Data Management Needs Assessment

Data ManagementNeeds Assessment

Uganda Ministry of Health

June 8th, 2007

Data Management Needs Assessment

Overview• Introduce Blum Fellows• Goals & Objectives• Background – technology & past efforts• Methods• Findings• Pilot Possibilities• Feedback, Discussion, and Questions

Data Management Needs Assessment

Team Introduction

Shaffeque Abas: Bachelors, Computer Science, Mbarara University

Melissa Ho: Ph.D., Information; MSc CS

Simon Morfit: Ph.D., Sociology; MPH

Mallory Primm: BA, Human Rights

Katrina Robinson: Masters, Social Welfare

Admas Zewdie: Masters, Business Administration

Data Management Needs Assessment

Guidance• Uganda

– Ananias Tumukunde, Presidential Private Secretary for Science & Technology – State House

– Harriet Mukunguzi, Executive Director Science and Technology Enterprise Development Organization

– Richard Tushemereirwe, Assistant to the Presidential Private Secretary for Science & Technology-State House

• UC Berkeley– Kristiana Raube, Haas School of Business– Sandra Dratler, School of Public Health– George Scharffenberger, Executive Director Blum

Center for Developing Economies

Data Management Needs Assessment

Original Objectives

• Assess the need for and feasibility of health data collection using smart phones – improve the timeliness of regional and

national data collection – save health worker time by performing

verification automatically– provide accurate and timely data for clinical

care and policy decision making

Data Management Needs Assessment

Revised Project Goals• Identify technological needs

– Data collection and reporting– Data analysis and decision making – Communication

• Evaluate feasibility of currently available technologies

• Determine key stakeholders• Inform future pilot projects

Data Management Needs Assessment

MOHMakerere U

UHIN(Kampala)

Health Centers(Rakai District)

Mbarara U(Mbarara District)

Health Centers(Nakaseke District)

Project Timeline

Data Management Needs Assessment

Methods

Interviews Observation

MOH X

Universities X

UHIN Offices X X

Health Centers

X X

Data Management Needs Assessment

Interviews CompletedLocation Hospital HC IV HC III HC II Total

MOH         6

UHIN         4

JCRC         1

Universities

Makerere University         6

Institute Of Public Health         2

Mbarara University         5

Health Centers

Rakai District 2 4 3 2 11

Nakaseke District 3 3 5 6 17

Total 52

Data Management Needs Assessment

Interview Content

• Current data collection, management and analysis procedures

• Strengths and weaknesses• Opportunities for

improvement• Existing technology

infrastructure

Data Management Needs Assessment

Findings - MOH

• Substantial compliance with HMIS

• Concerns of data quality

• Full capacity of electronic format not yet realized

• Labor intensive data entry

• Problem of migration of trained personnel from the rural to urban areas

Data Management Needs Assessment

Findings - Universities• Desire to collaborate with MOH

– Exchange data– Share ICT knowledge

• Mbarara University– Emphasis on rural needs and research– Research on solar energy technology

• Makerere University– Computer science expertise– Distance learning capacity

Data Management Needs Assessment

Findings – Rakai District HCs• Data captured on paper and PDA• PDAs:

– Used to complete and transmit HMIS forms– Used to receive information– Open to local innovation

• Challenges:– Power shortage– Limited points of connectivity to relay data

• Previous computer knowledge not required• Commendable training program• UHIN willingness to collaborate

Data Management Needs Assessment

Findings – Nakaseke HCs - 1• HMIS reports

– Weekly: often submitted via text message– Monthly: delivered in person– Data flow is unclear between HCs– Compiling reports is a time consuming and error

prone process

• Ascertaining patient medical histories can be difficult

• Little feedback from referrals and data submissions

Data Management Needs Assessment

Findings – Nakaseke HCs - 2

• Consistent network coverage, but inconsistent electricity supply

• Transportation difficulties – cost, road conditions and lack of vehicles

• Some data analysis at lower HC levels

• Lack of basic supplies

Data Management Needs Assessment

Findings – Current mobile phone use in HCs

• Emergency reporting

• Submitting weekly HMIS forms

• Checking salary and drug order

status

• Requesting transportation

• Clinical consultations

Data Management Needs Assessment

How much can data management tools improve healthcare?

Data Management Needs Assessment

Pilot Considerations

• Hybrid solutions – different technology for different HC levels

• Universal HC access to HMIS data

• Electronic medical record

• Software for automatic data compilation and analysis

• Bidirectional data flow

Data Management Needs Assessment

NakasekeDistrict Hospital

Semuto HCIV

HCIII HCIII

HCII HCII

Ngoma HCIV

HCIII

HCII

HCIII

HCII

smartphone

smartphone + pdas

MoH

computers + broadband

computer + smartphone

or paper

Data Management Needs Assessment

Smart Phone

• Electronic hand-held device• Functions as a mobile phone• Provides internet access• Has built-in keyboard• Additional capabilities:

– E-mail– Word processing and spreadsheets– GPS

• Custom programs can be installed

Data Management Needs Assessment

Related Work• CAMPhone: Use of smartphones with bar-coded forms to facilitate

microfinance. Tapan Parikh, University of Washington Computer Science. (India)

• OpenMRS: Open source web-based electronic medical record software, currently developing mobile phone-based interface. (Kenya, Rwanda, South Africa)

• ReACH: Web based system supporting asynchronous remote consultation between doctors and specialists over a variety of networks. Melissa Ho, Rowena Luk, Paul Aoki, University of California, Berkeley. (Ghana)

• Smartphone and web-based patient records pilot project. Dartmouth University. (Vietnam)

• Uganda Health Information Network: Use of PDAs for dissemination of content and submission of forms. (Uganda)

• Simputer: PDA-based data collection for monitoring of TB. (India)

Data Management Needs Assessment

Challengesto Implementing ICT

• Balancing paper vs digital data recording

• Power

• Network

• Clarity in data flow

• Current cost of ICT

• Limited computer literacy

• Privacy of health information

Data Management Needs Assessment

Thank You!