Post on 22-Dec-2015
transcript
INFORMATION TECHNOLOGY FOR THE HEALTH SECTOR IN
NEPAL
Dr Paras K Pokharel
Associate Professor
Department of Community Medicine
BP Koirala Institute of Health Sciences
Dharan ,Nepal
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HEALTH THREATS• POPULATION EXPLOSION
• RAVAGING EPIDEMICS
• NATURAL & SOCIAL CALAMITIES
• HIGH LEVEL OF INFANT AND MATERNAL
MORTALITY
• LOW LEVEL OF LIFE EXPECTANCY
• DETERIORATING HEALTH CARE FACILITIES
• CRISIS CAUSED BY HIV/AIDS
• SPREAD OF MALARIA, TUBERCULOSIS AND
OTHER INFECTIOUS DISEASES
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PROBLEMS FACEDTHESE THREATS PUT PRESSURE ON OUR ECONOMY AND PROMPTED FOCUS ON
• INCREASING DEMAND FOR FUNDS FOR HEALTHCARE
• TRAINING OF MORE DOCTORS AND PARAMEDICS
• CONSTRUCTION OF NEW HEALTH FACILITIES
• INVESTING MORE ON HEALTH RESEARCH
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PROBLEMS FACED (cont.)BUT THE SITUATION HAS NOT CHANGED SUBSTANTIALLY OVER THE LAST DECADE RATHER IT IS WORSENING. WE FACE
• DECLINING RESOURCES FOR PUBLIC HEALTH• RAPIDLY EXPANDING MEDICAL KNOWLEDGE• POOR COORDINATION BETWEEN MEDICAL FACILITIES
IN SUCH A SITUATION LET US EXAMINE HOW THE INFORMATION AND COMMUNICATION TECHNOLOGY (ICT) CAN PROVIDE US SOME HELP
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HEALTH SECTOR• MOST INFORMATION INTENSIVE
• INFORMATION POVERTY: ONE OF THE MOST SERIOUS OBSTACLE FACING HEALTH PROFESSIONALS
• ADVANCES IN ICT COULD PROVIDE • FAST• EFFICIENT• CHEAP ACCESS
TO INFORMATION RESULTING IN DRAMATIC IMPROVEMENT IN ACCESS TO ADVICE AND CARE
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INFORMATION & COMMUNICATION TECHNOLOGY
•NOT LIMITED TO TRANSFER OF INFORMATION
• PROMOTE BETTER HEALTH BEHAVIOUR
• IMPORVE DECISION MAKING
• PROMOTE INFORMATION EXCHANGE AMONGST PEERS
• PROMOTE SELF CARE
• PROVIDE PROFESSIONAL SUPPORT
• ENHANCED EFFECTIVENESS OF HEALTH INSTITUTIONS
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ICT APPLICATIONS
COST * QUALITY * ACCESSIBILITY * DELIVERY
• ELECTRONIC MEDICAL RECORDS
• HOSPITAL INFORMATION SYSTEM
• INTRANETS
• PUBLIC NETWORKS
• HEALTH DECISION SUPPORT
• EXPERT SYSTEMS
• TELEMEDICINE
• COMMUNITY HEALTH
• INFORMATION SYSTEM
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ICT - IMPLEMENTATION• MITIGATE THE SHORTAGE OF HEALTH WORKERS
• COMPLEMENT BASIC HEALTH SERVICES
• SIGNIFICANT COST REDUCTION BY REPLACING PAPER
TO ELECTRONIC MEANS
• EFFECTIVE AND TIMELY DELIVERY OF SERVICE
• MAXIMISE USE OF SCARE KNOWLEDGE, LIMITED
RESOURCE AND FACILITIES
• LIFE ENHANCING KNOWLEDGE IN EMERGENCIES
MOST IMPORTANT
• ICT : FLEXIBLE : INTERACTIVE : CAN REACH LARGE
POPULATION
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DISPARITY OF SERVICESURBAN : RURAL
• IMPROVING ACCESS TO HEALTH SERVICES IN
RURAL AREAS
• PUBLIUC EDUCATION CAMPAIGN IN CRITICAL
AREAS LIKE AIDS
• TRANSFERRING DIAGNOSTIC INFORMATION TO
SPECIALISED CENTRES
• STRENGTHENING THE BASIS FOR DECISION MAKING
• PROMOTE INFORMATION EXCHANGE
• REDUCE TRANSPORTATION COST OF PATIENT TO
URBAN AREAS
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PRIMARY HEALTH CARE•OPTIMAL COMMUNICATION WITH ALL HEALTH
CARE SERVICE PROVIDERS
•POPULATION BASED DATA COLLECTION :
COMMUNITY TO NATIONAL LEVELS
•EQUITABLE HEALTH CARE APPROACH
•ESTABLISH COMMUNITY HEALTH INFORMATION
SYSTEM
* DIAGNOSE COMMUNITY HEALTH
PROBLEMS
* COMBINE LOCAL KNOWLEDGE
* TRANSFER KEY DETERMINANTS OF
HEALTH
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PRIMARY HEALTH CARE(cont.)•STANDARDISATION OF PROCESS
•PROMOTE INTERNATIONAL CODING/
INFORMATION EXCHANGE
•NETWORKING FOR EPIDEMIOLOGICAL
