It hasn’t always been easy for medical personnel and the people to keep tabs on their health, information and tests have to done over and over again.
Taking such matters into consideration comes the e-health system to the rescue. It falls under one of the flagship programs in the current government’s manifesto emphasis- of building an online patient record system.
Chief ICT Officer, Directorate of Service, Ministry of Health (MoH), Garab Dorji, said that they have lined-up a trajectory for the flagship plan. The main objective of the current project of ePIS (Electronic Patient Information System) is to make health services more efficient.
Previously, the doctors would often end up with insufficient decision-making patterns since patient records were not available, he said, adding that with medical history, doctors can prescribe people with the right medication, and not actually restart the previous medication course (which results in wastage of resources and time in re-testing).
He added, “Currently there is no synchronized records, as each hospital in different regions have separate records. The previous year’s statistical report of lab tests conducted were over 10,000,00 patients in one year as compared to the entire country’s population which would falsely mean that 100 percent of the population was sick.”
That is the result of inefficiency, without the electronic record system in place, and in the process surmountable expenditure is incurred, he added. With integrated systems in place, these things along with prevention of deaths, early detection of cancers and non-communicable diseases can be avoided greatly.
Another such hurdle for the current system is in referring patients abroad as illness detection is late, and even referrals have a higher chance of not succeeding in operations.
He said that the current system is time consuming and inefficient as the patients have to sort out many information before getting a full-fledged report; they have to wait in queue to visit the doctor’s ward, furthermore if tests are required, patients will have to queue up at labs to collect samples and medical reports.
“Another problem is the ‘paper-based system’, although some hospitals have been recording information on computers, none of the systems across the 20 JDWNRH departments have shared-information. The HR constraint is another factor as higher professionals are still at minimal count,” he added.
Garab stated that previously the plan lacked coordination, and even if it didn’t, the timing was too early for Bhutan, considering the budding technological age. Doctors were opening up to IT and stable internet connection wasn’t fairly available.
Apart from people communicating to one another, complex medical equipment also have to be part of understanding the procedures and analysing data which is very complex to integrate altogether.
Since It is a matter of human life, the accuracy of system in place should be uncompromisable and in order to successfully implement the program, it will require experienced people which means higher costs.
In the past, there had not been a structured body to advocate this, and therefore, it failed.
This time there is a structured body, involving members from the Cabinet and an eHealth steering committee chaired by the Secretary, and then there is a technical group and the addition of stakeholder involvement, he said.
Meanwhile, he said that the connectivity, in terms of tertiary health unit linkages, will also be relying on MoIC’s connectivity support for the success of this system route.”In the first year, we are targeting 44 health facilities, which includes 7 hospitals, 13 BHU I, 16 BHU-II and one traditional medicine hospital and 20 traditional units within the hospital. 340 health facilities have been identified over the course of 5 years,” he said.
Since everything will be connected, huge outbreaks like malaria and others can be predetermined and traced in a timely manner. Currently, there are 14 systems in place, but once the project becomes full-fledged, all the new systems will be re-integrated along with the existing ones. Seamless data exchange will be accessible which will cutdown considerable expenditures, he added.
He said, “The vision for the system isn’t new for Bhutan. It was very challenging to rule it out successfully. The current project is under one of the government’s flagship programs with the support from Asian Development Bank (ADB). There has been a series of activities and the project has reached the tendering phase.”
Currently, stakeholder consultation, standard setting and procurement processes are underway, and once the contract has been awarded, MoH will grant the system unit training. The health facilities, in this regard, will have to work in consultation with Department of Information Technology and Telecom (DITT).