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Idea Increase data integration, particularly in resource limited settings

By Jumatil Fajar | 03 Dec, 2014

I suggest local government to connect the citizen data from other offices (population and civil registration office) to the medical record. This will improve the problem of justification of patient ID in insurance office. This also will improve the service at front office of hospital to the community.

Integration of data around hospital will also make everything become easier. This approach already exists in developed countries but is still growing in developing countries.

Connection between primary health care and secondary health care also improve referral of patients in two ways. Each party can monitor the referrals from primary health care to hospital and vice versa.

With connection between hospital and patients, the hospital can monitor the adherence of treatment given. The patients also can ask something to health care provider easily after returning from outpatient or inpatient treatment.


Hisham Yousif Advisor Replied at 11:51 AM, 5 Dec 2014

Thanks for your contribution Jumatil. The idea of connecting data from different sectors of public information (i.e. civil registration offices) to medical records is indeed something that can be truly disruptive in coordination of patient information in the healthcare setting. There are obstacles to making this happen, that if can be overcome, could make this a reality. The questions that comes to my mind is this:

(1) How do we ensure that this information, that would be linked from other public sectors to the medical record, is private, safe, and protected from invasion or intrusion? How can we guarantee that this information is not solicited by third-parties from insurance companies, or potential/current employers? We've seen major hacking operations of government networks, private accounts of public officials and celebrities, even major credit card companies, yet there seems to be a higher level of scrutiny and privacy that the public expects when it comes to health information (perhaps this *could* be less true in resource-limited settings), and this would be difficult to achieve. Moving towards an integrated data system that contains health and other sensitive information would require a intricate and heavily fortified security infrastructure in place that is impenetrable, which would cost a lot of money to make, to implement, to train people to use it, etc. and even then people would have concerns about how secure the information is.

(2) I wonder how feasible it would be to aggregate public data and integrate it into the medical record. A problem we see in both developed and developing countries is that each public office, hospital, clinic, so on and so forth has a proprietary system of collecting information and storing data that is not easily translatable to another format. I've worked in this sphere when it comes to medical research databases, and in our experience, even with the best complex algorithms we were only able to organize 60% of research data into a database that was somewhat usable. I think that if there can be a system that is used commonly across all public offices (including healthcare offices) that can be aggregated easily and integrated then this can be very useful indeed.

My favorite part of your idea is the integration in hospitals-- I think this can make a huge impact in resource-limited settings. If hospitals are able to have an integrated data system so that providers and specialists can access each others' records and be on the same page in terms of medical care for patients, this could be very useful. Taking this a step further, if the same health IT system can be used in all public hospitals/clinics/community health centers (ideally, even private hospitals), then this would make for better coordination of clinical care across different healthcare contexts. This could bring life your idea of having primary and secondary primary care connected, and would very well bring about real change in developing settings.

Thanks again for sharing Jumatil. Do you have any specific areas or examples where you think this could be especially effective? Looking forward to hearing more.

Thomas Tsai Advisor Replied at 2:36 PM, 5 Dec 2014

Hi Jumatil,

I think you've raised an important point about how important it is for data to work together. The catch 22 is, you're right this data integration would be most useful in resouce-limited settings, but they are also the settings that face the most challenges in integrating these data and developing the infrastructure to support it. Even in a well-resouced environment like the US, the complexity is tremendous. However, the complexity doesn't mean it can't be done, but incremental progress may be the way forward.

Hisham raises an excellent point in that data integration at the point of care hold tremendous promise. On the other hand for policymakers, being able to merge together administrative data and clinical outcomes data from electronic medical records would help them understand whether policies are achieving the intended impact on improving health outcomes.

Looking forward to hearing about some of the specific areas where you see this being most effective!

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