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Health IT Challenges and Needs for Disaster Relief and Rebuilding

Added on 10 Aug 2010
Last updated on 14 Jun 2011

Authors: Sophie Beauvais; Joaquin Blaya, PhD; Anat Rosenthal, PhD

Started as a panel on lessons learned for Health Information Technology post-earthquake Haiti this discussion quickly centered on data collection systems implementation and interoperability of reporting mechanisms.

“After the earthquake, there is more than ever an opportunity (and risks to go wrong) to show value in IT, and to strengthen local capacities by providing efficient tools that can make sense in our environment,” commented a member who runs a software company in Haiti – one of seventeen members who have shared their experiences so far.

Key Points

The need for standardized data collection among disaster responders is critical to:

  • Optimize the use of resources
  • Provide doctors with the clinical history of patients
  • Enable accurate reporting of the situation on the ground

Standardized reporting is difficult and requires a consensus among organizations as to the data to be collected:

  • An example of its difficulty is that in MSF, all five European operational centers are running field projects in Haiti. Though each runs its own system for data collection and reporting, sections agreed to report surgical activity in a joint 20-column Excel spreadsheet. When a patient is transferred within MSF or to an external center, the resume of hospitalization or care is written by hand on paper. There are currently no plans to implement an intersectional Electronic Medical Record system within MSF.
  • Having a consensus of a core set of data is the best approach and then projects can decide what tools to use to collect and manage that. Another member suggested the Canadian Physician Health Programs (CPHP) which has a list of common indicators which might be used in emergency situations (Sections 1, V, and VI).
  • Reporting and monitoring should include collecting from individual-level records. Some public health uses (notifiable condition reporting, case surveillance, quality improvement) rely on individual level reporting rather than population level reporting. The use of Emergency Department, school absenteeism, and other data in the US and EU for influenza surveillance is an example.
  • Organizations might have better records than “standardized reporting systems" which can lead to duplicate reporting or the use of an incomplete standardized system.

The following challenges and lessons learned were exchanged:

  • The use of Simple Messaging Systems (SMS), Twitter and other crowd sourcing solutions in and outside Haiti emerged as a means for many to participate in the disaster response but is not leveraged or integrated with monitoring and evaluation.
  • IT or data collection systems need to function both with and without internet connectivity.
  • Transferring knowledge to the community served, finding local advocates and creating partnerships before, during and after disasters is essential.
  • There must be a fine balance between providing an elaborate system that won't be used and a simple one which doesn't have enough information.
  • The use of patient data, even in aggregate form, may be misused. The example of MSF was cited and the critical need for independence of interventions noted.
  • According to members participating in this discussion, there are currently no laws or regulations for patient data in Haiti. Individual organizations have their own rules and procedures.

Key References

  • Two off- and online tools, Adobe Air and Microsoft Silverlight, were mentioned as easy-to-use, adaptable, and well capable of handling database interactions with the simplicity of web page development.
  • Cloud computing solutions like Google Documents or shared online folders like Dropbox are convenient for small team but may not accommodate larger groups. Additionally, data is hosted by a third party so confidentiality and back-up may become issues.
  • A member mentioned a software company in Haiti, MESI as involved in different health IT projects.
  • Two members in particular, one from a group of surgeons called SIGN and the non-profit Aptivate, mentioned interest in developing a robust system to work in such situations.
  • NOULA, a website for the management of the Crisis in Haiti.
  • UN Office of Coordination of Humanitarian Affairs (OCHA) Disaster Response Tools and Services
  • Haitian Association for ICT development(AHTIC) that represents about 40 ICT organizations (telcos, MNOs, ISPs, software developers, hardware resellers, etc.), mostly based in Port-au-Prince.
  • Haitian Presidential Commission on ICT

Enrich the GHDonline Knowledge Base: Please consider replying to this discussion with the following information

  • Have you had experiences implementing a standard data set in your organization or country?
  • Are there other technologies or systems that you’ve used during a disaster relief or rebuilding effort?

Download: 08_10_10_Disaster_Relief_Panel.pdf (45.2 KB)