Uganda to adopt electronic health records system

Uganda is on a push for healthcare providers to switch to electronic health records for cost effectiveness and to deliver quality health care services.

A seven-year, just concluded, study of the Uganda Health Information Network (UHIN) has shown that use of electronic networks reduces the cost of managing health information by 25 percent compared to the cumbersome paper-based manual systems that are delay-prone, less reliable, and in some cases incomplete.

“The completion of the Uganda Health Information Network project does not in any way indicate its end. Health workers say they can’t imagine going back to life without it,” said Holly Ladd, AED Vice President and Director of the AED-Satellife Center.

The Ministry of Health is incorporating the UHIN solution into its formulation of a comprehensive strategy for a National Health Information System and the districts will continue using the system for health data gathering, reporting, and delivering vital medical information.

“The network provided the Ministry of Health with an efficient and cost-effective way of fulfilling its mandate to deliver quality health services to the population of the districts,” said Dr. Eddie Mukooyo, resource centre assistant Commissioner at the Ministry of Health.

Mobile Technology for Better Healthcare

In the network, the health providers used cellular telephone networks and low-cost, simple to use, and energy-efficient hand-held computers or Personal Digital Assistants or PDAs.

It then provided a two–way communication system linking remote health workers with district and national health system managers, which enabled them easy access to health care information and to speed decision makers’ access to accurate public health data.

UHIN has meant that “there are fewer disruptions of health service to the population due to reduced travel to residential workshops,” said Dr. Francis Abaimo, the District Health Officer of Mbale, “which increased the availability of health workers at health facilities for treating patients.”

The project has equipped 700 healthcare providers in five districts of Rakai, Mbale, Lyantonde, Bududa, and Manafwa that participated and reported improved data quality at the point of collection, more timely access to data for analysis and decision-making, as well as more rapid responses to emerging health situations.

“Healthcare providers received PDAs loaded with a Mobile Clinical Library, comprised of Ministry of Health documents such as the Uganda Clinical Guidelines and other information resources on topics including HIV/AIDS treatment and care, treatment of malaria, nutrition, mental illness, cervical cancer, diabetes, and maternal and child health care” said Berhane Gebru, Director of Programs of AED-SATELLIFE Center.

Through the network, the District Health Services obtained timely and accurate data from various levels of health centers including reports on infectious disease surveillance, facility usage, and information specifically related to HIV/AIDS, tuberculosis, and malaria.

“We received accurate HMIS data in a timely manner empowering us to make evidence-based decisions regarding resource allocation and response to outbreak prone diseases quickly,” says Dr. Robert Mayanja, the District Health Officer for Rakai District.

Rural hospitals are using the system to capture data on a wide range of health care activities including prevention of mother-to-Child transmission of HIV (PMTCT), inpatient care, laboratory testing, HIV counseling, and the administration of anti-retroviral therapy (ART) to AIDS patients.

Multiple benefits

The information obtained assists in daily surveillance of patients and diseases, monitoring resource allocation and utilization, and the generation of reports for management and control purposes. 

Local staff at health facilities trained to use UHIN have also taken the initiative to develop additional tools for electronic data collection related to community-based care, nutrition, and environmental sanitation programs. 

These ‘home grown’ contributions demonstrate how enthusiastically rural health workers have embraced UHIN for data capture and reporting. But each PDA distributed had a digital ‘Mobile Medical Library’ consisting of treatment guidelines and procedures, medical dictionary, drug database, medical calculators, and a wide range of medical reference materials.

Health workers regularly consult the ‘Mobile Medical Library’ for treatment and care of patients. “There is no medical library in our district but the one on the PDAs is the only reference material used by health professionals in our district. It enabled us make better diagnoses, decisions for treatment, and drug choices,” Dr. Sam Obbo, Medical Superintendent of Lyantonde Hospital. 

In addition, UHIN has provided regular access to Continuing Medical Education (CME) to doctors, nurses, clinical officers, and community health workers.

Health workers use this information for diagnosis, treatment, and prevention of major health problems such as diarrhea, pneumonia, malaria, HIV/AIDS, and tuberculosis.

UHIN has also contributed to the reduction of costs to the health worker and the health system associated with professional training.

The UHIN project was made possible through grant funding from the International Development Research Centre, Canada (IDRC).