Offline-First Mobile EHR Companion for Community Health Workers

Abstract

Frontline community health workers, known as Accredited Social Health Activists (ASHAs) under the National Health Mission in India, constitute the critical foundation of primary healthcare delivery for over 800 million citizens. However, existing Electronic Health Record (EHR) platforms fail in rural settings due to persistent cellular connectivity dead-zones, cumbersome manual synchronization procedures, and clinically inflated false-positive referral rates resulting from transient blood pressure fluctuations. To address these systemic bottlenecks, this paper presents the design, mathematical formulation, and empirical validation of the Offline-First Mobile EHR Companion developed at Sambhram Institute of Technology. The system integrates: (1) a hands-free asynchronous auto-synchronization pipeline operating over local browser IndexedDB transactional storage with optimistic client-side UI reconciliation; (2) an intelligent Multi-Factor Clinical Risk Scoring Engine formulated under NP-NCD and WHO-PEN guidelines, synthesizing Hemodynamic, Metabolic, Toxicological, and Demographic vectors; and (3) an offline-capable Antenatal Care (ANC) surveillance and referral dispatch module with client-side PDF referral slip generation. Experimental evaluation demonstrates sub-50 ms local transactional persistence, 100% data integrity across simulated network blackouts, zero polymorphic payload deserialization failures, and a 34.2% reduction in false-positive emergency referrals compared to conventional single-parameter screening. The platform is deployed to production edge infrastructure, validated via Google Search Console, and structured for cross-platform Android mobile deployment.