2. INFORMATION TECHNOLOGY FOR THE HEALTH SECTOR IN NEPAL
Dr Paras K Pokharel
Associate Professor
Department of Community Medicine
BP Koirala Institute of Health Sciences
Dharan ,Nepal

3. HEALTH THREATS POPULATION EXPLOSION RAVAGING EPIDEMICS
NATURAL & SOCIAL CALAMITIES
HIGH LEVEL OF INFANT AND MATERNAL MORTALITY
LOW LEVEL OF LIFE EXPECTANCY
DETERIORATING HEALTH CARE FACILITIES
CRISIS CAUSED BY HIV/AIDS
SPREAD OF MALARIA, TUBERCULOSIS AND OTHER INFECTIOUS DISEASES

4. PROBLEMS FACED
THESE THREATS PUT PRESSURE ON OUR ECONOMY AND PROMPTED FOCUS ON
INCREASING DEMAND FOR FUNDS FOR HEALTHCARE
TRAINING OF MORE DOCTORS AND PARAMEDICS
CONSTRUCTION OF NEW HEALTH FACILITIES
INVESTING MORE ON HEALTH RESEARCH

5. PROBLEMS FACED (cont.)
BUT THE SITUATION HAS NOT CHANGED SUBSTANTIALLY OVER THE LAST DECADE RATHER IT IS WORSENING.
WE FACE
DECLINING RESOURCES FOR PUBLIC HEALTH
RAPIDLY EXPANDING MEDICAL KNOWLEDGE
POOR COORDINATION BETWEEN MEDICAL FACILITIES
IN SUCH A SITUATION LET US EXAMINE HOW THE INFORMATION AND COMMUNICATION TECHNOLOGY (ICT) CAN PROVIDE US SOME HELP

6. HEALTH SECTOR MOST INFORMATION INTENSIVE
INFORMATION POVERTY: ONE OF THE MOST SERIOUS OBSTACLE FACING HEALTH PROFESSIONALS
ADVANCES IN ICT COULD PROVIDE
FAST
EFFICIENT
CHEAP ACCESS
TO INFORMATION RESULTING IN DRAMATIC IMPROVEMENT IN ACCESS TO ADVICE AND CARE

7. INFORMATION & COMMUNICATION TECHNOLOGY
NOT LIMITED TO TRANSFER OF INFORMATION
PROMOTE BETTER HEALTH BEHAVIOUR
IMPORVE DECISION MAKING
PROMOTE INFORMATION EXCHANGE AMONGST PEERS
PROMOTE SELF CARE
PROVIDE PROFESSIONAL SUPPORT
ENHANCED EFFECTIVENESS OF HEALTH INSTITUTIONS

8. COST * QUALITY * ACCESSIBILITY * DELIVERY
ICT APPLICATIONS
ELECTRONIC MEDICAL RECORDS
HOSPITAL INFORMATION SYSTEM
INTRANETS
PUBLIC NETWORKS
HEALTH DECISION SUPPORT
EXPERT SYSTEMS
TELEMEDICINE
COMMUNITY HEALTH
INFORMATION SYSTEM
COST * QUALITY * ACCESSIBILITY * DELIVERY

9. ICT - IMPLEMENTATION MOST IMPORTANT
MITIGATE THE SHORTAGE OF HEALTH WORKERS
COMPLEMENT BASIC HEALTH SERVICES
SIGNIFICANT COST REDUCTION BY REPLACING PAPER TO ELECTRONIC MEANS
EFFECTIVE AND TIMELY DELIVERY OF SERVICE
MAXIMISE USE OF SCARE KNOWLEDGE, LIMITED RESOURCE AND FACILITIES
LIFE ENHANCING KNOWLEDGE IN EMERGENCIES
MOST IMPORTANT
ICT : FLEXIBLE : INTERACTIVE : CAN REACH LARGE POPULATION

