HIS Country Case Study: ADVOCACY: Importance of using local data EMR (Patient Information System - PATIS)

Transcription

1 Pacific Health Information Network HIS Country Case Study: ADVOCACY: Importance of using local data EMR (Patient Information System - PATIS) Presenter: Mr Shivnay Naidu

2 HIS Challenge Principle: Support and promote patient's health care rights as well as enhance community health and policy initiatives that focus on the availability, safety and quality of care. Vision: A Healthy population in Fiji that is driven by a Caring Health Care Delivery System Reality: Decentralized PATIS with data quality and clinical information issues. Goal: Redevelopment of a centralized web-based EMR system with a focus on sharing clinical and statistical information on patient/customer. Key Players: MoH, FNU, AUSAID, SFL, STA (Data), Bureau of Statistics, Register General

3 PATIS Challenges 1. Identification of all apparent data quality issues 2. Replication of data problems 3. Data entry problems 4. Technological problems (software, hardware, network) 5. Staffing Constraints (IT, records, coders) 6. Budget to sustain the system 7. Dependency on vendor for support on enhancements 8. Reporting Issues (bed occupancy rates, length of stay, etc) 9. Coding Problems (ICD10 AM) 10. No Clinical Notes (Outpatients, Dietary, Physiotherapy, OT etc) 11. No lab test results 12. No radiology images Data Quality Resources Business Process Mapping

4 Actions Taken Data Quality 1. Health Information Policy WHO, GF 2. STA hired to review data and clean using algorithms for 15 databases 3. Analysis to determine causes and whether some errors were programmatic and not due to replication 4. Tools and staff identified to resolve these discrepancies 5. Methodologies in place to ensure sustainability and clean data

5 Actions Taken cont Resources (Technology, Budget, Human) 1. MS Windows Server 2008 R2, MS SQL Server 2008 R2,.Net 4.5 Framework, RAD tools 2. Expansion of WAN (MPLS, dedicated leased lines - SLA) 3. Web User Interface 4. Use of intellisense to assist in faster data entry 5. AUSAID funded FNU 6. Appointment of IT Staff (National PATIS Administrator, Asst PA) 7. Appointment of Health Information Officers 8. Capacity Strengthening of HIU staff (coders, recorders) 9. Appointment of additional staff (NEC)

6 Actions Taken cont Business Process Mapping 1. Requirements Specifications for each module was conducted 2. Use case diagrams created and verified with module champions 3. Every report from current system was assessed by the user community and module champions - (working, usefulness, change) 4. Non-functional reports analyzed for causes of failure (programmatic or poor quality data) 5. Dependencies with other applications (HRIS, LIMS, FMIS) identified 6. Workflows designed as is and to be 7. Test case scenarios prepared and put to test

7 Impact 1. Development and Endorsement of HI Policy 2. Development of National HIS Strategic Plan 3. Promotion of Data Quality and Training by HIO and NPA 4. Appropriate application of information and communication technology (ICT) 5. Enhancement of mechanisms for effective communication, cooperation and coordination (NHIC) 6. Development and allocation of HIS resources (human and financial) through development partners and government assistance 7. Provision of clinical and statistical data based on roles to staff for operational or strategic decision making 8. Improved patient care 9. Platform for public private partnership

8 Next steps and key messages What steps are being taken to ensure continued impact? Enactment of steering committees and working group Regular monitoring and evaluation with feedback Staff capacity strengthening and retention strategies What are key takeaways for workshop participants? Think big and start small with quick rewards/achievements to gain support Let s communicate more for a better regional HIS How will this case study aid in learning and implementation of PHIN strategic plan? Potential to be used as a regional HIS model Explored/Developed further to incorporate health care costing

9 THANK YOU! Community Norms from Asia Pacific Leadership Forum 1. Think before you do, not after you re done 2. You know, you teach, you don t know, you learn 3. Don t ride an elephant to catch a grasshopper Towards a Healthy Pacific Region