That’s how one Minnesota doctor described the presence of a digital
health record in Ilula Lutheran Hospital’s (ILH) inpatient and outpatient
wards. I spent the morning with Joshua, the head of Ilula’s IT department. He showed
me the system and answered all my questions. Then, we toured the facility to
see all the computer installations.
Ilula uses a system called “CareMD.” Doctors carry tablets during
their rounds to enter diagnoses, lab requests, medications and other notes. Lab
and pharmacy requests are sent immediately to the respective departments. Nurses
have a desktop at their nursing station for entering their information. On the
wards, they still to write orders and medication schedules in designated books.
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| Medical Records registration desk today |
All departments, inpatient and outpatient, have computer workstations
– the wards, the outpatient department, Reproductive and Child Health, dental,
pharmacy and lab. The system can generate many kinds of reports. I reviewed a
report of the last 26 days with the top 10 diagnoses. Other reports include
diagnoses by age and gender.
Can you guess what the top 10 diagnoses are for the past 26
days? (1) Other, (2) hypertension, (3 and 5) pneumonia, (4) HIV, (6) gastroenteritis,
(7) allergic reactions, (8) peptic ulcer, (9) cystitis, and (10) urinary tract
infection. I found the list surprising, as did many of my fellow travelers.
The server is protected by UPS to prevent loss of patient
data during power outages and surges. A back-up copy of all data is made every
evening in case of a larger system failure.
Some system capabilities are not yet available. Perhaps the
most important is a pop-up indicating the Standard Treatment Guidelines (STG)
for Tanzania when a diagnosis is entered. Currently, not following the STGs is
the most common reason for the National Health Insurance Fund to deny a claim.
If the system to alert the provider at the time of treatment, it would greatly
reduce insurance denials.
I was impressed when I learned from both Joshua and Ilula’s
administrator, Alamu Kikoti, that ILH had purchased the software and hardware from
revenue flows. They received a loan and are repaying it from patient revenues.
See the changes.
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Medical Records files today
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| Medical Records office in 2016 |
by Cindy
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