At New Hope Hospital, all record taking was paper-based. Managing chronic conditions such as malaria and malnutrition, monitoring the recovery after operations via outpatient visits, and ensuring that prescribed medication and diagnosis was effectively recorded, was therefore a terribly arduous task for Dr Pascal and his staff.
Admin overhead was keeping the hospital small scale, leaving patients requiring treatment unable to book appointments with doctors. There is no public healthcare in the DCR, so ensuring medical billing was kept up to date was a difficult task, when all Dr Pascal had was notebooks and the lockers you see below to organise his patients’ records.
Our first step was to install an electronic medical records platform. After much research we settled on the OpenMRS system. By choosing open-source software, we could depend upon a motivated network of global contributors to help us solve any issues, and extend the capabilities if required.
Power cuts happen daily in the DRC. Dr Pascal often has to often switch to solar power and what charge he has left on motorcycle batteries. Every watt counts to a hospital here. We needed to make sure our technology choice was low power, could operate on a solar powered battery and that other staff could continue to log patient data in such a scenario.
We repurposed a discreet low-power home-entertainment PC to act as the server hub, and provided rugged Android tablets to nursing staff. We utilised the rugged internet router, BRCK, designed in Kenya, (we had met the company in our Nairobi workshop) to regularly back-up the patient database to the cloud. Our fabulous creative technology intern, Arthur, is seen here installing the system.
At the end of January 2015, our system was installed. As staff would have never used equipment like this before, we provided low-literacy digital guides for operating the tablets and server, illustrating how to maintain the system.
Within two weeks, Dr Pascal had moved all his patients over onto the system.
Between January to May this year, Dr Pascal has been able to add 500 patients to the database. Crucially, the improvements in the administration overhead have allowed the hospital to double its staff. Most rewardingly, the system proved pivotal in securing a U.N. contract for the hospital to treat up to 1000 U.N. employees.
We are thrilled that the system has allowed Dr Pascal to expand his operations. We now need to try to do more to improve healthcare in Kavumu.
The service opportunities
Now that we have an IT system with internet connectivity, we can begin to design some interesting services. Although smartphone penetration is extremely low, most people have access to a low-cost mobile phone. Creative uses of SMS services in Africa lead to some revolutionary new services with global implications. Services such as Safaricom’s Mpesa, allow the “unbanked” to make micro-payments of mobile credit to anyone for anything. Credit can be transferred to bank accounts or exchanged for cash at nationwide kiosks. Smartphones will become cheaper, but until connectivity improves and costs decrease, people remain cut-off to richer forms of communication.
We are prototyping and introducing an ambulance service, and an automated prescription service powered by SMS. We believe such services could have global impact.
Dr Pascal also desperately needs a sustainable Blood Bank, and we need to help encourage the local people to give blood.
If you would like to learn more and perhaps get involved, email firstname.lastname@example.org