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SOUTHERN AFRICA: Health systems need to go online to improve efficiency

21 May 2007 17:16:53 GMT
Source: IRIN

MBABANE, 21 May 2007 (IRIN) - To cope with rising demand and complexity, Africa's health systems need to go online, health officials told a regional governments' conference in Swaziland.

Information technology is no longer a luxury purchased at the expense of other needs, but a basic tool, heard an annual pan-African government ministerial information technology summit last week.

"Hospitals are the most dangerous environment in the world," Dr Shaheen Khotu, chief information officer for South Africa's Department of Health, told IRIN. "Inefficiency means patients take their lives in their hands when they are admitted. We need to improve patient tracking, reduce misdiagnosis and misinformation and loss of vital information."

Doctors, nurses and admission desks can spend critical hours dealing with misplaced files rather than looking after patients.

South Africa, however is pioneering an electronic healthcare database which is a quantum leap forward. It's National Health Information System aims to issue South Africans with birth-to-grave medical identity numbers and update patient histories.

"Everyone connected to healthcare will have access to a person's medical history through a secure, tamper-proof system. Patients will also have access to check for any mistakes," said Dr Khotu. The internet could also be used to relay patient information to doctors, clinics, hospitals or even pharmacies throughout the country.

Inkosi Albert Luthuli Hospital, in South Africa's eastern KwaZulu-Natal province, is the prototype of a "paperless hospital", where patient information is entered electronically at the admissions' desk, stored in a central database and updated by doctors and nurses.

"The major challenge for years was to get doctors and nurses to use the same records. The common electronic database solved that; Information is accessed at a common computer, on doctors' laptops, and at patients' beds," said Dr Khotu.

The new system has only been implemented in some hospitals in South Africa, so it "was difficult to assess its impact," said Tebogo Phadu, head of the health policy unit of the National Education Health and Allied Workers Union. "But we have some concerns about human resources: loss of jobs, training; and how is the government going to source funds for putting the system in place".

The key challenge for implementing electronic health care systems lies not in the cost or performance of technology, but with the resistance of healthcare administrators and government officials.

"Ignorance of information and communications technologies by key decision makers is a very big problem. They are fearful of new things," said Martin Klyingi, systems administrator for Uganda's Ministry of Health.

In Uganda, resistance from doctors to the use of computers to access patient information, rather than rely on notes scribbled on clipboards, vanished with practice.

"Wireless handheld computers have been very successful in Uganda. The health ministry can transmit information to rural doctors instantly," said Klyingi.

Entire medical books and text updates are sent to the nation's doctors, who previously could only receive medical journals and data through the inefficient mail service.

The spread of diseases like cholera can be tracked by "geocoding" or locating all the affected health facilities on electronic maps. In Mozambique, clinics equipped with electronic data systems monitor patient appointments.

"This is especially important for people living with HIV and AIDS. The clinics will call up the patient to remind them about appointments and refilling prescriptions," Dr Salamao Manhica, chairman of the National Communications Institute of Mozambique, told IRIN.

Rural patients are easier to track than urban patients. The former are usually settled at a fixed location, while urban dwellers are more mobile, said Manhica.

"A problem we have had with paper records is when a patient is moved from ward to ward. During handover, records get lost, or information is illegible to the new staff. Having electronic records eliminates that, and it dramatically improves patient safety," said Manhica.

"The level of education is a determinant of a person's health. The same holds true for national healthcare systems. Service improves and patients get better care in relation to the quality of data available," said Dr Khotu.

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Last updated:Mon May 21 17:20:00 2007