Sri Lanka Journal of Bio-medical Informatics最新文献

{"title":"Use of IT for effective management of ambulance service in National Health Service","authors":"S. Dharmaratne, C. C. James, B. Abeysinghe, R. Hewapathirana","doi":"10.4038/SLJBMI.V1I0.3565","DOIUrl":"https://doi.org/10.4038/SLJBMI.V1I0.3565","url":null,"abstract":"Nearly USD four billion is spent annually on the health sector in Sri Lanka. This will utilise 4.2 per cent of GDP (2006). Government health service of Sri Lanka is non-profit oriented and Sri Lanka being a nation which is recovering from economic impacts of the war, it is vital to cost effectively mange heath resources. The ambulances play a crucial role in handling emergencies. However, it is not uncommon to find that the service of an ambulance is not always available when the need arises. Ambulances not being in running condition, non availability of an ambulance driver are some of the shortcomings that can be avoided by proper record keeping. The healthcare system is spending unnecessarily for keeping patients in tertiary institutions waiting to be transferred to their peripheral institutions, This is mainly due to the difficulty faced in knowing where exactly an ambulance currently is. Gathering information about the usage of an ambulance will guide us in the decision making regarding the necessity of an ambulances for a given institution. Servicing the ambulances on time prevents unnecessary repairs and proper routing of ambulances prevents money being unnecessarily spent on fuel, both of which can be easily avoided by the use of IT. Above shortcomings can be avoided by employing a vehicle management system that manages the use of ambulances in a healthcare institution. This system will expedite the current process and will enhance the accountability and cost effectiveness thereby enabling one to obtain the maximum service out of the limited resources available.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132518074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Procurement monitoring and coordination through Information Technology to overcome drug shortage in the health sector","authors":"H. Herath, K. Ranaweera, E. Rodrigo","doi":"10.4038/SLJBMI.V1I0.3554","DOIUrl":"https://doi.org/10.4038/SLJBMI.V1I0.3554","url":null,"abstract":"The drug bill is an area in which savings can be made by timely rational procurements without an impact on patients. In 2009, drug cost was Rupees 14 billion but actual requirement was Rupees 26 billion. Procurement of drugs through open tenders takes at least nine months. All steps in procurement of drugs are carried out according to the procurement plan. Poor coordination between the departments leads to a delay in procurement procedures invariably result in a shortage and local purchase of drugs at higher prices worsening the financial situation. Delays in procurements beyond the bid validity period give opportunity to bidders to increase their quoted prices aggravating the situation. In view of the above issues, it is proposed to establish a Procurement Monitoring and Coordination Unit (PMCU) consisting of representatives from each unit involving a procurement process through Information Technology at the ministry of health to monitor and coordinate procurement of pharmaceuticals. Pro active approach should be the key strategy of proposed unit. Initially PMCU should monitor only procurement of essential drugs, Ministry and cabinet level drugs only. Whenever a tender file is submitted from one unit to another unit, it should be informed to PMCU through internet. Monthly requirements, stock positions at central and regional drugs stores should be linked to PMCU. In addition, list of essential drugs, CAPC and MPC drugs tender list, testing capacity, time and cost for quality testing and consultant data base for technical evaluation of drugs have to be maintained by the PMCU. If any tender file is stagnated at one unit, automatic warning massages can be sent to that unit through proposed software to expedite the procurement process. If this system functions properly, several billions can be saved avoiding local purchases and shortages of drugs in the health sector.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122151444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computerised out-patient records in Sri Lankan hospitals","authors":"Pole Denham","doi":"10.4038/SLJBMI.V1I0.3568","DOIUrl":"https://doi.org/10.4038/SLJBMI.V1I0.3568","url":null,"abstract":"The need for better hospital records: The out-patient departments of Sri Lanka are amongst the busiest hospital departments in the world. The majority of patients who visit government hospitals are treated there. They are the prime source of healthcare for the population and the data collected would be invaluable for public health planning and intervention. If computers could replace the written paper, it would increase the speed of documentation and access to the previous clinical record. It would also allow collection of statistics on out-patients. Constraints: But the doctors are so busy that they barely have time to write the clinical details. In most hospitals, space is so limited that it is difficult to find somewhere for a mouse on the table, much less a PC. With the high turnover of staff in government hospitals, experienced staff leave and a new batch arrive to find a mouse has replaced the pen on their desk. If computers can replace paper, they must be quicker and easier to use, and require a minimum of training. Data must be selected from lists - villages, presenting complaints or drugs prescribed. Patients must have a positive identification number that never changes. The database must be simple and easy to use. It must run at lightning speed even when 10 other doctors are hammering away at the system. The system must be reliable and low cost. Achievements in Sri Lanka up to now: In a project funded by the Austrian/Swiss Red Cross, computerised medical record-keeping systems were installed in 27 hospitals in the Eastern Province. Medical staff in five of these hospitals are now entering out-patient data directly into the computer as they see the patient. In the others only admissions are being recorded. Rapid access to the previous record is the most impressive feature, and the computer is already starting to replace paper documentation.