Post on 15-Jan-2017
IMPACT OF ELECTRONIC HEALTH RECORDS IN SRI LANKA: CASE STUDY OF GOVERNMENT HOSPITALS.
SHRIyananda RathnayakeProgramme Manager – ICT Agency of Sri Lanka
Background
• High life expectancy of 77.4• Low rate of maternal mortality (41.6 per 100,000 live
births)• Low rate of infant mortality (8.5 per 1,000 live births)• Over 89% of the population has access to safe drinking
water • 85% of population has proper sanitation facilities
BUT The burden of Non Communicable Diseases (NCD) have
increased rapidly during last two decades Communicable diseases such as Tuberculosis, Leprosy,
Dengue is on the rise due to environmental and social factors
Why EHR • Total health expenditure in Sri Lanka is recorded as
between 3.4% and 3.7% of GDP • Contribution from government to health care
expenditure 47%.
• Contribution from Private sector 53% 80% of out-of-pocket expenditure 20% of Insurance, non profit activity contribution
Private sector is expanding further, outpatient care and medical laboratory services
Patients accessing healthcare services in an ad hoc and piecemeal fashion owing to cost of care
NCDs are chronic in nature and demand systematic treatment protocols being adopted in disease management.
Poor management of such diseases leads to worsening health condition
Government Health -OPD settings • Long Queue• Maximum 2 minutes per patient• No time to ask patient history • No health information, • Long stay to access the health care
Why EHR
2010 2011 2012 2013 2014 2015 2016 2017
EHR implementation
kick off. HHIMS v.1.0
Dr. A.I JagodaDr. K.N.G
SenevirathneLunar Technology
Karawanella B.HHHIMS v 1.1
Dompe D.HHHIMS v 1.2
(Beta)Queue
management system
Dr. Sampath Kulathilake
HHIMS v 1.3 Release
Stable Version
Dr. Sampath Kulathilake
Dr. Yasith Mayabandara
HHIMS v 1.4 Awissawella
Base Hospital
Dr. Pradeep KeerthiMallawa
Dr. Shantha Senevirathne
Dr. Sampath Kulathilake
Nipun Sachindra
HHIMS v 2.0 Base hospital
Panadura (2014)
HHIMS v 2.0 and HHIMS v
2.1
(will be release soon)
HHIMS v 3.0(Cloud Based)Android App and mobile devices for Ward RoundNational DB for Patient
Registration (Central PHN Registration)
Dr. Clive James
Dr. Sampath Kulathilake
Dr. Yasith Mayabandara
Dr. A.I Jagoda
History and Versions
What is HHIMSHHIMS is Free and Open Source Hospital Health Information Management System specially designed for the requirement of Sri Lankan hospitals. HHIMS comprises Electronic Medical Record (EMR), Computerized Provider Order Entry (CPOE), Pharmacy Management, and Laboratory Information Management.
Research Settings • Research Question - To what extend adaptation of electronic
health records improve the quality and efficiency in government health care services
• Research Sample - Dambadeniya, Mahaoya, Awissawella Base hospitals and Dompe District Hospital.
• Survey Method – Mixed Method, (Qualitative and Quantitative Method)
• Data Collection Techniques - Questionnaire, Focus Group Discussions (FGDs) and Key Informant Interviews (KIIs). Telephone interviews
• Respondents - Medical staff and health care services staff at hospitals, Patients and individual beneficiaries.
Research Focused
• Level of awareness of information system • Level of usage of information system • Whether or not users believe that there are benefits from
HIS• Whether the users are aware of the benefits of HIS• Whether the users believe that the HIS is sustainable• Critical success factors according to the users views • Negative impacts if any form due to HIS• Usability and operational difficulties• Awareness on Organizational benefits and challenges in
use of HHIMS
Results
81%
3%
59%
22%
35%
19% Hassel free quality and speedy health service
Can make advance appointments now
No need to repeat our details
Accurate diagnosis
Enhanced care by the doctors
Appropriate management plan for the patients
Results 93% of the patients have mentioned that they think it is
beneficial for them to get services from hospital which has a HIS.
Among them 79% experienced reduction of waiting time for health care services
59% believes that HIS enhanced quality of health service since the records will be reviewed by other doctors in a future day when the same patient visits the hospital
93% of the patients believe that there are no negative impacts and only 7% have said there are negative impacts due to the failures of the system.
Usability and operational acceptance play a major role in implementing the HIS in any health care institute
88% of system user rate the HIS as “easy and user-friendly” 99% of the system users are familiar with the system.
94% of system users believe that they are benefited through HIS implementation
70% of health care staff believes that the HIS implementation resulted reduction of patient waiting time
52% mentioned that it is also pave the path for hassle free healthcare services.
More than 50% of health staff mentioned that availability of electronic medical records create an environment to improve the quality of care by health staff.
Results
Limitations of research
The medical staff, nurses and pharmacists at the dispensaries were extremely busy throughout the day
Three hospitals have implemented the HIS (HHIMS) only in OPD and clinics sections and only Dompe district hospital implemented the system covering inward section
system implementation in clinic section also limited to few clinics such as family medical clinics.
Photo Story
Needs a bit of a computer literacy. Need a bit of English Knowledge (esp. Registration
Desk staff ). Need the supervision of a IT admin Power failure solution is needed. Difficult to use in extreme weather(thundering)
Drawbacks
• Health Information system implementation in government hospitals will lead to quality and efficiency improvement of the health sector in Sri Lanka.
• More empirical research to be conducted to measure the outcome and impact
Conclusion
Q & A