The incredible potential to improve global health delivery through appropriate use of health information technology (HIT) drives discussion in this community. Members connect to learn about feasibility, planning, and implementation of a broad spectrum of HIT projects, including electronic medical record systems and mobile devices.
As more health information systems become implemented, the focus becomes interoperability, how these systems can communicate between them to integrate data. One of the components is standards which have existed for decades including HL7, SNOMED, RxNorm, and LOINC among others. Further, organizations have been created to help organizations and countries implement these most notably OpenHIE.
Australia formally started their eHealth interoperability about 10 years ago. More than technical integration, this was an effort to establish layers of policy, workflow, semantics, and technology to support agreements on what these organizations will collaborate and on which things they won’t. Australia currently has a range of clinical communities electronically interacting with varying degrees of policy support, behavior consistency, semantic agreement, and technical integration.
This Project Spotlight provided an overview of the Australian experience with the viewpoint of what other countries and organizations implementing eHealth interoperability could learn.
A discussion was started by a member who explained how difficult it was to find a job in Global Health (GH) and health IT despite having an advanced degree, and many members corroborated the reality that finding a job was difficult. The community responded with suggestions on both things to do as well as places to look for positions if you are starting off your career in international development.
Uno de los grandes obstáculos en proveer servicios de salud y de informática en salud en zonas de bajos recursos es la falta de capacitación y personal capacitado. Hay varias razones por esto: el alto costo de capacitar, especialmente en zonas remotas; que personal capacitado se va a zonas urbanas; y la falta de educación y oportunidades en zonas rurales. Una estrategia para reducir estos problemas es eLearning: proveer capacitación y otras posibilidades educativas en linea.
El aumento de los centros de aprendizaje electrónico, aulas virtuales y de materiales código abierto (eLearning) es uno de los sectores de mayor crecimiento de la educación. La cantidad gastada en eLearning se prevé que supere 69 mil millones de dólares en todo el mundo el 2015. Una plataforma de eLearning popular, Moodle, una de varias que son código abierto, tiene más de 65.000 sitios registrados y tiene unos 1.500 nuevos cada mes.
Este Panel se centró en cómo eLearning afecta a la educación y el aprendizaje, así como las posibilidades que tiene para el desarrollo y la formación, tanto a nivel personal y organizacional, para aquellos trabajando en informática en salud.
A key challenge in providing healthcare and health IT in resource-poor settings is the lack of training and trained personnel. There are many reasons for this: the high cost of training, especially in remote areas; the fact that trained personnel usually move to urban areas; and the lack of education and opportunities in rural areas. One strategy to reduce these problems is eLearning: providing training and other educational possibilities online.
The rise of e-learning centers, virtual classrooms, and open-source materials (eLearning) is one of the largest growing sub-sectors of education. The amount spent in eLearning is forecasted to exceed $69 billion worldwide by 2015. A popular eLearning platform, Moodle, one of a number of open-source eLearning platforms, has over 65,000 registered sites and sees some 1,500 new ones every month.
This Expert Panel focused on how eLearning affects education and learning, as well as the possibilities it holds for development and training both at the personal and organizational levels for those of us working in global health IT.
Agencias de desarrollo como el Banco Mundial, USAID, PEPFAR, y el Fondo Global han invertido mas entre US$3.000 y US$5.000 millones en proyectos de eSalud en países de medianos y bajos recursos en la ultima década. Varios de estos proyecto han sido para Registros Clínicos Electrónicos (RCE) y varios de estos no se están usando actualmente. Sistemas de Información en Salud son complejos y optimizar estos programas para el uso en ambos países desarrollados y en desarrollo es un desafío continuo.
La comunidad de OpenMRS esta enfrentando ese desafío. OpenMRS, un RCE código abierto, ha sido implementado en mas de 130 ubicación en 50 países, incluyendo los EE.UU., Sud África, Alemania, las Filipinas, y Chile. Adicionalmente, los gobiernos de Ruanda y Kenia has escogido a OpenMRS para la implementación de infraestructura nacional de eSalud.
Este Panel de Expertos se centró en la plataforma de OpenMRS y su comunidad de usuarios (Seebregts 2010), sus experiencias, los obstáculos que han enfrentado en implementar OpenMRS en zonas de bajos recursos y los beneficios que han visto de usar esta plataforma.
