04/10/2304/10/23 Computer and Information systems for general Computer and Information systems for general practices by Dr O.A Makindepractices by Dr O.A Makinde

Computer and Information Computer and Information systems for general systems for general

practicespracticesDr Olusesan Makinde Dr Olusesan Makinde (MBBS, M.Sc, (MBBS, M.Sc,

O.C.P)O.C.P)

Epidemiology/Health Informatics SpecialistEpidemiology/Health Informatics Specialist

04/10/2304/10/23 Computer and Information systems for general Computer and Information systems for general practices by Dr O.A Makindepractices by Dr O.A Makinde

Computer applications in MedicineComputer applications in Medicine

Computers have become a part of our day to Computers have become a part of our day to day life and are utilized in all spheres of life.day life and are utilized in all spheres of life.

Considering the statement “turning the world into Considering the statement “turning the world into a global village” and taking a closer look at the a global village” and taking a closer look at the 88thth UN millennium development goal, one cannot UN millennium development goal, one cannot but say that to foster international collaborations but say that to foster international collaborations as suggested, one needs a means of linkage as suggested, one needs a means of linkage between the North and the South between the North and the South

04/10/2304/10/23 Computer and Information systems for general Computer and Information systems for general practices by Dr O.A Makindepractices by Dr O.A Makinde

““Medical Informatics is not about Medical Informatics is not about using Microsoft Word to enter using Microsoft Word to enter patient information…”patient information…”

Charles Friedman, PhDCharles Friedman, PhDUniversity of PittsburghUniversity of Pittsburgh

at the UW Symposium, Fall 2000at the UW Symposium, Fall 2000

04/10/2304/10/23 Computer and Information systems for general Computer and Information systems for general practices by Dr O.A Makindepractices by Dr O.A Makinde

Computers and General PracticeComputers and General PracticeAreas of scopeAreas of scope

Electronic Patient records and Clinical Electronic Patient records and Clinical Information ManagementInformation Management

Public health informaticsPublic health informaticsTelemedicineTelemedicine Information RetrievalInformation RetrievalEducation and trainingEducation and trainingComputerized Clinical GuidelinesComputerized Clinical Guidelines

04/10/2304/10/23 Computer and Information systems for general Computer and Information systems for general practices by Dr O.A Makindepractices by Dr O.A Makinde

Computers and General PracticeComputers and General Practice

Electronic prescription notesElectronic prescription notesConsumer Health InformaticsConsumer Health InformaticsArtificial intelligence & Decision support Artificial intelligence & Decision support

systemssystemsCoding and classificationCoding and classification Imaging, robotics and virtual realityImaging, robotics and virtual realityNursing informaticsNursing informaticsEthical, legal and social Ethical, legal and social

04/10/2304/10/23 Computer and Information systems for general Computer and Information systems for general practices by Dr O.A Makindepractices by Dr O.A Makinde

A general overviewA general overview

04/10/2304/10/23 Computer and Information systems for general Computer and Information systems for general practices by Dr O.A Makindepractices by Dr O.A Makinde

Electronic Medical RecordsElectronic Medical Records

Electronic medical record (EMR) is simply Electronic medical record (EMR) is simply storing case files electronically thereby storing case files electronically thereby eliminating the dilapidation and missing eliminating the dilapidation and missing case file situation. It also aids easy case file situation. It also aids easy retrieval and storage of case files.retrieval and storage of case files.

EMR’s are built on relational database EMR’s are built on relational database management systems (RDBMS) that management systems (RDBMS) that organize the storage of data electronicallyorganize the storage of data electronically

04/10/2304/10/23 Computer and Information systems for general Computer and Information systems for general practices by Dr O.A Makindepractices by Dr O.A Makinde

What is a database?What is a database?

A database is any organized collection of A database is any organized collection of data.data. Some examples of databases that Some examples of databases that we encounter in our daily life are: we encounter in our daily life are: Patient encounter recordsPatient encounter recordsmotor vehicle registration records motor vehicle registration records papers in your filing cabinet papers in your filing cabinet files on your computer hard drive.  files on your computer hard drive.  a telephone book a telephone book

04/10/2304/10/23 Computer and Information systems for general Computer and Information systems for general practices by Dr O.A Makindepractices by Dr O.A Makinde

Why do we need a database?Why do we need a database? Keep records of our:Keep records of our:

Clients/ PatientsClients/ Patients StaffStaff VolunteersVolunteers

To keep a record of activities To keep a record of activities and interventions;and interventions;

Keep sales records;Keep sales records; Develop reports;Develop reports; Perform researchPerform research Longitudinal trackingLongitudinal tracking

04/10/2304/10/23 Computer and Information systems for general Computer and Information systems for general practices by Dr O.A Makindepractices by Dr O.A Makinde

What is the ultimate purpose of a What is the ultimate purpose of a DBMS?DBMS?