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115333265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"eClinics Integration Techniques to Clincal Information Systems moving into a National Network","authors":"V. Dinusha, Shiromi Arunatilake, K. Chapman, S. Saatviga, C. Abeywardhana","doi":"10.4038/SLJBMI.V1I0.3566","DOIUrl":"https://doi.org/10.4038/SLJBMI.V1I0.3566","url":null,"abstract":"Patients in rural areas in developing countries have less access to specialised consultations within their hometown. They are required to incur a great cost, time and effort to reach a Health Institute that provides specialised health care. Yet, it is discovered that through the utilisation of comparatively cheaper Information and Communication Technology advances, it is possible to provide better health services for developing regions. The healthcare delivery setting in rural parts of Sri Lanka today exposes limited access to highly specialised consultancies. It is stated that 35 per cent of the medical specialists in the curative sector are concentrated in the Colombo district. A pilot project funded by the Information and Communication Technology Agency of Sri Lanka (ICTA) was initiated connecting the Marawila Base Hospital and Dankotuwa Peripheral hospital which is situated around 33 miles away from Colombo in the North-Western province of Sri Lanka. The hospitals are connected through a web-based Electronic Medical Record (EMR) system along with a video-conferencing component through which a patient from his/her village peripheral hospital can consult a Specialist in the city/urban area to receive treatment with the assistance of a doctor in an eClinic. After the successful implementation of this concept, a research is being carried out by the authors focusing on eClinics integration and role based access level security implementation to the Clinical Information Systems. The pilot project involves one-to-one connection. However, when going for a wider network in order to replicate the solution throughout the island, several integration techniques must be considered. This includes patient-to-eClinic, patient-to-consultant and hospital-to-eClinic connections. Also in the wider network with many eclinics integrated, access rights must be enforced to users using role based access level security model. This paper describes the architecture, methodology, features and security model of the eClinics Integration module in Clinical Information Systems.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"118 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117220122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of adapting Cloud Computing Technology in hospital for patient care and service","authors":"G. Raghavendra","doi":"10.4038/SLJBMI.V1I0.3562","DOIUrl":"https://doi.org/10.4038/SLJBMI.V1I0.3562","url":null,"abstract":"This paper deals with the impact of cloud computing in the group of non-adopted and adopted hospitals for patient care and services. In hospitals working hour means 24 x 7 and not 9 a.m. to 5 p.m. Giving access to the consumer on his demand whenever/wherever required and pay as per the usage will be the mantra. That is expected from the cloud computing approach which gives accurate and quick access to required personal data, which can replace the usual trend in hospital’s hospitality. Advancement in technology is always required to give vast information for every healthcare professional to give the best quality of the patient care and hospital management. Cloud computing is providing services to web based technology clients as and when required by storing information in servers. In cloud computing, Virtual Machines (VM) will be running different software in parallel instead of having to run only one application leading to higher efficiency and better utilisation of computing resources. This technology drives down costs and increases resources utilisation by delivering resources for the period of requirement only and hence reduces the ICT capital budget reservation. By giving additional support to the user for getting vast information through the existing support of Google Cal,Docs,Sites, Zoomerang, YouTube etc, cloud computing also adds value. It is already used successfully in the library information systems. In a group of hospitals having cloud computing infrastructure encourage and promote the advantages available to the user community. This research is also highlighting the issues related to security of patients’ data especially related to medical reports. But only security may not be a constraint. Following a case study approach the author is studying the impact of cloud computing adoption in the context of Indian healthcare sector.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123638431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A private hospital management system","authors":"M. Ariyaratne","doi":"10.4038/SLJBMI.V1I0.3551","DOIUrl":"https://doi.org/10.4038/SLJBMI.V1I0.3551","url":null,"abstract":"In Sri Lanka, several private hospitals have adapted computerised systems for management purposes. This is a description of such systems used in a major private hospital in Southern Province to manage admissions and day care surgeries. Virtually no emphasis was given on recording clinical data of patients. The admissions are recorded at the reception real-time and all the units are updated. The issue of medicines, performing procedures and delivery of other services are all recorded. The admission fee, room charges, nursing charges, linen charges, medicine charges, professional charges are all automatically calculated. If done manually, the accurate calculation would have been difficult as some charges are done only once for the admission, some are for the duration of the stay, while others depend on time spend in different rooms or ITU. At any given moment, the current bill is ready, and if the patient is discharged, he does not have to wait for hours till the bill is finalised manually. The system can handle cash payments, credit payments and payments that are covered by insurance companies. These different payment methods have different charges for the same service, and system looks after the difficult part of calculations. The day-end summaries, shift-end summaries, professional payment summaries are useful to handle daily income. Payments by Insurance Agencies, their balance and credit limit are also efficiently handled.