Transcript HIS_CCIH2004 - Public Health Strengthening in Guyana

IMPROVING HEALTHCARE USING HEALTH INFORMATION SYSTEMS IN GUYANA
An integral component of the CIDA FUNDED
Ministry of Health Guyana
PUBLIC HEALTH STRENGTHENING PROJECT IN GUYANA
IMPLEMENTED BY THE CANADIAN SOCIETY FOR INTERNATIONAL HEALTH
Gavin Walters, Paul D. Fisher, John Farley, R. Benedict
Introduction
Guyana HIS Development Team
Health Information Systems (HIS) play an important role in the efficient
delivery of care and in the planning and management of health care
services. A properly designed HIS provides key epidemiological
information, which is valuable at the government level in making human
and material resource allocation decisions. At the clinical level, HIS
streamlines the flow of data into the system, communication of data
across the system, and information generation by the system. This
supplies health care providers access to information that allows them to
make more knowledgeable decisions and deliver better care and
treatment to the patient. At the patient level, HIS systems improve the
efficiency and quality of care that the patient receives as well as
providing patient confidentiality.
The Guyana HIS Development Team is comprised of Dr. Paul Fisher, Gavin
Walters, Amar Samaroo, Nellie Chang, and Dr. John Farley. Dr. Paul Fisher is an
expert in HIS (s) and the HIS Team leader. He contributed significantly to the
overall design of the system as well as providing guidance and is responsible
for the administrative details of the project. Gavin Walters is the HIS software
developer. He is responsible for developing the HIS database and client
software. Amar Samaroo is the local system administrator based in Georgetown.
He is responsible for all hardware and software administration. Nellie Chang is a
CSIH NetCorp intern working with the HIS development team to lead the training
of the users and develop documentation for the HIS. Dr. John Farley, the HIV/STI
expert contributed significantly to the design of the HIV/STI modules for the HIS.
He provides ongoing consulting advice for various aspects of the HIS.
Justification
Guyana HIS Current Status – Prototyping Phase
Data collection in Guyana is currently done on paper or using
disconnected databases. There is very little interoperability between
the data collection systems, a high degree of data duplication, a high
error rate, and long reporting delays. Patient confidentiality is an
important requirement and will be reflected in the HIS. A properly
designed and implemented HIS and appropriately trained users are
needed to streamline the collection of data and improve the efficiency
of clinical processes.
During the early October 2004 mission in Guyana, version 0.1 of the HIS was
installed at the GUM and TB Clinics in Georgetown. This was the first prototype
version to be installed at the pilot sites. Users from both clinics have the
opportunity to see the HIS in operation and also have a chance to use the
system. Nellie Chang is continuing to introduce users at both clinics with the
HIS and is documenting changes and feedback that will be sent to Gavin Walters
so that these changes can be reflected in the next version of the HIS.
CIDA
Guyana HIS Version 0.1 Screenshots (Continued)
Fig 7 – Patient Summary Form
Fig 6 – Clinical Workspace used by Physicians
and Nurses
Fig 9 – Encounter Entry Form
Guyana HIS Version 0.1 Screenshots
Objectives
The primary objective of the HIS component of the Public Health
Strengthening in Guyana project is to develop a primary and
ambulatory HIS that is flexible, scalable, secure and sustainable to be
utilized in different health care settings and customizable to meet the
diversified needs of different clinical providers.
Fig 8 – Case Entry Form
Fig 1 - HIS login screen
Description of Methods
The initial horizontal scope of the project is primary and ambulatory
care at the Genito-Urinary Medicine (GUM) Clinic, TB Clinic, and
Dorothy Bailey Health Center (DBHC). Each of the pilots sites have
there own local area network. The GUM and TB Clinic buildings are
networked together and share one central database server. The DBHC
has its own database server. Each of the locations will have around 5
workstations so the different users of the system can test out the
different aspects of the HIS. The vertical scope of the project is clinical
decision support, institutional resource management, health care
services planning and epidemiological reporting.
Fig 10 – Encounter Detailed Form
Fig 2 - Patient Lookup Screen
Fig 3 – Receptionist Workspace
Description of Approaches
Fig 11 – DOT Worker Workspace
(1) Design a HIS, based on current clinical, management and planning
activities, that is flexible and scalable to accommodate for future
needs. In addition, the HIS will be designed with a strong emphasis
on security to ensure the confidentiality of the patient data.
(2) Develop a multi-user, client server, Windows based HIS with Visual
Basic .Net clients and Microsoft SQL server for the database server.
(3) A prototyping development approach will be used where a
prototype HIS system is implemented, tested by the users and
feedback is obtained. This implies several cycles or prototyping with
the end result being a quality, customized HIS.
Fig 12 – DOT Encounter Entry Form
CONCLUSIONS
Fig 4 – Patient Electronic Record
CSIH Ottawa office:
Roumyana Benedict
Project Director, PHSG
Tel: (613) 241-5785
Ext.307
[email protected]
Fig 5 - Scheduler
CSIH Guyana office:
Suzanne Marquis
Project Field Manager
Georgetown, Guyana
Tel: (592) 227 3673
[email protected]
The next major release of the Guyana HIS, version 0.2 is scheduled for early 2005.
Feedback and changes requested since the October 2004 mission will be reflected in version
0.2. The new version will include the immunization and pregnancy modules. Version 0.2 will
be installed at the DBHC. The HIS at both the GUM and TB clinics will be updated with
version 0.2. Work will commence in training users, documenting feedback and changes at
the DBHC site, and will be pursued at the GUM and TB Clinics. The prototyping phase will
continue, with updated versions of the HIS being released every three to four months, until a
stable production version is obtained. Once a production release of the Guyana HIS is
obtained it will be available for installation in other regions in Guyana.
The Guyana HIS will help significantly improve the delivery of health services in Guyana.