..

DataData InformationInformation KnowledgeKnowledge ActionAction

Is to transformIs to transform

04/10/2304/10/23 Computer and Information systems for general Computer and Information systems for general practices by Dr O.A Makindepractices by Dr O.A Makinde

Advantages of a DBMSAdvantages of a DBMS Some of the advantages of DBMS include: Some of the advantages of DBMS include: avoids redundant dataavoids redundant data

space waste, inconsistency, extra data entryspace waste, inconsistency, extra data entry improves accuracy and consistencyimproves accuracy and consistency lower cost of storing and retrieving datalower cost of storing and retrieving data security; central controlsecurity; central control

Storing data in a database helps scientists and Storing data in a database helps scientists and researchers: researchers: insert, update, and delete the data insert, update, and delete the data search for and retrieve data search for and retrieve data share datashare data

04/10/2304/10/23 Computer and Information systems for general Computer and Information systems for general practices by Dr O.A Makindepractices by Dr O.A Makinde

Public Health InformaticsPublic Health Informatics

Public health informatics has been defined Public health informatics has been defined as the application of information and as the application of information and computer science and technology to public computer science and technology to public health.health.

It is essentially the aspect of public health It is essentially the aspect of public health that deals with disease surveillance and that deals with disease surveillance and health outcomes research.health outcomes research.

04/10/2304/10/23 Computer and Information systems for general Computer and Information systems for general practices by Dr O.A Makindepractices by Dr O.A Makinde

Public heath informatics (Cont’d)Public heath informatics (Cont’d)

For an effective health surveillance system For an effective health surveillance system to thrive, reliable data must be generated to thrive, reliable data must be generated at the point of contact e.g. hospital data at the point of contact e.g. hospital data and vital statistics.and vital statistics.

04/10/2304/10/23 Computer and Information systems for general Computer and Information systems for general practices by Dr O.A Makindepractices by Dr O.A Makinde

TelemedicineTelemedicine

Telemedicine is a new ground breaking Telemedicine is a new ground breaking aspect of health informatics.aspect of health informatics.

Telemedicine derives its meaning from the Telemedicine derives its meaning from the Greek word “Tele” meaning distance and Greek word “Tele” meaning distance and “medicine” which itself derives from the “medicine” which itself derives from the Latin word “mederi” meaning healing.Latin word “mederi” meaning healing.

As such, telemedicine could be said to As such, telemedicine could be said to mean healing from a distancemean healing from a distance

04/10/2304/10/23 Computer and Information systems for general Computer and Information systems for general practices by Dr O.A Makindepractices by Dr O.A Makinde

Telemedicine Cont’dTelemedicine Cont’d

In Telemedicine, Physicians use the power In Telemedicine, Physicians use the power of telecommunications to reach patients of telecommunications to reach patients that are far away.that are far away.

This method makes scarce specialists This method makes scarce specialists accessible to the rural populace in lesser accessible to the rural populace in lesser developed countries.developed countries.

It is a popular way of reaching the rural It is a popular way of reaching the rural poor in India.poor in India.

04/10/2304/10/23 Computer and Information systems for general Computer and Information systems for general practices by Dr O.A Makindepractices by Dr O.A Makinde

Telemedicine Cont’dTelemedicine Cont’d

Telemedicine in developed countries is so Telemedicine in developed countries is so advanced that specialist endoscopic advanced that specialist endoscopic surgeons can perform surgeries from surgeons can perform surgeries from anywhere across the world. anywhere across the world.

However, while this is being done, there However, while this is being done, there must be a surgeon on ground who is ready must be a surgeon on ground who is ready to intervene if anything goes wrong.to intervene if anything goes wrong.

04/10/2304/10/23 Computer and Information systems for general Computer and Information systems for general practices by Dr O.A Makindepractices by Dr O.A Makinde

Computerized Clinical GuidelinesComputerized Clinical Guidelines

For efficiency and patient safety, there is For efficiency and patient safety, there is an increasing use of computerized clinical an increasing use of computerized clinical guidelines in developed countries.guidelines in developed countries.

This reduces error and misdiagnosis.This reduces error and misdiagnosis.

04/10/2304/10/23 Computer and Information systems for general Computer and Information systems for general practices by Dr O.A Makindepractices by Dr O.A Makinde

e-Prescriptione-Prescription

Electronic prescriptions improves patient safety Electronic prescriptions improves patient safety and reduces the error rate .and reduces the error rate .

Prescriptions are sent electronically from the Prescriptions are sent electronically from the Physician to the PharmacistPhysician to the Pharmacist

A software validates the combination of therapy A software validates the combination of therapy thus ensuring no negative interactions of drugs.thus ensuring no negative interactions of drugs.