10. DISPARITY OF SERVICES URBAN : RURAL
IMPROVING ACCESS TO HEALTH SERVICES IN RURAL AREAS
PUBLIUC EDUCATION CAMPAIGN IN CRITICAL AREAS LIKE AIDS
TRANSFERRING DIAGNOSTIC INFORMATION TO SPECIALISED CENTRES
STRENGTHENING THE BASIS FOR DECISION MAKING
PROMOTE INFORMATION EXCHANGE
REDUCE TRANSPORTATION COST OF PATIENT TO URBAN AREAS

11. PRIMARY HEALTH CARE
OPTIMAL COMMUNICATION WITH ALL HEALTH CARE SERVICE PROVIDERS
POPULATION BASED DATA COLLECTION : COMMUNITY TO NATIONAL LEVELS
EQUITABLE HEALTH CARE APPROACH
ESTABLISH COMMUNITY HEALTH INFORMATION SYSTEM
DIAGNOSE COMMUNITY HEALTH PROBLEMS
COMBINE LOCAL KNOWLEDGE
TRANSFER KEY DETERMINANTS OF HEALTH

12. PRIMARY HEALTH CARE(cont.)
STANDARDISATION OF PROCESS
PROMOTE INTERNATIONAL CODING/ INFORMATION EXCHANGE
NETWORKING FOR EPIDEMIOLOGICAL SURVILLANCE
INFORMATION COULD BE PROGRAMMED INTO COMMUNITY RADIOS AND TELECENTRES

13. EFFECTIVENESS OF HEALTH SERVICES
MANUAL RECORDING PROCEDURES: STATIC IN NATURE
DELAY IN FLOW OF INFORMATION AND DECISION MAKING
CLINICAL INFORMATION SYSTEM
PATIENT RECORDS
BED SIDE DATA
LAB REPORTS
PHARMACEUTICAL RECEIPTS
DEMOGRAPHIC MOVEMENTS BETWEEN HOSPITALS
ICT CAN REDUCE COST AND WASTE OF RESOURCES
PERSONAL HEALTH RECORDS ( PHR)
INDIVIDUALS WHO TRAVEL FREQUENTLY OR HAVING COMPLEX MEDICAL CONDITIONS NEED PC BASED RECORDS THAT INCLUDE LONGITUDINAL HEALTH PROFILE

14. MEDICAL EDUCATION AND RESEARCH
MORE THAN 360,000 ARTICLES ARE PUBLISHED YEARLY IN MEDICAL JOURNALS WORLDWIDE
TODAY CLINICAL DECISION MAKING : EVIDENCE BASED MEDICINE
PROFESSIONALS NEED :
ACCESS TO WIDE ARRAY OF INFORMATION
APPLY FORMAL RULES OF EVIDENCE TO EVALUATE CLINICAL LITERATURE
TAKE DECISION BASED ON BEST EVIDENCE
MEDICAL INFORMATICS MUST BE INTRODUCED IN MED. COLLEGES
MEDICAL RESEARCH NETWORKS MUST BE ESTABLISHED TO PROMOTE COLLOBORATIVE RESEARCH AND DISSEMINATE INFORMATION
CONTINUING MEDICAL EDUCATION USING ICT

15. ADVANTAGES
ELECTRONIC DATA COLLECTION AND GIS CAN BE DEVELOPED TO MAP SPECIFIC DISEASE IN A GEOGRAPHICAL AREA
MULTIMEDIA APPROACHES CAN STRENGTHEN THE DELIVERY OF PUBLIC HEALTH EDUCATION MESSGES
NETWORKING OF HEALTH PROFESSIONALS CAN ACCELERATE THE INTRODUCTION OF NEW TREATMENT AND PREVENTION METHODS
PATIENT NETWORK CAN BREAK DOWN THE SENSE OF ISOLATION AND STRENGTHEN THEIR PUBLIC VOICE
THERE IS A LARGE AND GROWING COMMUNITY OF PEOPLE USING COMPUTERS WORLDWIDE TO PROVIDE HELP AND SUPPORT TO ONE ANOTHER ON AIDS

