incorporates community work into the curriculum. It encompasses three main components: service, curricular connection, and refl ection. Service learning helps students emerge from the theoretical world gained in the classroom to the real world learning experiences. Nursing students are given this learning opportunity to apply
knowledge gained in the classroom to reality by getting hands-on experience in the community. Students are evaluated on their ability to connect their course readings to class discussions and to their volunteer work. Class discussions and written materials are meant to demonstrate analytical thinking and use of college and community resource by students. Service learning creates a winwin
situation where the student meets a community need, and the community organizations build student knowledge that relates to nursing.
Deborah L. Threats
Medstar Georgetown University Hospital | USA
Title: A unit method of solving disruptive behavior
Time : 15:35-16:10
Biography:
Deborah L Threats has completed her MDIV in 1998 from Howard University and BSN in 1981 from Catholic University of America. She is currently working as a Clinical Nurse at Georgetown University Hospital. She has had fi ve poster presentations and one oral presentation on Disruptive Behavior. The one poster presentation was nationally at the ASPAN conference 2017. She has done her Nursing in the USA and International Nursing. She was a Major in the US
Army. She has over 35 years of experience in Nursing from being Hospital Administrator, Manager, and ICU Nursing to Med-Surg Nursing. She is now in the process of writing an article on how a unit manages Disruptive Behavior.
Abstract:
Disruptive behavior has and will continue to be an issue in nursing until it is made aware of and the staff is educated on the behavior. Disruptive behavior has plagued the nursing area for years to the point that nursing students are learning about a healthy work place environment. Nursing has had several articles on the subject but the issue continues to be prevalent within the
work environment. The unit that I currently work on has tackled the issue with surveys and frank conversations on the matter. The issue persists because nurses continue to have fear of retaliation and no management support. To decrease and completely eradicate this issue it has to be addressed. This was handled with the use of a sacred word, a sacred person, and when all else failed, mediation took place. The unit’s disruptive behavior has diminished and management has conducted less counseling on this behavior. I have developed a guideline for the unit to assure that there will continue to be a way of decreasing and eliminating disruptive behavior.
Hulya Kocyigit
Sivas Cumhuriyet University | Turkey
Title: The effect of scenario-based high fi delity and redo simulation methods on the medical error tendency, self-effi cacy and state anxiety levels of nursing students
Time : 16:30-17:05
Biography:
Hulya Kocyigit is currently working as Research Assistant at the Universty of Sivas Cumhuriyet, Turkey. She graduated from the Department of Nursing, Faculty of Health Sciences at the Universty of Sivas Cumhuriyet in 2015. She is
currently a Master’s degree student in the Department of Fundamentals of Nursing at the Universty of Sivas Cumhuriyet.
Abstract:
This study aims to defi ne the effect of scenario-based high fi delity and redo simulation methods on medical error tendency, self-effi cacy and state anxiety levels of nursing students. Our study which is designed as control group in experimental quality pre and post-test research was approved by Sivas Cumhuriyet University Ethical Committee and its consents was taken from all informed participants. The sample of the study consists of the second grade 80 students (redo simulation group n=40, single simulation group n=40) who have been trained in the Faculty of Health Sciences during the spring semester in 2017-2018 academic year. Including the single simulation group (20) and the repeated simulation group (20), a total of 40 subgroups were formed in two-student-groups. These subgroups were participated in the education of ‘the simulation scenario of a patient with chronic lymphocytic leukaemia’ which consists of fi ve steps. Self-description form, the state anxiety inventory, the self-effi cacy scale and the chronic lymphocytic leukaemia patient scenario skill assessment and the medical error situation evaluation checklist have been used as data collecting tools. Data have been evaluated by using Student t-Test, Mann Whitney U Test, Wilcoxon Marked Rank Test, Paired Sample t-Test, Chi-square Test, Kruskal Wallis H Test and Cronbach alfa analysis.
