IMPROVING HEALTHCARE USING HEALTH INFORMATION SYSTEMS IN GUYANA

1
IMPROVING HEALTHCARE USING HEALTH
INFORMATION SYSTEMS IN GUYANA
An integral component of the CIDA FUNDED
PUBLIC HEALTH STRENGTHENING PROJECT IN GUYANA
IMPLEMENTED BY THE CANADIAN SOCIETY FOR
INTERNATIONAL HEALTH Gavin Walters, Paul D. Fish
er, John Farley, R. Benedict
Ministry of Health Guyana
CIDA
Guyana HIS Development Team
Introduction
Guyana HIS Version 0.1 Screenshots (Continued)
The Guyana HIS Development Team is comprised of
Dr. Paul Fisher, Gavin Walters, Amar Samaroo,
Nellie Chang, and Dr. John Farley. Dr. Paul
Fisher is an expert in HIS (s) and the HIS Team
leader. He contributed significantly to the
overall design of the system as well as providing
guidance and is responsible for the
administrative details of the project. Gavin
Walters is the HIS software developer. He is
responsible for developing the HIS database and
client software. Amar Samaroo is the local system
administrator based in Georgetown. He is
responsible for all hardware and software
administration. Nellie Chang is a CSIH NetCorp
intern working with the HIS development team to
lead the training of the users and develop
documentation for the HIS. Dr. John Farley, the
HIV/STI expert contributed significantly to the
design of the HIV/STI modules for the HIS. He
provides ongoing consulting advice for various
aspects of the HIS.
Health Information Systems (HIS) play an
important role in the efficient delivery of care
and in the planning and management of health care
services. A properly designed HIS provides key
epidemiological information, which is valuable at
the government level in making human and material
resource allocation decisions. At the clinical
level, HIS streamlines the flow of data into the
system, communication of data across the system,
and information generation by the system. This
supplies health care providers access to
information that allows them to make more
knowledgeable decisions and deliver better care
and treatment to the patient. At the patient
level, HIS systems improve the efficiency and
quality of care that the patient receives as well
as providing patient confidentiality.
Guyana HIS Current Status Prototyping Phase
Fig 7 Patient Summary Form
Justification
Data collection in Guyana is currently done on
paper or using disconnected databases. There is
very little interoperability between the data
collection systems, a high degree of data
duplication, a high error rate, and long
reporting delays. Patient confidentiality is an
important requirement and will be reflected in
the HIS. A properly designed and implemented HIS
and appropriately trained users are needed to
streamline the collection of data and improve the
efficiency of clinical processes.
During the early October 2004 mission in Guyana,
version 0.1 of the HIS was installed at the GUM
and TB Clinics in Georgetown. This was the first
prototype version to be installed at the pilot
sites. Users from both clinics have the
opportunity to see the HIS in operation and also
have a chance to use the system. Nellie Chang
is continuing to introduce users at both clinics
with the HIS and is documenting changes and
feedback that will be sent to Gavin Walters so
that these changes can be reflected in the next
version of the HIS.
Fig 6 Clinical Workspace used by Physicians
and Nurses
Fig 9 Encounter Entry Form
Guyana HIS Version 0.1 Screenshots
Objectives
The primary objective of the HIS component of the
Public Health Strengthening in Guyana project is
to develop a primary and ambulatory HIS that is
flexible, scalable, secure and sustainable to be
utilized in different health care settings and
customizable to meet the diversified needs of
different clinical providers.
 
Fig 8 Case Entry Form
Fig 1 - HIS login screen
Description of Methods
The initial horizontal scope of the project is
primary and ambulatory care at the Genito-Urinary
Medicine (GUM) Clinic, TB Clinic, and Dorothy
Bailey Health Center (DBHC). Each of the pilots
sites have there own local area network. The GUM
and TB Clinic buildings are networked together
and share one central database server. The DBHC
has its own database server. Each of the
locations will have around 5 workstations so the
different users of the system can test out the
different aspects of the HIS. The vertical scope
of the project is clinical decision support,
institutional resource management, health care
services planning and epidemiological reporting.
Fig 10 Encounter Detailed Form
Fig 2 - Patient Lookup Screen
Fig 3 Receptionist Workspace
Description of Approaches
Fig 11 DOT Worker Workspace
Fig 12 DOT Encounter Entry Form
(1) Design a HIS, based on current clinical,
management and planning activities, that is
flexible and scalable to accommodate for future
needs. In addition, the HIS will be designed with
a strong emphasis on security to ensure the
confidentiality of the patient data.
(2) Develop a multi-user, client server, Windows
based HIS with Visual Basic .Net clients and
Microsoft SQL server for the database server.
(3) A prototyping development approach will be
used where a prototype HIS system is implemented,
tested by the users and feedback is obtained.
This implies several cycles or prototyping with
the end result being a quality, customized HIS.
CONCLUSIONS
The next major release of the Guyana HIS, version
0.2 is scheduled for early 2005. Feedback and
changes requested since the October 2004 mission
will be reflected in version 0.2. The new
version will include the immunization and
pregnancy modules. Version 0.2 will be installed
at the DBHC. The HIS at both the GUM and TB
clinics will be updated with version 0.2. Work
will commence in training users, documenting
feedback and changes at the DBHC site, and will
be pursued at the GUM and TB Clinics. The
prototyping phase will continue, with updated
versions of the HIS being released every three to
four months, until a stable production version is
obtained. Once a production release of the
Guyana HIS is obtained it will be available for
installation in other regions in Guyana.
The Guyana HIS will help significantly improve
the delivery of health services in Guyana.
Fig 5 - Scheduler
Fig 4 Patient Electronic Record
CSIH Ottawa office Roumyana Benedict Project
Director, PHSG Tel [phone] Ext.307 rben
edict_at_csih.org
CSIH Guyana office Suzanne Marquis Project Fi
eld Manager Georgetown, Guyana Tel [phone]
73
csih_at_guyanapsu.org.gy