CALAT ICT CO - GNU Health CON 2019 · DHIS2 Level 3 Health Services OPD, IPD HMIS/ DHIS2 HMIS Level...
Transcript of CALAT ICT CO - GNU Health CON 2019 · DHIS2 Level 3 Health Services OPD, IPD HMIS/ DHIS2 HMIS Level...
CALAT ICT CO.LTD
Laos profile , as still affected by legacy of war, “Vietnam war”
Overview of HMIS in Lao PDR and its challenges
GNU health in Lao PDR, its evolving throughout;
GNU health functionality ,and its core module approaches;
GNU health project main tasks performed, and to be done within timeframe;
Main challenges;
Lesson learnt;
GNU Health prospective in Lao PDR.
Land area: 236,800 sq km
Population:6971202/ Y.2016
Provinces: 18
Districts: 148; poor: 72;
Villages: 8,438.
Male life expectancy: 60.5Female life expectancy: 64.4
B-52 F-aircrafts did 580,000 sorties; Many types of
Bombs -two million tons dropped over 2/3 of Laos
territory; 30% of them remain unexploded (UXOs) >
WW.II’s bombing.
42/47 poorest districts seriously affected.
Bombing destroyed many villages and displaced
hundred thousand of Lao civilians during 9 year period.
Each year there are now just under 50 new casualties,
down from 310 in 2008.Close to 60% of accidents result
in death, and 40% of victims are children…..
Over 25 years on, less than 1% of these munition have been destroyed.
Overview of Health Information Systems in Lao PDR - 2016
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5 Copyright 2015 FUJITSU LIMITED
DHIS2
Level 3
Health
Serv
ices
OPD, IPD HMIS/DHIS2
HMISLevel 1
DHC
MCH M&C HandbookDigitalization
Form/Data entry report TallyTally Tally
Publishing
Indicator figures
Already connected
Planned to be connected
DHHP,MCH Center
Health InformationForm/Data entry
DPIC
Individual data CentralHealth facility District/Province
Form/Data entry
UNDPA
Report
UNDPA
Health Financing National Health Accountant SystemDOF
Healt
h
Hu
man
R
esou
rces
Deployment
Retention
Training CourseInformation System (TCIS)
Health Personnel Information Management System (HPIMS) DHP
Facility, equipment
Meds
Level 0
m-Supply Level 2
DHC, DFD, MPSCM
ed
s,
tech
nolo
gy,
facilit
y
Level 1
Level 1N/A
N/A
N/A
Fin
an
ce
Health insurances
Health Equity Fund, Free Maternal ServicesDOF
3 infectiousdiseases
Malaria Information System Level 2
Tb Information System Level 2
HIV/AIDS National Monitoring and Evaluation Reporting System (MERS) Level 2
ProductionHealth training institute Students information
DTR
EPI Information System
Early Warning and Responding Network(ERWAN)
Model Healthy Village
Early warming
Health promotion
DCDCLab & Epi Center
DHHP
DCDCHIV/AIDS Center
DCDCTb Center
DCDCMalaria Center
DHHP,MCH Center
EPI
N/A
N/A
N/A
DTR
Info. Exchange
Overview of HIS in Lao PDR
• Fragmentations of Health information system driven by vertical programs and diseases funded by different funding agencies
• Since 2013 to present , MOH applying Open source web base system using DHIS2 for data collection, reporting , analyzing and dissemination of Health information.
• Only 3 mains data sets are incorporated to DHIS2 (OPD, IPD and Maternal and Child Health information) aggregate at health facilities level
• MOH are now working with relevant Ministry of Health Departments concern and Diseases center to merge into a single platform using DHIS2
• Ongoing development of merging Malaria , TB, and HIV.AIDS into DHIS2 are now on progress.
• Remaining Human Resource, Health Financing, Surveillance system, etc ..
Overall Achievement
Health Information System (HIS) is the 5th prioritised
area of the Health Sector Reform (HSR) strategy of
Ministry of Health
Integrated health information platform has been
established on DHIS2 – an online, web-based system:
HMIS, MNCH, summary HR, populations and soon, HIV,
TB, Malaria to join the platform (Dec. 2016)
DHIS2/HMIS covers all MOH health facilities with 96%
reporting complete rate
Challenges
Use of information limits to reporting leads to:
Data quality assurance is limited
Many managers are unaware of the system
Staff enter data but get little feedback
Concept of specific assignment and shifting roles of data
managers is new in the DHIS2 system
Recognition of DHIS2/HMIS not for overall health sector , yet
Access to internet and computers
Current capacity and training doesn’t meet demands for the
extension of the system.