While the self-effi cacy and anxiety levels of the groups are close to each other in our study, it is determined that there is a statistically remarkable increase in self-effi cacy and a decrease in anxiety of the repetitive simulation group after the training. At the fi rst application, the skill levels and their tendency to medical errors of both groups are close to each other, but, after the second application, it is determined that there is a statistically remarkable decrease in the tendency to medical errors of the repeated simulation group and that those students correctly fulfi lled the nursing attempts expected from them (p<0.05). The majority of the students in our study emphasized that the simulation
should be repeated for the effectiveness of education. As a result, it could be said that the repeated simulation method is effective for nursing students in increasing self-effi cacy, and reducing anxiety and tendency to a medical error. In this context, it is recommended to include a repetitive simulation method in nursing curriculum programs.
Seyda Orhan
Sivas Cumhuriyet University | Turkey
Title: Determining the levels of anxiety, satisfaction and confi dence of nursing students in learning aspiration skills with low and high fi delity simulations
Time : 17:05-17:40
Biography:
Seyda Orhan is currently working as a Nurse at the Education and Research Hospital, University of Sivas Cumhuriyet. She has graduated from the Department of Nursing, Faculty of Health Sciences at the University of Sivas Cumhuriyet, in 2015. Currently, she is pursuing her Master’s in Fundamentals of Nursing at the University of Sivas Cumhuriyet.
Abstract:
The aim of our study was to determine the levels of anxiety, satisfaction and confi dence of nursing students in learning aspiration skills with low fi delity simulation (LFS) and high fi delity simulation (HFS). This experimental type of pre-post pattern was conducted with 80 students in 2017-2018 academic periods. The study was approved by the Ethics Committee of Cumhuriyet
University and informed consent was obtained from all participants. The data of the study were collected through Demographic Information Sheet (DIS), Evaluation Form of Aspiration Information and Skills (EFAIS), State-Trait Anxiety Inventory by Spielberger (STAI), Student Satisfaction and Self-Confi dence in Learning Scale (SSSCLS) and Simulation Design Scale (SDS). The students were given video footage that contains the training on aspiration skills and that was prepared by the researchers, and they were asked to repeat the topic before they came to the practice. Before the skill training, a pre-briefi ng was given to the students of the HFS group, and the students in LFS group were informed about the preliminary stage of the application. After this stage, DIS and STAI were applied to both groups. The skill training of the HFS group was carried out with a scenario on the application of endotracheal aspiration while the application for the LFS group was conducted with a case report similar to the scenario. In accordance with the simulation method, the training
in the HFS group was provided with the facilitator, and the application process in the LFS group was provided to the students without the intervention of the educator. In both groups, students were taken to the practice one by one, the training lasted approximately 20-30 minutes and the skill was evaluated by the researcher during the training. After the application, the students in the LFS group were made discussion on the process steps, and the students in HFS group were made discussion by giving feedback via video footage during the debriefi ng stage. In the aftermath of the training, STAI, SSSCLS and SDS were reapplied to the students. Student’s t-test, paired sample t-Test, Chisquare
analysis, frequency, percentage and Cronbach's alpha analysis were used in the analysis of the collected data and the analyses were conducted by SPSS for v-23.0 statistical package program. According to our fi ndings, there was no statistically signifi cant difference between the pre-training and post-training anxiety levels of the nursing students in the LFS and HFS groups (p>0.05), the
students in both groups had lower level of anxiety after training than before training and those in HFS group experienced further reduction, the knowledge and skill scores on the aspiration process, the level of self-confi dence after training, the problem solving skills, and the level of reaching the goal and knowledge were signifi cantly higher in the HFS group (p<0.05), and the level of satisfaction from training method was higher in both groups after training. As a result, it can be said that successful skill training can be implemented with low and high fi delity simulation, but with a well prepared scenario and the use of higher technology, students’ skills of knowledge, self-confi dence, reaching the goal and problem solving can be increased further. Therefore, it is recommended to use and extend the scenario-based HFS method in skills training in nursing.
