Green Book- HMIS

8/6/2019 Green Book- HMIS

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Primary Care Informatics

Information Systems in Healthcare

Dr. Shariq Khoja; MBBS. MSc. PhD (e-Health)Assistant Professor

Department of CHS & Medical Directors OfficeAga Khan University, Karachi. Pakistan


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Roadmap

Existing Information system for Primary care

in PakistanConcept of PCI and its componentsHow PCI could benefitWould PCI system work for Pakistan.?What could be the structure of PCI inPakistan


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Current situation

F irst point of contact(BHU, RHC,

health workers, physicians offices

LHWs

TBAs

Vaccinators

District

Province

National

Laboratories Radiology

PharmaciesOther

providers

TB

CP

MC p


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Current situationRole of Primary Care Provider Care (Cure??) Provider Expert / Storehouse of Information Information Administrator Information Source / Channel

Implementer of health programs Isolated component of a Disintegrated

Patient Care System


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Current situation

Role of a client in health care

Care (Cure??) receiver Amateur / learner Information provider Information Source Receiver of health programs Sufferer of a Disintegrated Patient Care

System


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Definitions

eelectronic

elitist, exclusive, exhausting, ephemeral, andexasperating

vs

ethics, equity, efficiency, empowerment,encouragement, education, enhancement of quality,evidence-based decisions, extension of the scope of

health care, and enablement of information exchangeand communication in standardized ways


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Definitions

e-Health:

consumer-centered model of healthcare wherestakeholders collaborate using ICTs includingInternet technologies to manage health,arrange, deliver, and account for care, and

manage the healthcare system. (OntarioHospitals e-Health Council)


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Definitions

Telehealth is the use of information and

communication technology(ICT ) to deliver healthservices, expertise andinformation over distance

e-Health

Health InformaticsTelehealth

Health Informatics dealswith the storage, retrieval

and optimal use of biomedical information,data and knowledge for problem solving anddecision-making


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DefinitionsHI= Collection of Health Information

+

Conversion of information into knowledge

Primary care describes the health servicesthat play a central role in the local community,such as family doctors (GPs), pharmacists,dentists and midwives.


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DefinitionsPrimary Care Informatics

T he scientific study of data,information and knowledge , and how they can be modelled, processed or harnessed to promote health and

develop patient-centred primary medical care.

Simon de Lusignan, Primary Care Informatics, LONDON SW17 0RE. 8th July 2002


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Definitions

People MachinesMethods

Data Collection, Process, Transmission & Dissemination


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Evolution

Physiciansmemory

EMR/EHR History &Physical exam

Organized data


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Why??Need of organization and integration

Advancements in ICT

T echnical Infrastructure deployment inhealthcare institutions

Powerful networked PCs and serversGovernment programsWHO initiatives


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Uses3 Rs of Primary Care Informatics:

Repository (collect-store)Collection, flow (interfacing), and organization(Clinical data repositories)Completeness and Accuracy

Reporting (display)Clinical data, integration, admin info

Research (analysis)Intelligent analysis of data for patient andpopulation


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Components

Patient

Provider EMR


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Components

Patient

Provider EMR

Decision Support


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Components

Patient

Provider EMR

Decision SupportLinks to lab &

imaging

Alerts

Entry of orders &data communications

support

KnowledgeResources

Patient access toknowledge,

Communications& EMR data


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Why???

If it aint break - Dont fix it


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BenefitsBetter / highest quality of health care(not possible with poor, incomplete or missing information)Enhancing quality by includingknowledge resources, practiceguidelines (minimizing variationbetween individual practice and optimalpractices)


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BenefitsAvoiding errors in practiceImproving service to the patients, andimprove their satisfaction with careControlling costs by avoiding: Rework Ordering duplicate tests Inappropriate diagnosis and treatment measures Medical errors


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ChallengesLack of education, training & supportLack of information exchange

Lack of a reasonable business caseLack of a common data model & CodingschemeLack of a drug database & drug decisionsupportLack of a decision support frameworkLack of quality


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Lack of Quality


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EvaluationWhy? Goals & Benefits Objectives Processes Indicators


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Relevance

Would Primary Care Informatics systemwork for Pakistan.?


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Relevance



LHWs

TBAs

Vaccinators

District

Province

National


PharmaciesOther

providers

TB

CP

MC p


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Relevance



LHWs

TBAs

Vaccinators

District

Province

National


PharmaciesOther

providers

TB

CP

MC p

Patient


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Relevance



LHWs

TBAs

Vaccinators

District

Province

National


PharmaciesOther

providers

TB

CP

MC p

Patient


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Next stepsT he direction is clear, the pace uncertain

Determining the structure of PCI mostappropriate for PakistanExpanding knowledge among physicians,

other care providers and managersMoving towards complete, widespreadimplementation of EMR

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