GNU health was firstly introduced at CMR in Laos by CALATICT
on Jan.2014,and completed by Nov.14.it has been customized
and translated to Lao language. Now well functioning.
Early Jan 2016, started implementing GNU Health at Mahosot, a
public hospital.
With Main functionalities: EMR,HIS and HeIS(Health information
system),and
Core module approach: Individual & community management,
patient management, hospital information management.
In Lao PDR, the hospitals are about forming in
terms of the public health services, similarly to
many other developing countries.
Mahosot, is an old & complex public hospital with
more than 600 beds, some buildings were built
since French colony, for more than 6o years ago;
Some equipment are too old such as: TCS,
mammo… cannot be incorporated easily (file
attached needed)
Identified location where the networking is being set-up thru
optical fibers and UTP cables
Set up seven point of optical fiber, and 350 drop point of UTP
Set up the main server and work-stations
Collect and consolidate the users’view points to customize to
Mahosot context and situation;
Completed the system translation into Lao language, and
manual operating for various departments;
Completed data entry of drugs, staffs, and health care
service thru overall the hospital;
Adapted GNU Health system to be closely to the real context
&situation to become specific to Mahosot hospital ( large
infrastructure with old physical facilities)
Revise and reset the network due to irrelevant system
designed with Cissco experts collaboration;
Completed data entry of drugs, staffs, and health care service
thru overall the hospital;
Customize GNU Health system to be very closed to the real
situation to become specific to Mahosot hospital ( large
infrastructure with old buildings)
Training sessions for GNU health operation ( IT Team, MD,
nurses….)
Medical care service( reception, registration, card issuing,
syndrome , categorize the patient and their needs)
Set-up GNU health into the remaining departments such as
:ER,ICU, OB, IPD and OPD..
Set-up GNU health into every medical care support likewise
Analysis, Xrays, ultra-sound,mammo..;
Some other tasks out of plan, to make the analysis system
more efficient.(additional project cost to be agreed upon)
Dr Luis Falcon’s instructions for setting-up LIMS,
Medical service processes
Medical service processes cont.
1. Review and revise the networking systems that are
found not suitable to the project team and the health
professionals, that leads to some delay;
2.Equipment and support materials of the GNU health
system (Switches; size and specifications to be relevant
for bigger data, concern for future extension )
3.Service medical care process to cope with changes
toward to new and modern systems.
4.Linkage electronic data of Laboratory and Xray units ,
incorporate with LIMS.
5. Paradigm shift from old habits & culture of the staffs to online
system as required (eager, reluctant, resistant)
6. Conceived TOT did not work well as expected ; CALAT’s Team
are committed to help them operate the new system.
7. Data entry for all patient from overall country (8,438 villages,
drugs purchase & sell price, health care service price, etc..)
8. Budget constraints versus needs & requirement from such a big
hospital in terms equipment& devices.
Standards and accreditations not yet set-up.
Full support of high authorities as MoH &CEO is a must, that is the case. They are
eager to see HIS feature from GNU Health , and its outcome (apart from its
advantages over non free license software)
Mastering English language is part of need for end users , despite Lao language
translation.
IT staffs of the hospital cannot act as good trainers without the assistance of
CALAT’s teams.
Should budget allocation be relevant to project costing, to ensure smooth
implementation ,particularly for such a big & complex hospital.
Well planned and designed project implemented by well trained health
professionals, along with budget allocation, is a must, to ensure high quality of
system with high level of sustainability;
In addition to being free software, the system focuses on holistic approach to
patient, health promotion, disease prevention.
Centre of Medical Rehabilitation (CMR) as a small size center, is using HIS since late 2015, as Good example.
Project completion of GNU health at Mahosot hospital will be a good model for other public health centers overall country;
Calat ICT team‘s presentation to Military Hospital (103 H),and Savannakhet province hospital . Leaders from both hospitals are very interested.
Extension of GNU health overall country seems to be envisaged.
FEDERATION;
MOBILE APPS;
SYNCHRONIZATION WITH OTHER HOSPITALS;
LIMS, PACS MORE FRIENDLY USED/TEACH;
LAOS IN NEED OF HELP FROM OUR COMMUNITY TO STEP FORWARD ONTO OVERALL HSR,ESPECIALL HeIS.
Monalisa