Presentation Au Rwanda Phil
-
Upload
jean-nsengimana -
Category
Documents
-
view
1.539 -
download
0
Transcript of Presentation Au Rwanda Phil
Transforming Health Services Through ICT - The Case of Rwanda’s TRACnet Program
Jean Philbert NsengimanaCountry Director
Voxiva [email protected]
+250-78-830-8998
outline
• E-Health Defined• Vision for e-Health in Rwanda• Benefits• What’s TRACnet• TRACnet: addressing crucial HMIS
challenges • TRACnet: Overview of Technology• Key lessons learned
Rwanda and ICT : the regional context
• Rwanda still lagging behind in penetration indicators
• Ambition is to be the regional ICT hub
• 2020 vision: Transform the country from a predominantly agriculture-based to a knowledge-based economy by 2020
• NICI Plans– Education and HR dvpt,
Infrastructure, Socio-economic dvpt, e-Gov, Private Sector dvpt, Rural and Community Access, Legal and Regulatory, National Security Law and Order
0.345.430.73
0.65
42.11
8.71
0.17
15.5
3
0.3
31.37
1.25
0.53
26.82
7.84
3.38
38.54
6.93
0
10
20
30
40
50
60
Burundi Kenya Rwanda Tanzania Uganda Africa
Internet users per 100 inhab.
Mobi le subscribers per 100 inhab.
Fixed phone per 100 inhab.
0
200000
400000
600000
800000
1000000
1200000
1400000
1600000
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Mobile subscribers
Fixed phone subscribers
Internet subscribers
Rural phones
eHealth Defined
• Ministry of Health Rwanda: The Use of Information and Communications Technologies to Provide and Support Healthcare service delivery.– Efficient delivery of healthcare services– Transformed health sector decision-making
culture– A clearly defined architecture and standards
for integrated and interoperable e-Health systems
Foundational components Developing policies for e-health
Equipping hospitals with networks and computers Connectivity of healthcare facilities
System security Subscription to evidence based medical literature
Minimum set of indicators NID integration
Development of Integrated e-Health architecture and standards Providing remote IT support to healthcare facilities
e-Health Center of Excellence
Co
mm
un
ity b
ase
d IS
Prim
ary
Ca
re I
S
Ho
spita
l ma
nage
men
t IS
Dia
gn
ost
ic S
erv
ice
s IS
Pu
blic
He
alth
re
port
ing
IS
He
alth
Ca
re I
nsu
ran
ce I
S
Su
pp
ly C
ha
in IS
H
um
an
Re
sou
rce
IS
Major Benefits to the health sector Improved accessibility to healthcare services Evidence based practice, improved quality Informed clinical and public health planning
Better efficiency, productivity, cost effectiveness
Tel
em
ed
icin
e a
nd e
-le
arn
ing
IS
Rwanda eHealth Building Blocks
Benefits
Public & Patients
• Improved Health Outcomes
• Improved, specialized care more available and accessible (remote consultation, patient monitoring, imaging, etc.)
• Health information follows patient
• Reduced travel costs• Access to education
and prevention resources ($1 on prevention saves $8 on treatment)
Health Care Providers
• Better access to clinical information
• Less duplication of diagnosis tests
• Better coordination of interventions
• Greater practice efficiency
• Improved financial and administrative efficiency
• Ability to reach many without travel risks and costs involved
Health System
• Better population health and protection (e.g. Integrated Disease Surveillance and Response)
• More effective health planning and decision making
• Cost effective and sustainable health system
• Improved Health education and Research
TRACnet
• Dynamic, innovative, adaptable, IT system that collects, stores, retrieves, and disseminates critical program, patient and drug information related to HIV/AIDS care and treatment.
• Developed by Voxiva under a grant funded by the CDC under the aegis of PEFPAR.
Background: HIV situation in Rwanda
• Persons on ARV as of December 2008•57,514 adults•5,635 children
• HIV prevalence sex ratio (F/M): 3.6/2.3
• Access to ART services• 2004: 12 facilities offering
ART• Jan 2010: 266 out of 513
country wide• 2012: Universal Access: all
facilities offering ART, VCT/PMTCT
HMIS – Challenges and opportunities
MOHTB Malaria HIV/AIDS MCH EPI Disease
Surv.
Nat’l AIDSCommission
Global Fund
PEPFAR
Other Donors
DistrictHealth Authority
ProvincialHealth Authority
Labs
Warehouse/Distribution Center
NGO NGO NGO NGO NGO
si986hs
X5t77s
X5t6hs
3k9dbns
0kb3YY
X5t6hs9w
3k9dbns
0kb3YY
X5t6hs
N7uKK0
X5t6hs9w
3k9dbns
CellPhone
PCs/Internet
PDA/Smartphone
SAMPLE DATA
TRACnet allows users to:•Collect real-time
information from the field via web, phone, mobile application, paper...
•View, analyze and map the data in real-time to make more informed decisions.
•Communicate and send alerts and information back out to the field in a timely and systematic way.
LocalApplications
Phone
Technology
TRACnet system
TRACnet
Functional Modules
Program Indicators (ART, PMTCT, VCT)
Patient Registry (Registry, Care & Treatment Record)
Inventory (Shortage Reports, ART Inventory)
Laboratory (Results, Inventory Supplies)
Integrated Disease Surveillance & Response
Outbreak Alerting
Communications Modules
Interactive Voice Response
Cell Phone Client
PC Client
SMS
Systems Modules
Facility Registry
User registry
Access Control and Permissions
Dashboards and Analytics
Configuration
Communications
Notifications
Under Construction
TRACnet in use
• Hosts National Facility Registry (513 facilities)
• Used by all 266 ART facilities
• 90% of facilities using phone to report
• 1,159 registered users• Close to 1,000,000 user
sessions so far
Key lessons learned
• Stakeholder engagement and ownership• Flexibility and scalability• System documentation• Data quality from the source (garbage in,
garbage out)• Integration, interoperability with other
systems• Governance structures and mechanisms• Capacity building crucial for sustainability
ICT development framework - what should investment be focused on?
• Awareness• Content • Applications
• Policy• Legal,
Regulatory
•Skills to use•Affordability
•Infrastructure•Energy•Connectivity
Access
Ability
VALUEEnvironment
Is it time to shift the focus from infrastructure to content and applications?(Since the individual market for access will be saturated soon).