Health IT

Thank you for your contribution.
Rwanda have been promoting Information and technologie in the whole countrie.this is one of the recommendation for success .
1.cost effective?it depends upon what is implemented.I suggest to rely on existing technology and try to improve it(mobile phones based information system like tracnet is a good exemple).there already exist an information system in Rwandan district hospitals.the question is how to improve it?
2. challenges for implementation: I think the first challenge is to know if the beneficiaries(rwandans) need it and are willing to scale it up.
the second challenge relate to infrastructure(electricity,human ressource with skills to deal with ICT).the good news is that all of these challenges are beeing addressed by Rwandan gouvernment.
3. recommandation for such a system to succeed : high political will to put in practice the already known solutions to deliver incentives so that the self interest of the health workforce be coordinated with the goal of the project
4.there is no doubt that both patients and service users will benefit from information system managment if it is well used and correspond to their need.

Thanks Fidele for the ideas. I am really interested in seeing the success of health information systems in Rwanda. Your ideas have opened up my mind and added more curiosity to the research.

We are just beginning to create what people imagine when they sit down and
try to do what they want and need to do.
All the while cursing the reality that is.

I hope we can identify common human needs and tend to those. We can achieve
happiness and security so thank you all here for your interest and service.

I'm a bit confused though. . Is there any existing software using SMS to
transmit form entries that also manage inventory control?

There is a conference in Rwanda in a week's time which is addressing some of these issues, it is being run jointly by the Rwandan government and the WHO.

There are two sections. The first is dealing with contracting for healthcare software in Africa. It is aiming to create a code of conduct for companies contracting software with the governments in terms of specifications, openness, ownership of data etc.

The second part is on creating an ehealth architecture for Rwanda. This will address the required functionality of the different systems such as EMRs, laboratory systems, pharmacy systems, national reporting systems (such as TRACnet in Rwanda and DHIS is other parts of Africa), cell phone based applications for community healthcare workers, insurance systems etc. In addition, the interactions between systems will be defined and the standards for data exchange between the systems. For example at present we are working on interchanging data from EMR systems like OpenMRS and TRACnet or DHIS to automate reporting using a WHO standard. We also have the capability to exchange lab data with EMR systems and are working on standard tools for exchanges between EMR systems and mobile phones. This will hopefully allow multiple different ...

There is a conference in Rwanda in a week's time which is addressing some of these issues, it is being run jointly by the Rwandan government and the WHO.

There are two sections. The first is dealing with contracting for healthcare software in Africa. It is aiming to create a code of conduct for companies contracting software with the governments in terms of specifications, openness, ownership of data etc.

The second part is on creating an ehealth architecture for Rwanda. This will address the required functionality of the different systems such as EMRs, laboratory systems, pharmacy systems, national reporting systems (such as TRACnet in Rwanda and DHIS is other parts of Africa), cell phone based applications for community healthcare workers, insurance systems etc. In addition, the interactions between systems will be defined and the standards for data exchange between the systems. For example at present we are working on interchanging data from EMR systems like OpenMRS and TRACnet or DHIS to automate reporting using a WHO standard. We also have the capability to exchange lab data with EMR systems and are working on standard tools for exchanges between EMR systems and mobile phones. This will hopefully allow multiple different systems to be designed to fulfill the same roles giving clinics the chance to mix and match.

We hope that the ideas and models created for Rwanda will help to push forward a systematic approach to information systems in other African countries and help to avoid the proliferation of closed, disease specific systems.

Thank you Dr Fraser,
I would like to know if there exist cell phone based referral system in primary health care(between health centres and district hospitals) in developing countries.

Dear Bana,

We use cellphones to coordinate primary health care referrals.

Link is here: http://www.ncbi.nlm.nih.gov/pubmed/18998858?log$=activity

An important lesson in using cellphones for healthcare --

the health workers using this system must believe that they are all working
as one team and that they are all responsible for the patient. This may seem
obvious but there are many times when the receiving facility will make
themselves unavailable for the referring facility (and will make excuses for
not answering the phone).

alvin

Dear Bana,

For more information on cell phone based referral system, you may be interested in a recent thread on the GHDonline forum:
http://www.ghdonline.org/tech/discussion/blog-post-on-stop-the-stockouts-for-...

I work at a hospital in Malawi that has been using FrontlineSMS for more than a year. The latest addition to this project is to add a phone/SMS based form that outlying health centers can use to coordinate emergency obstetrics referrals with the central hospital.