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Namibia: Information's Critical Role in Health Care
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New Era (Windhoek)
COLUMN
4 April 2008
Posted to the web 4 April 2008
Manfredt Kavetu
Windhoek
Namibia's health system aims to improve and maintain the well-being of its citizens by providing services to prevent and cure diseases, to rehabilitate those that have suffered illness, and to generally promote good health.
Some of the most serious challenges facing healthcare today-medical errors, inconsistent quality, and rising costs-can be addressed through effective application of readily available information technology that links providers and health information throughout a community and throughout the country.
Such networks enable decision support anywhere at any time, improving public and individual health and reducing cost. In this article, we propose a grand vision to integrate and connect all the public hospitals, health centers and clinics through an IP/MPLS network infrastructure, and further, integrate all the processes, applications and documents through the web portal.
Why We Need the Integrated National Health Information Infrastructure
Our healthcare system is facing significant challenges from medical errors, inconsistent quality, neglect, and rising costs, and these factors are already contributing to preventable deaths in our hospitals each year. Recent cases of neglect and errors have made headlines in local newspapers. The recent outbreak of cholera highlighted the significant new challenges to our public health system.
The current paper-based healthcare system is unable to consistently deliver recommended care, particularly for chronic diseases, and therefore substantial improvement in healthcare is only attainable with the ubiquitous availability of complete healthcare information and decision support at any point of care through our proposed integrated national health connected infrastructure.
There is abundant evidence from international practices that effective use of information technology can improve patient safety, quality of care, efficiency, and reduce costs. Preventive service reminders, for example, have been shown to significantly improve the delivery of preventive healthcare.
Continuity and Quality in Medical Care
The health framework supports four major domains - personal health, clinical care (medication, allergies, immunization, surgical, trauma, alerts, family medical history, physician note), public health, research and policy.
As such, it will provide an improved link between healthcare and public health, facilitating disease surveillance and response and eliminates the need for redundant tests and X-rays because prior results will be readily available.
It will facilitate the use of decision support, allowing clinicians to apply the latest treatment recommendations and research advances without the need for superhuman memory. It will automate billing and quality reports from the record of care, minimizing additional work.
The medical record must "tell the story" of the patient as determined by the physician in the circumstances in which he or she saw the patient. The record is not just a personal memory aid for the individual physician who creates it, it must allow other health care providers to read quickly and understand the patient's past and current health concerns.
It is not expected, however, that all patients will always be able to read and understand their medical records. Medical records may contain abbreviations and terminology unique to the health care professions.
The Integrated Connected Health Framework Model
The integrated connected health framework is a central data warehouse of health information that collects information from all the hospitals, health centers, clinics, laboratories, as needed for patient care.
The key to the successful integration of state-of-the-art IT services, applications, and business processes is the combination of the IP/MPLS network infrastructure, wireless-based network infrastructure from Telecom, and the GPRS/3G/HSDP mobile connectivity from the cellular companies. An embedded, mini .net framework in mobile handheld devices like cell phones and PDAs enable these devices seamless access to the web portal.
We believe the proposed integrated health framework is the most technologically advanced in the whole of Africa for the public health system. It will form the basis for entirely new treatment methods, increased efficiencies, and better patient care.
The wireless network (SWITCH from telecom) and GPRS/3G/HSDP from the mobile phone operators (MTC, Cell One) will deliver patient information any time, and from any location, along with communication systems, alarms, and calls. Already the mobile phone operators are covering more than 90% of Namibia.
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For mobility of use and access to the Internet, 3G/HSDPA is becoming faster and very reliable. HSDPA (High-Speed Downlink Packet Access) enables a user to access the Internet and transfer data wirelessly through mobile telephone technology at up to 1.8 Mbps.
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