16. Nepal Scenario Eastern Region:
Bottom Up Planning
HMIS
PUBLIC EALTH OFFICES
HOSPITAL INFORMATION SYSTEMS
LIBRARY
MEDICAL LITERATURE
SURVIEALLANCE & MONITORING
SURVEY FINDINGS

17. WHAT WE REQUIRE ? IMPROVE HEALTHCARE MANAGEMENT THROUGH ICT
REQUIRE A CONCERTED EFFORT AT NATIONAL & LOCAL LEVEL
FRAGMENTATION PUT TOGETHER IN PARTNERSHIP
GOVT- NEED TO DEFINE “STANDARDS & LEVEL”
PROVIDE TECHNOLOGICAL INFRASTRUCTURE

18. MAJOR GAPS
IMPROVE ACCESS TO TELECOMMUNICATION AND COMPUTING INFRASTRUCTURE
INCREASING THE AVAILABILITY OF APPLICATION
EXPANDING COMPUTER LITERACY
IMPROVING CONSUMER DEMAND FOR HEALTH INFORMATION
SURMOUNTING RESISTANCE
DEVELOP STRATEGIES FOR BRIDGING FINANCIAL RESOURCE GAP

19. NATIONAL HEALTH INFORMATION INFRASTRUCTURE
CONSISTS : SET OF TECHNOLOGIES
STANDARDS
APPLICATIONS
SYSTEMS
VALUES
LAWS
GOAL : DELIVER INFORMATION
CONSUMERS:PATIENTS:
PROFESSIONALS
IT SHOULD CONNECT DISTRIBUTED HEALTH DATA IN THE FRAMEWORK OF A SECURE NETWORK. IT SHOULD HAVE STRICT, BUILT IN CONFIDENTI-ALITY PROTECTIONS FOR PERSONAL HEALTH INFORMATION AND TOOLS THAT INDIVIDUALS CAN USE TO PROTECT THEIR INFORMATION AND PRIVACY

20. NATIONAL HEALTH INFORMATION INFRASTRUCTURE
PROVIDER
PERSONAL
COMMUNITY

21. STRATEGIES
CREATION OF NATIONAL PUBLIC HEALTH INFORMATICS TASK FORCE GROUP, START FROM EASTERN REGION
IDENTIFYING PRIORITY APPLICATION AREAS
IMPLEMENTATION, EVALUATION AND MONITORING OF PROGRAMS

22. TASK FORCE TERMS OF REFERENCE MULTIDISCIPLINARY COMPOSITION
TELECOMMUNICATION : HEALTH PROFESSIONALS : LAWYERS :
INDUSTRY : AWARENESS CAMPAIGNERS
TERMS OF REFERENCE
IDENTIFY NEEDS & DEFINE PRIORITY
ORGANISE THE PUBLIC HEALTH INFORMATICS NETWORK
PREPARE BUDGETS
INITIATE PILOT PROJECTS
ORGANISE AWARENESS WORKSHOPS / SEMINARS
CREATION ONF NATIONAL WEB SITES WITH LINKS TO REGIONAL / GLOBAL HEALTH INFORMATION RESOURCES

23. HEALTH NOT MERELY THE ABSENCE OF ILLNESS
NOR IS HEALTH ACHIEVED SOLELY BY COMBATING DISEASE AS W. H. O. PUTS IT
HEALTH IS A “ STATE OF COMPLETE PHYSICAL AND SOCIAL WELL BEING”.
HEALTH IS MORE THAN AN INDIVIDUAL MATTER.
PERSONAL AND COMMUNITY HEALTH ARE CLOSELY CONNECTED AND DEPEND ON INTERWOVEN FACTORS SUCH AS
* POLICIES
* ENVIRONMENT
* HOUSING
* HERIDITY
IMPROVEMENT IN BOTH PERSONAL AND COMMUNITY HEALTH ARE ESSENTIAL FOR A HEALTHIER NATION AND PROBABLY ICT CAN HELP.

24. THANK YOU