Cross checks the patient age and dosage for Cross checks the patient age and dosage for which prescription is made otherwise prompts which prescription is made otherwise prompts the Pharmacist.the Pharmacist.

04/10/2304/10/23 Computer and Information systems for general Computer and Information systems for general practices by Dr O.A Makindepractices by Dr O.A Makinde

e-Prescription (Advantages)e-Prescription (Advantages)

Eliminates patient waiting timeEliminates patient waiting timeProvides quality careProvides quality careReduces errorReduces error

04/10/2304/10/23 Computer and Information systems for general Computer and Information systems for general practices by Dr O.A Makindepractices by Dr O.A Makinde

Disease CodingDisease Coding

Using the ICD 10 classification, ICPC 2 Using the ICD 10 classification, ICPC 2 etc.etc.

Data exchange on HL-7 and other Data exchange on HL-7 and other standard exchange pathwaysstandard exchange pathways

These standards help in conducting trans-These standards help in conducting trans-border research and compare disease border research and compare disease patterns in differing populations.patterns in differing populations.

04/10/2304/10/23 Computer and Information systems for general Computer and Information systems for general practices by Dr O.A Makindepractices by Dr O.A Makinde

Why the need for a working health Why the need for a working health information system?information system?

The level of development of a nation is The level of development of a nation is directly related to the health status of its directly related to the health status of its population. population.

As such, it is necessary to know at each As such, it is necessary to know at each point in time diseases that are prevalent in point in time diseases that are prevalent in the population and put in place measures the population and put in place measures that can be used to reduce its impact on that can be used to reduce its impact on the socioeconomic state of the nation.the socioeconomic state of the nation.

04/10/2304/10/23 Computer and Information systems for general Computer and Information systems for general practices by Dr O.A Makindepractices by Dr O.A Makinde

The UN MDG’sThe UN MDG’s

The millennium development goals (MDG) The millennium development goals (MDG) are very much fashioned around the are very much fashioned around the health status of the nation.health status of the nation.

It includes reducing infant mortality, It includes reducing infant mortality, improving maternal health, combating improving maternal health, combating HIV/AIDS, malaria and other HIV/AIDS, malaria and other communicable diseases, protecting the communicable diseases, protecting the environment and the development of a environment and the development of a global partnership for development.global partnership for development.

04/10/2304/10/23 Computer and Information systems for general Computer and Information systems for general practices by Dr O.A Makindepractices by Dr O.A Makinde

UN MDG’s Cont’dUN MDG’s Cont’d

There has been a loud cry in the last few There has been a loud cry in the last few months on the inability to assess the level months on the inability to assess the level of progress towards the achievement of of progress towards the achievement of the goals in Sub-Saharan Africa.the goals in Sub-Saharan Africa.

This is virtually due to the absolute This is virtually due to the absolute absence of a functioning HIS.absence of a functioning HIS.

Policy makers have to depend on Policy makers have to depend on estimates which may not be accurate to estimates which may not be accurate to make health policies and take decisions.make health policies and take decisions.

04/10/2304/10/23 Computer and Information systems for general Computer and Information systems for general practices by Dr O.A Makindepractices by Dr O.A Makinde

Where we are todayWhere we are today

The DSN 001 and 002 form for reportage The DSN 001 and 002 form for reportage of diseases remain a policy and are not of diseases remain a policy and are not being effected.being effected.

Lack of funding for disease surveillanceLack of funding for disease surveillancePoor human resource management in the Poor human resource management in the

ministriesministriesLack of technical know how.Lack of technical know how.No feedback to health care partners/ PHC No feedback to health care partners/ PHC

centres.centres.

04/10/2304/10/23 Computer and Information systems for general Computer and Information systems for general practices by Dr O.A Makindepractices by Dr O.A Makinde

Where to start from in our practicesWhere to start from in our practices

A Patient master index; an electronic A Patient master index; an electronic register/ spreadsheet for entry of patient register/ spreadsheet for entry of patient information each time a patient visits the information each time a patient visits the health facility.health facility.

This facilitates easy conversion from raw This facilitates easy conversion from raw data to information.data to information.

04/10/2304/10/23 Computer and Information systems for general Computer and Information systems for general practices by Dr O.A Makindepractices by Dr O.A Makinde

ConclusionConclusion

A sustainable health management A sustainable health management information system is needed in Nigeria for information system is needed in Nigeria for proper, planning, allocation of scarce proper, planning, allocation of scarce resources, implementation as well as resources, implementation as well as evaluating health programs or projectsevaluating health programs or projects

04/10/2304/10/23 Computer and Information systems for general Computer and Information systems for general practices by Dr O.A Makindepractices by Dr O.A Makinde

Computers and Medicine do go Computers and Medicine do go togethertogether

Thank you for listening