SURVILLANCE
• INFORMATION COULD BE PROGRAMMED INTO
COMMUNITY RADIOS AND TELECENTRES
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EFFECTIVENESS OF HEALTH SERVICES
• MANUAL RECORDING PROCEDURES: STATIC IN NATURE
• DELAY IN FLOW OF INFORMATION AND DECISION MAKING
• CLINICAL INFORMATION SYSTEM> PATIENT RECORDS> BED SIDE DATA> LAB REPORTS> PHARMACEUTICAL RECEIPTS> DEMOGRAPHIC MOVEMENTS BETWEEN
HOSPITALS
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MEDICAL EDUCATION AND RESEARCH
MORE THAN 360,000 ARTICLES ARE PUBLISHED YEARLY IN MEDICAL JOURNALS WORLDWIDE
TODAY CLINICAL DECISION MAKING : EVIDENCE BASED MEDICINE
PROFESSIONALS NEED :• ACCESS TO WIDE ARRAY OF INFORMATION• APPLY FORMAL RULES OF EVIDENCE TO
EVALUATE CLINICAL LITERATURE• TAKE DECISION BASED ON BEST EVIDENCE
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• ELECTRONIC DATA COLLECTION AND GIS CAN BE DEVELOPED TO MAP SPECIFIC DISEASE IN A GEOGRAPHICAL AREA
• MULTIMEDIA APPROACHES CAN STRENGTHEN THE DELIVERY OF PUBLIC HEALTH EDUCATION MESSGES
• NETWORKING OF HEALTH PROFESSIONALS CAN ACCELERATE THE INTRODUCTION OF NEW TREATMENT AND PREVENTION METHODS
• PATIENT NETWORK CAN BREAK DOWN THE SENSE OF ISOLATION AND STRENGTHEN THEIR PUBLIC VOICE
ADVANTAGES
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• HMIS
• PUBLIC EALTH OFFICES
• HOSPITAL INFORMATION SYSTEMS
• LIBRARY
• MEDICAL LITERATURE
• SURVIEALLANCE & MONITORING
• SURVEY FINDINGS
Nepal Scenario Eastern Region:Bottom Up Planning
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WHAT WE REQUIRE ?
• IMPROVE HEALTHCARE MANAGEMENT THROUGH
ICT
• REQUIRE A CONCERTED EFFORT AT NATIONAL &
LOCAL LEVEL
• FRAGMENTATION PUT TOGETHER IN PARTNERSHIP
• GOVT- NEED TO DEFINE “STANDARDS & LEVEL”
• PROVIDE TECHNOLOGICAL INFRASTRUCTURE
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MAJOR GAPS
• IMPROVE ACCESS TO TELECOMMUNICATION AND
COMPUTING INFRASTRUCTURE
• INCREASING THE AVAILABILITY OF APPLICATION
• EXPANDING COMPUTER LITERACY
• IMPROVING CONSUMER DEMAND FOR HEALTH
INFORMATION
• SURMOUNTING RESISTANCE
• DEVELOP STRATEGIES FOR BRIDGING FINANCIAL
RESOURCE GAP
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CONSISTS : SET OF TECHNOLOGIES
STANDARDS
APPLICATIONS
SYSTEMS
VALUES
LAWS
GOAL : DELIVER INFORMATION
CONSUMERS:PATIENTS:
PROFESSIONALS
NATIONAL HEALTH INFORMATION INFRASTRUCTURE
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NATIONAL HEALTH INFORMATION INFRASTRUCTURE
PROVIDERPERSONAL
COMMUNITY
HEALTH INFORMATION INFRASTRUCTURE
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STRATEGIES
• CREATION OF NATIONAL PUBLIC
HEALTH INFORMATICS TASK FORCE
GROUP, START FROM EASTERN REGION
• IDENTIFYING PRIORITY APPLICATION
AREAS
• IMPLEMENTATION, EVALUATION AND
MONITORING OF PROGRAMS
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TASK FORCE
MULTIDISCIPLINARY COMPOSITION
TELECOMMUNICATION : HEALTH PROFESSIONALS : LAWYERS :
INDUSTRY : AWARENESS CAMPAIGNERS
TERMS OF REFERENCE• IDENTIFY NEEDS & DEFINE PRIORITY
• ORGANISE THE PUBLIC HEALTH INFORMATICS NETWORK
• PREPARE BUDGETS
• INITIATE PILOT PROJECTS
• ORGANISE AWARENESS WORKSHOPS / SEMINARS
• CREATION ONF NATIONAL WEB SITES WITH LINKS TO
REGIONAL / GLOBAL HEALTH INFORMATION RESOURCES
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HEALTH•NOT MERELY THE ABSENCE OF ILLNESS•NOR IS HEALTH ACHIEVED SOLELY BY COMBATING
DISEASE AS W. H. O. PUTS IT
HEALTH IS A “ STATE OF COMPLETE PHYSICAL AND SOCIAL WELL BEING”.
HEALTH IS MORE THAN AN INDIVIDUAL MATTER. PERSONAL AND COMMUNITY HEALTH ARE
CLOSELY CONNECTED AND DEPEND ON INTERWOVEN FACTORS SUCH AS
* POLICIES* ENVIRONMENT
* HOUSING * HERIDITY