- Hospital Management and Nursing | Telemedicine and healthcare Administration | Patient Safety | Infertility & Related Disorders: Diagnosis, Treatment & Management | Menopause & Contraception | Health Care Technologies and Tele-Medicine
Location: Vasco de Gama 2
Chair
Michelle Black
University of Queensland, Australia
Session Introduction
Antonio Jose Lopes de Almeida
Sao Jose Hospital | Portugal
Title: Hospital management and nursing
Time : 10:15-10:50
Biography:
Antonio Jose Lopes de Almeida has a Master's Degree in Nursing from the School of Nursing in Lisbon (ESEL) since 2012. He is a Specialist in Medical-Surgical Nursing at the School of Nursing of Lisbon (ESEL) since 2012.
He has worked as a Nurse in the Hospital Center of Central Lisbon (CHLC), Sao Jose Hospital, in the Neurocritical Intensive Care Unit, since 1992. He is also a Guest Assistant Professor at the Department of Adult and Elderly
Medical-Surgical Nursing at the School of Nursing of Lisbon (ESEL) since 2007, a member of the Nursing Section of the Portuguese Society of Intensive Care (SPCI) in the triennium 2018-2020, Vice-President of SPCI for the triennia 2012-2014 and 2015-2017 and President of the Nursing Section of SPCI in the 2006-2008 and 2009-2011 triennia.
Abstract:
Justifi cation: Hospital management is always based on its quality cost structure, which are the costs linked to quality control in the production, logistics of a product or service. It should be borne in mind that it is necessary to maintain permanent investments not only to acquire quality but also to
maintain it. The costs of intensive care continue to rise (since the 1970s).
The implementation of protocols results in reduction of costs/gains for the patient, evidence-based practice results in gain, protocols for prevention of catheter-related infections and associated pneumonia, Mechanical ventilation, use of sedation and analgesia in the ICU, associated with weaning and inadequate use of antibiotics and nutritional support. Strategic management involves patient satisfaction, through "talent retention" (specialist nurse
maintenance) in order to achieve continuous improvement through training, in which alone it can achieve the success of an institution.
It should be noted that the technical qualifi cations of nurses must be taken into account. Theproportion of nurse/patient can be adjusted by taking into account the competencies or other health professionals.
Objective: To design basic knowledge in the area of business management applied to health, in the strategic planning approach of a nursing professional
Content: Literature review including models studied in the human knowledge area, as well as the basic requirements recommendations in the ICU as well as the structural and organizational aspects Conclusion: Professional training as a culture of prevention and the role of nurses in the development of prevention and control of infection are highlighted. Education continues with strategies to
implement more effective measures in the quest for quality of care. The basis of management is the education of the nurse and the care of the caregiver.
Catia Sofi a Gabriel Caneiras
University of Lisbon, Portugal
Title: Hospital-acquired infections by carbapenem-resistant Gram-negative bacteria: An old hospital management challenge in a new technology era
Time : 11:10-11:45
Biography:
Catia Sofi a Gabriel Caneiras has completed her graduation in Pharmaceutical Sciences (Pharm D) from University of Lisbon (Faculty of Pharmacy) and Master’s degree in Clinical Microbiology (MSc) in the Faculty of Medicine from the same university. Currently, she is a PhD student in the fi eld of Health Sciences and Technologies, specialty in Microbiology. She is working as the Healthcare Business Director and Scientifi c Director of Praxair Portugal
and she is responsible for the telemedicine development area. She is a Senior Researcher in the Department of Microbiology and Immunology at FFUL and Invited Researcher at the Institute of Environmental Health. She has
participated in more than 100 scientifi c activities, including 25 oral communications and 30 publications. She is an invited Reviewer of Journal of Medical Microbiology, Microorganisms, Journal of Clinical Medicine and International Journal of Environment and Public Health.
Abstract:
The acquisition and emergence of carbapenem resistance among Gram-negative bacteria (GNB) is a major cause of concern, since carbapenems currently represent the treatment of choice for severe infections caused by multidrug-resistant (MDR) strains producing extended-spectrum
β-lactamases (ESBL). In 2017, the World Health Organization had published a global priority pathogens list of antibiotic-resistant bacteria to help in prioritizing the research and development of new and effective antibiotic treatments. In this list, it identifi ed carbapenem-resistant Enterobacteriaceae (which includes Klebsiella pneumoniae and Escherichia coli), Pseudomonas
aeruginosa and Acinetobacter baumannii, as the top three critical threats. Although great efforts have been made to enhance epidemiological surveillance in Europe, virulence traits and molecular characterization of carbapenem-resistant isolates from some countries remains scarce. Additionally, it remains somewhat unclear how pathogenic bacteria, its resistance and virulence, have evolved in over the time and its relationship with the healthcare system changes imposed by medical technologies. All combined, this thematic can constitute an important threat to safety patients, a
signifi cative economic burden and a serious challenge to hospital management.
