Information and Communication Technology Agency of Sri Lanka

Thanks to a project initiated by the Information and Communication Technology Agency of Sri Lanka (ICTA) implemented by the University of Colombo School of Computing (UCSC) it will be not long before much cost and trouble-cutting will occur on specialist care for patients.

The project called “Vidu Suwa” that will bring comfort to the rural patient, specialist doctor and the peripheral clinic was inaugurated by Health Minister Nimal Siripala de Silva this week.

With this inauguration a project ideal for developing countries will be put in place for the first time in Sri Lanka between the Base Hospital in Marawila and the district hospital in Dankotuwa. In this first ‘vidu suwa’ project that the Marawila hospital will be the specialist e-consultation centre while the Dankotuwa hospital will act as an e-care clinic. 

Expressing their views on the project as a whole Consultant Surgeon DGH Chilaw Dr. Keith Chapman and Senior Lecturer, UCSC Dr. Shiromi Arunatileka stated:

“ICT in Health has evolved to bridge the gap between the urban healthcare specialists and their rural patients. This approach will improve the quality of healthcare by way of enabling healthcare professionals to make better decisions on their patients wherever they are located in Sri Lanka.

In a developing country, due to the resource restrictions, lack of funds, lack of proper infrastructure and low level of patient know-how, transfer of technology among the general public is slow. It is also crucial that the process starts in a non-complicated environment which is easy to use by the patients, doctors and other healthcare workers. Therefore, the best would be to keep the technology simple and local and build on existing technology used by all”.

The main focus of the ‘vidu suwa’ project is to link the specialist in a general hospital in a city with a patient in a peripheral setting via a doctor using easily acquirable relatively inexpensive technology that is currently being used. This simple concept can be put into practice with a very little extension to the existing technology. The whole scenario consists of four components as given below.

(i) The Peripheral e-Health Clinic

A District Hospital, Rural Hospital, MOH (Medical Officer of Health) or Peripheral Unit will form the first level of an e-care clinic. At this level of care, in a rural setting, a trained doctor competent in using a computer, Internet, E-mail, SMS (Short Messaging Service) and data recording experience is an essential factor. This doctor should have at his disposal a computer, a printer, a high resolution digital camera, a webcam, broadband internet connection, headset or audio facility and telephone facility and a healthcare assistant (nursing officer).

(ii) Web-based e-Health record system

The peripheral e-care clinic is connected through a web-based patient medical record (herein referred to as an e-health record). This consists of the patient profile and a detailed checklist for every visit to the e-care clinic.

(iii) The m-Communication System

At the diagnosis stage of this research project, a preliminary survey was done and the results show that over 51% of the patients have access to their own personal mobile phone, out of which 50% use the SMS tool for communication. Nearly 80% of the patients have access to mobile phones through an immediate family member. Therefore, the m-communication system can be used for sending important information such as the Clinic date, Operation date, Medication, Re-admission date etc. to patients.

(iv)The e-Consultation Centre with a Specialist

The Specialist (consultant) is based at the Teaching Hospital, District General Hospital or Base Hospital at an e-Consultancy centre which would also have the basic system requirements as in the rural e-care clinic. In addition to the specialist’s advice, Medical prescription notes, Diabetic advisory charts, postoperative mobility regimens, dietary advice etc. are transmitted to the rural e-care clinic via the web-based system.

Benefits of the proposed solution

Benefits to the Patient: The main beneficiary of this system is the patient as his travel expenditure, difficulty of travelling and travel time will be reduced tremendously. Unnecessary secondary visits to tertiary centres and specialist clinics will be reduced.
Benefits for the Peripheral Hospitals: The cost of transfer of patients from peripheral hospitals to tertiary centres also can be drastically reduced. This will facilitate the availability of ambulances for critical and emergency transfers between institutions. The availability of patient health records electronically will help these hospitals to make pro-active decisions on resource allocations and patient care.

Benefits to the Specialist (Consultant): The e-Specialist makes himself available across a distance at many e-clinics within the shortest possible timeframe. This has the added impact of specialised care reaching out to the periphery. Needless to say that knowledge transfer occurs with benefit to the doctor at the peripheral e-clinic and a closer professional link is established between the specialist and the peripheral doctor.

This project explores the benefits, issues and challenges in evolving healthcare methodology with regard to the setting up of a realistic e-Health plan in a developing country.

http://www.thebottomline.lk/2009/06/24/living4.html

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