Jury: an automation framework for protocolised primary healthcare delivery

It is often hard to get trained doctors as primary healthcare providers in rural India. In an emergent tiered model, clinicians trained in basic health practices are deployed at rural clinics, and instructed to follow structured clinical protocols. Medical records are maintained electronically and a regular medical audit is performed on the records by skilled doctors to ensure that the clinicians stationed in rural clinics provide high quality delivery of care. Manual audit of the medical records is however non-scalable and prone to error. We describe the development of Jury, a highly configurable and extensible framework for automation of clinical audit of electronic medical records (EMRs). Socio-economic complexities and paradigmatic differences between public health research and computer science throw up interesting challenges that were tackled on the way to arriving at a solution. A pilot implementation was done for the hypertension protocol. Our field partner ICTPH has evinced interest in integrating Jury into their regular workflow.