This article first appeared in MediaGlobal, an independent international media organization, based in the United Nations, creating awareness in the global media on social justice and development issues in the world’s least developed countries.
“Rebuild better” has become a mantra in Haiti as the nation struggles to recover from the devastating January earthquake. The healthcare system in Haiti, which was weak even before the disaster, is one area where this mantra is particularly applicable. A major weakness in Haitian healthcare is the lack of health systems supported by electronic and information technologies (e-health) and electronic medical records (EMR). Interoperable, or sharable EMR, provides easier access to individuals’ medical records and better tracks drug and medical supplies coming in from other places.
At present, Partners in Health (PIH) with the support of Canada’s International Development Research Centre (IDRC) and the I-TECH program at the University of Washington, is working with the Haitian Ministry of Health to support the strengthening of EMR interoperability in Haiti. The project will provide research as well as lessons learned in order to ‘rebuild better’ and improve health outcomes not just in Haiti, but throughout the developing world.
Chaitali Sinha, Program Officer with IDRC, explained to MediaGlobal that most EMR systems in Haiti before the earthquake were focused on specific diseases and existed only in individual health clinics and hospitals. “This poses a considerable challenge to providing continuity of care because the absence of interoperability prevents exchange of patient data across different care settings,” Sinha said. “For instance, an HIV patient on treatment at one location would be unable to continue her antiretroviral therapy upon moving to another location.” This lack of interoperability proved to be an enormous problem after the earthquake. Haitians were not only displaced, but in need of medical treatment.
As the health care infrastructure deteriorated, problems with the medical supply chain increased. The distribution of essential drugs and medical supplies to victims became virtually impossible. What is inevitably a logistical nightmare after any natural disaster was made even more difficult by the lack of electronic records of supplies coming into Haiti. Much-needed supplies were left sitting on the tarmac and in warehouses because it was impossible to track what was coming in.
Better EMR could help solve this problem. “It rapidly became apparent to the most (maybe all) organizations doing relief work there just how essential it was to be able to track inventories of supplies, forecast requirements, submit orders and track the shipments,” Dr. Hamish Fraser the PIH Project Leader, told MediaGlobal by e-mail. “Many groups saw recent advances in mobile phones and mHealth [health information systems that can be accessed by mobile phone devices] as a solution to these challenges. At PIH we are developing a new version of our pharmacy system that will work better offline (due to the poor quality internet connectivity) and also building tools to track the shipment process.”
Upgrading EMR in Haiti has the added benefit of compiling records to determine the location of recurring health problems. “The ability to track disease outbreaks and get staff and supplies where they are needed should improve responsiveness of the health system,” Fraser said. “If we find more diabetes or liver disease for example, then more resources can be deployed for those conditions improving the patient experience.”
The organizations engaged in the Haiti e-health project will use this opportunity to not only build on interconnectivity in Haiti’s health system but to provide other countries with feedback and research on best practices. “IDRC’s focus on supporting research grounded in felt needs, and subsequently translated into use, is central to ‘rebuilding better’, Sinha said. “That is why this particular effort has been designed as an action research and evaluation project to inform the rebuilding of Haiti’s health system, and also other health systems that may need to recover from similar post-disaster circumstances.”