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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

NATIONAL HEALTH INFORMATION INFRASTRUCTURE PROVIDER PERSONAL COMMUNITY

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

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

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.

THANK YOU