Sandra Abi Daher Frangieh
Lebanese University, Lebanon
Title: Communication and patient experience
Time : 11:45-12:20
Biography:
Sandra Abi Daher Frangieh has completed her Master’s Degree in Hospital Management from Lebanese University-Beirut. She is currently pursuing her PhD in the same fi eld from British International College-London and a Doctorate in Leadership and Human Ressources from USJ-Beirut. She has accomplished Post-graduate studies in Quality Management in Healthcare from USJ-Beirut and in Professional Mediation from CPM-USJ-Beirut. She is an Instructor in the Faculty of Public Health at the Lebanese University. She is the Head of Training and Development Department in a private Hospital in North-Lebanon and Quality Consultant. She has recently joined the group of national surveyors for Hospital Accreditation, project with the Ministry of Public Health - Lebanon. She is a Trainer and animates workshops related to communication skills, emotional intelligence and personal development
Abstract:
Communication and Patient Experience (Project in a Hospital): Introducing change to a healthcare institution requires more than just isolated events, but rather a continuous performance improvement cycle that includes defi ning the vision and strategy, analyzing the gap existing between desired and actual status, planning for projects and activities to reach objectives, driving the implementation plan and training staff and lastly coaching of managers and performance monitoring. Developing a professional image of staff and overall institution through communication in order to reach excellence in patient experience, provide top quality services to each patient, ensure long term
business success and enhance its branding and attractiveness in the region.
It is a transformational project that will involve many different hospital stakeholders. Its success relies on the engagement of everyone involved and a solid project management structure which would enable completion of project phases within proper deadlines, and attainment of high quality deliverables.
Yeong-tae Song
Towson University, USA
Title: Pharmacy care delivery using SMS in developing countries
Time : 12:20-12:55
Biography:
Yeong-Tae Song has earned his PhD in Computer Science from the University of Texas at Dallas in 1999. He started his career in academia from University of Arkansas at Little Rock and is currently a full professor at Towson University. He has published more than 70 conference papers and journal papers. He is currently an editor of KSII Transactions on Internet and Information System.
Abstract:
Currently in developing countries, distribution of pharmacy drugs in a controlled way can be a challenging task due to lack of medical doctors and/or adequate technology especially in rural areas. For the patients in rural areas, getting prescriptions or getting adequate drugs for their illness can be diffi cult due to aforementioned reason, so expected patient outcome in the regions
remains low. Also the patients in rural areas may try substitute medicine for their illness due to the unavailability of pharmacy drugs, so early detection of possible epidemic can be diffi cult as such treatments do not leave any related data to collect. Even if prescriptions for the patients in rural area are available, access to nearby city pharmacies is still diffi cult due to lack of adequate transportation. In an attempt to resolve such issues, we propose an approach that utilizes information technology available in rural areas of developing countries such as 2G/2.5G SMS, that is available in most of developing countries, to deliver prescription/medication to the patients. Our SMS approach includes various associated technologies such as mobile payments, method of delivery, tracing prescription status, and storing SMS based prescription/medication related conversation for a patient to a cloud
based electronic health record system after conversion to HL7 clinical document architecture (CDA) for future reference. In our approach, doctors can prescribe medication for their patients using SMS technology to any of the pharmacies listed in the pharmacy database. The pharmacy who
received prescription(s) may fulfi ll the prescription and send a text message to the patient notifying that medication is ready to be delivered. As soon as the patient chooses a delivery method, the prescribed drugs are delivered to the patient. After the delivery, a text message is sent back to the doctor notifying that the prescription is fulfi lled.