In the last decade, development agencies like the World Bank, USAID, PEPFAR and the Global Fund have spent between $3 and $5 Billion on eHealth projects in low and middle income countries. Many of these expenditures have been on Electronic Medical Record (EMR) projects which in some cases are no longer being used. Health Information Management Systems are complex and optimizing these programs for real world use in both developed and developing countries is an ongoing challenge.
Facing that challenge is the community of OpenMRS users and developers. OpenMRS, an open-source EMR, has been implemented in over 130 sites in 50 countries, including the US, South Africa, Germany, the Philippines, and Chile. Further, both the Rwandan and Kenyan governments have chosen OpenMRS for the implementation of their national eHealth infrastructure.
This Expert Panel centered on the OpenMRS platform and surrounding community of users (Seebregts 2010): their experiences, the challenges they encountered implementing OpenMRS in resource-constrained settings, as well as the benefits they’ve found from using this platform.
Telemedicine projects range from an e-mail link with a digital image to high-resolution video calls. Telemedicine has been shown to be feasible in low-resource settings (Wooton, 2010) and worldwide systematic reviews in 2001 and 2006 have shown telemedicine projects are frequently evaluated in resource poor settings.
GHDonline’s Health IT community organized an Expert Panel to discuss what has been learned in telemedicine, its benefits, and what existing projects or services are available for organizations and individuals to participate in.
A member working at a clinic in rural India shares challenges with patient identification. Advocates for unique patients identifiers (UPI, also “patient ID” and “unique identifiers”) insist that a health care system in which every patient has a unique, nondisclosing patient identiﬁer is desirable for reducing errors, simplifying interoperability, increasing eﬃciency, improving patient conﬁdence, promoting ﬂexibility, and improving the continuity of care for chronic conditions like HIV/AIDS and across the health system. (RAND. 2008. UNAIDS. 2009) They also note privacy concerns over personal health information. Members from across the American, Asian, and African continents share their experiences on various health IT systems and thoughts on policy issues.
In the words of GHDonline member Anup Akkilah, “the efficacy of medicine is irrelevant if drugs are not available in the first place.” This discussion focuses on the use of SMS technologies for drug supply chain management in which members in India, Malawi, and the United States share experience with specific advocacy campaigns.
A systematic review of patients who initiated antiretroviral therapy (ART) across sub-Saharan Africa found that approximately 25% were no longer in care one year after initiation, a figure rising to 40% after two years (Rosen et al. 2007). This challenge combined with the need for strict adherence to medications for HIV and other chronic diseases make the use of technologies to monitor and improve adherence a much needed effort.
GHDonline’s Adherence & Retention and Health IT communities organized a joint panel discussion on how implementers are using wireless technologies to improve adherence monitoring and interventions. Participants discussed limitations of the technological approach and under-explored opportunities, and expanded the discussion to address challenges and solutions in the delivery of Directly Observed Treatment Short course (DOTS) for tuberculosis.
Building and supporting local capacity and expertise is seen by many as critical to the successful development and roll-out of eHealth solutions in countries, programs, and communities. What are the benefits and challenges of having local organizations create and maintain health software and what are the lessons learned from various projects? These are addressed in depth by 26 members, moderators, and panelists with experience in for- and non-profit organizations across the globe.
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.
Started by a community member working in Nicaragua to implement a community-based health care model where a health team consisting of a physician, a nurse and an auxiliary nurse are in charge of a population of 2000 people, this discussion centers on the pros and cons of using low cost laptops for Community Health Workers (CHWs).
Initiated by a community member working in a program in Haiti involving 7 hospitals and the World Health Organization, the US military, Handicap International, HelpAge International, and UNICEF, members participating in this discussion provide a list of requirements and systems available for the collection and sorting of demographic information about patients, their follow-up plans, the distribution of non-food items (NFI) and vulnerability indices using mobile devices.
In settings where electricity is unreliable at best, experience and knowledge with solar-powered or solar set-ups for wireless routers is critical to connect remote sites to the Internet.
In this discussion, members share various solutions for navigating this challenge, explaining set-ups for sites in Malawi, Uganda, and Mozambique, and also recommend vendors.