MDS PROJECT IN KALMUNAI HEALTH DISTRICT & TRINCOMALEE HOSPITALS (2008-2009)

The experience gained in the first project in Batticaloa District proved that the concept of simple computerized patient records is viable in Sri Lanka if adequate technical and material support is given to hospitals after installation. Because of this success, the Austrian/Swiss Red Cross was requested by the Health Ministry to extend the project to the other two administrative districts of the Eastern Province, Ampara and Trincomalee. All three districts were severely affected by the tsunami, but in Ampara District it was mainly the area close to the sea. For this reason only the coastal health district of Kalmunai was included.

The project plan was to install computer systems in the three large hospitals of the area and the 10 smaller hospitals, and to develop an improved version of the MDS software. As in the previous project, hospital staff were to be given training on basic computer usage and network management, as well as on-the-job training. It was hoped for computers to replace the paper records and the books written by hospital staff. The main objective was now to support improved patient care, but the previous objective of providing information for public health management and planning remained.

In the first project, the database deliberately concentrated on disease surveillance as this was the most important priority in tsunami-affected districts. However, it was not long before health care staff in the hospitals realized that the computer could provide them with much more assistance if they could record detailed patient medical records. Even in government hospitals, which do not have typically computerised functions such as billing, appointments and waiting lists, computerization of patient information could greatly increase the quality of care and the efficiency of the clinical staff.

As is now well known, the project was an astonishing success, and the staff of nearly all the hospitals started to keep computerized medical records. To this day the OPD clinic in the Trincomalee General Hospital is paperless and has been so for 5 years. In nearly all the smaller hospitals of the second project, the systems are still in use for recording OPD visits and admissions. In the last few months of the project, the new software was also installed in the hospitals of the first project.

Unfortunately funds for a complete project as had been planned, with one-year hands-on training and an orderly hand-over of the project to the healthcare authorities, were not available from the Austrian/Swiss Red Cross and the 4-years planned for the projects were reduced to three. In the fourth year of activity in the Eastern Province, funding for project was therefore taken over by Lunar Technologies with the approval of the Swiss Red Cross and the EP Provincial Department of Health Services. But after six months, the PDHS was able to mobilise funds to restart the project and to maintain, which continues to this day.

OUTCOME

The MDS projects resulted in partial computerization of patient records in 27 hospitals in the Eastern Province. This contributed considerably to hospital efficiency and the quality of health care provided. As well as improved patient documentation, MDS produced more accurate medical statistics and speeded notification of infectious diseases. In addition to the benefits in hospitals, the Internet connections provided to the Health Service facilitated electronic notifications and information transfers, thus greatly improving communication between the public health offices of the district.