Operation Smile Case Study - Giving children a brighter future

Vitro Software together with Microsoft are official technology partners to Operation Smile, Inc.. Vitro Software donated its software Vitro®, an Electronic Medical Record (EMR) solution to Operation Smile, allowing them to collect patient data electronically during their 180+ global missions and reducing their reliance on paper.

Background

Operation Smile is an international medical charity that has provided hundreds of thousands of free surgeries for children and young adults in developing countries who are born with cleft lip, cleft palate or other facial deformities. It is one of the oldest and largest volunteer-based organizations dedicated to improving the health and lives of children worldwide through access to surgical care. Since 1982, Operation Smile has developed expertise in mobilizing volunteer medical teams to conduct surgical missions in resource-poor environments while adhering to the highest standards of care and safety, and has provided hundreds of thousands of free surgeries.

Operation Smile helps to fill the gap in providing access to safe, well-timed surgeries by partnering with hospitals, governments and ministries of health, training local medical personnel, and donating much-needed supplies and equipment to surgical sites around the world. Founded and based in Virginia, U.S., Operation Smile has extended its global reach to more than 60 countries through its network of credentialed surgeons, paediatricians, doctors, nurses, and student volunteers.

Vitro in use in an Operation Smile Mission in Hanoi

Challenges

After 34 years of providing quality care and with all the systems in place Ruben Ayala, MD, Senior Vice President of Medical Affairs, Operation Smile, says that “We were not able to reach all the children we wanted to reach - It’s a matter of scale”.

• As Operation Smile continues to grow and with 180+ missions per year, the logistics and cost of transporting, managing, assessing and storing paper records was becoming impractical;
• Each mission engages more than 50 clinical and administrative volunteers. The volunteers who are brought together for each mission come from a wide range of countries speaking multiple languages. The volunteers whether from a clinical or non-clinical background will range from having little or no software experience to using the systems that they are individually accustomed to;
• Analysing data from high volumes of paper was becoming challenging as the organisation scaled up. Operation Smile required access to data so that they could assist their research programs, with the data helping to identify prevalence, trends and patterns of occurrence to help future planning of missions and ultimately eradicate the backlog of untreated cleft lips and cleft palates. With each mission generating thousands of pages of patient data, a better solution was needed.

The Benefits

Ruben Ayala, MD, Senior Vice President of Medical Affairs, Operation Smile says “Vitro has basically unleashed this amazing opportunity to truly understand our patients”.

• Minimal to no training required – Vitro is intuitive and retains the exact same look and feel of Operation Smile’s existing paper forms, so once a surgeon, anaesthetist, clinician or administrator has a tablet running Vitro, it only takes about 5/10 minutes for them to start productively and independently using the software;
• Capturing data on Vitro is quick and easy - you can capture more information, including complex clinical data fast, making it available to multiple clinicians supporting a mission and researchers simultaneously;
• Vitro provides custom alerts and automated calculations, early warnings such as prospective patient weight variances and/or medication dosage warning alerts are embedded and react to inputted data;
• Electronic workflow customised to reflect the existing paper workflow, on tablets – retains the same ‘look and feel’ for clinicians, with inputted data flowing from one clinical screening area to the next scheduled area;
• Syncing offline data to the cloud – Although mission site data entry is constrained by the remote locations of host hospitals and IT restrictions, Vitro is able to overcome these IT challenges by enabling data capture in an offline mode with secure synchronization to a global database stored in Microsoft’s Azure™ cloud when connectivity is established;
• Because Vitro streamlines the data capture process, volunteer clinicians can maximise their interaction with families;

Vitro Software says “Operation Smile uses thousands of medical volunteers annually across 40+ countries, with multiple languages in difficult environments and with no guarantee of network connectivity and no training time for any of the staff. To be able to deliver something that can be picked up and mastered that easily and make that kind of a difference is an amazing feeling for everybody involved at Vitro”.

Today

Since the start of the project it was essential that we understood the unique challenges that Operation Smile faced. By attending missions such as one in Morocco and meeting with the volunteer and management team we understood the unique needs of Operation Smile, the challenges faced in a mission environment and their vision. Following the initial scoping, the Vitro Software team worked through the best approach to the project with Operation Smile using Vitro during missions in Paraguay, Brazil and Vietnam. The Product team at Vitro Software continues to work on improvements/modifications to Vitro.

Some of the IT infrastructure during Operation Smile’s global missions requires Vitro to be flexible in its approach to facilitating data capture, at both mission level and globally. Using Microsoft’s cloud storage platform, Azure™ , as a key part of the solution along with the Iguana integration engine (also donated technology), we can enable missions to capture data while offline and sync online at a later date.

The Vitro Software development team are also working with students from the Florida Institute of Technology in Melbourne, Florida who are developing mobile Apps for Operation Smile. One of these will allow patients to be registered with Vitro prior to missions which will help to identify regions that have a high instance of children with cleft deformities and aid Operation Smile in efficiently recruiting those patients to treatment and effectively planning locations for upcoming missions.

Another App will allow for capturing images before and after surgery. Vitro will utilise the output of the image App to automate the workflow for an existing but manual surgical outcome evaluation process that will allow surgeons timely feedback on the quality of the surgeries they conduct as part of Operation Smile’s ongoing quest to continuously improve the quality of their work.

For more information about Operation Smile visit www.operationsmile.org

Watch the impact of Vitro during an Operation Smile mission in Vietnam

What they say...

Chris Bryant, Senior Vice President, Enterprise Applications & Technology, Operation Smile “First and foremost Vitro has been an absolutely quick study for all our clinical providers and our medical records personnel as well. What we have found is that we were able to show the product to our surgeons and anaesthesiologists and within about five to ten minutes of handholding they were off and running and skilfully using the solution”.

Paul Smolke, Industry Managing Director, Worldwide Health, Microsoft “Vitro is an amazing solution because it allows us to take the existing paperwork flow that Operation Smile has done such a great job in developing and actually put that on tablet devices without changing the look or feel of the workflow. So for a clinician already used to dealing with the paperwork flow that exists with Operation Smile today they have the same workflow, but now it’s on a tablet and we are able to digitise that information”.