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123698587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why PHR when EHR is the record of future","authors":"Das Mogli Goverdhan","doi":"10.4038/SLJBMI.V1I0.3572","DOIUrl":"https://doi.org/10.4038/SLJBMI.V1I0.3572","url":null,"abstract":"DOI: http://dx.doi.org/10.4038/sljbmi.v2i2.2246 Intr oduction: The 20th century has revolutionized the medical records system from outpatient cards to comprehensive unit records due to its important role played in effective healthcare delivery. The unit record system served almost the later half of the 20 th century and with the advent of information technology, the electronic health record gained global importance. The theme of this paper is “Why PHR required in 21st Century? When EHR is the record of the future? Materials and Methods : Examination of medical record system practiced in the last century will enlighten as to what type of medical records required for the 21 st century and beyond so that each and every individual of this globe will get swift, safe and good quality care with affordable cost. Results: Physicians need comprehensive information for providing effective care and depend on patient record. Patient care information is scattered, disintegrated due to patient gets treatment at different health organizations, And even within one institution, the specialty information is not integrated. Patient also at times, treats himself, self medication, and also uses other services such as herbal, Unani, homeopathy and Ayurveda. All these information is not available to physician. Discussions: In spit of the fact, the EHR is proved to be a great potential and the “record” of future, also has some implementation difficulties and is not helping in exchange of information. This is also a hurdle and being tackled by applying various international standards like HL7, SNOMED-CT, LOINC, ICD, DIOCOM, NCPDP etc., to be fully interoperable. The Definition of PHR: The “PHR is a Health Passbook containing the identification data of a person, is a lifelong electronic, universally available document, initiated at the time of birth, containing, mother’s delivery information including congenital anomaly, immunizations given. This health passbook will have briefly entire information such as episodic, hospitalization, self medications and other habits including significant events, advance directives of living wills, organ donor authorization, usually not available to care providers. The PHR is maintained by parents/guardian till the child become responsible, followed by child development information including, immunizations, growth charts, significant events and health status. The PHR which comes from healthcare providers and individuals is a resource of health information to make health decisions. Individuals own and manage the information and maintained in a secure and private environment, with the individual determining rights of access”. The PHR passbook should have the following formats: Patient Identification Data, Health Summary, Child Development, Immunizations, Self care/treatments, Medications, Investigations, Hospitalization, Obstetric & Gynecology, Therapy, Chronic Disease (old age) , and Dental . Conclusion: Effective EHR at health institution l","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121310914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An advanced laboratory management software","authors":"M. Ariyaratne","doi":"10.4038/SLJBMI.V1I0.3587","DOIUrl":"https://doi.org/10.4038/SLJBMI.V1I0.3587","url":null,"abstract":"","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132845105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated medical store management","authors":"M. Ariyaratne","doi":"10.4038/SLJBMI.V1I0.3571","DOIUrl":"https://doi.org/10.4038/SLJBMI.V1I0.3571","url":null,"abstract":"Efficiency and cost-effectiveness are essential components of a medical store management system. Manual systems lack several advantages of an automated computer system. A complete medical store management must have advanced features that lack in an ordinary stock management system. This paper will be useful to all who are still adhering to a manual system to think of implementing a computerised system, to others who are already using such a system to compare and add features as necessary, and to all who are involved in developing similar software. The auto order generation considers the trends of long term and short term past usage, usual monthly variations and the time taken by the particular supplier to deliver orders in the process of generating orders without any user intervention at the most appropriate time. Though the process is automatic, it can be customised manually at any stage to meet any unpredictable variation. Reports like fast moving items, slow moving items, non moving will help increase the efficiency of the ordering process. The value of each item in the stock, especially in comparison to the value of utilisation will improve the cost effectiveness. In contrast to a normal stock management software, the stocks are handled batch vise. Different levels of warnings on impending drug expiry is another unique feature. As the items are categorised by generic name and the form, user can easily find possible alternatives during issuing a prescription and making orders. The ability to handle unlimited number of separate stores is essential when implementing in large scale institutions. The ability to inform the sub optimum availability of a certain item among different stores will prevent unnecessary ordering of an item when there is an excess in another unit.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125751139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic evaluation of a clinically effective Brief Mobile Treatment (BMT) on suicide prevention in Sri Lanka","authors":"R. Marasinghe, M. Bensink, S. Edirippulige, Anthony C. Smith, D. Kavanagh","doi":"10.4038/SLJBMI.V1I0.3543","DOIUrl":"https://doi.org/10.4038/SLJBMI.V1I0.3543","url":null,"abstract":"Introduction: Economic analyses are helpful in decision making. We conducted a Sri Lankan RCT, evaluating a “Brief Mobile Treatment” (BMT) that used a combination of brief inpatient intervention and mobile phone messages to reduce suicide risk. The trial found that the intervention was superior to the usual care (UC). Objective: The current research performed an economic evaluation of BMT versus UC, using data in the Sri Lankan RCT. Method: Cost-Utility Analysis (CUA) was selected. The analysis was completed in nine steps which includes calculation of the cost of the intervention and UC, analysis of incremental cost and effect, calculation on the incremental cost-effectiveness ratio (ICER) and ICER 95% confidence interval together with a graphical presentation of calculated ICER and 95% confidence interval, calculation of acceptability threshold under different willingness-to-pay thresholds with graphical presentation of acceptability curves and finally a completion of oneway sensitivity analyses. Results: The total establishment cost for the BMT was Rs. 91,918/= with an average cost of Rs. 2,703/= per patient. The variable cost to provide BMT totaled at Rs. 32,17/=. Total cost of usual care was Rs. 774/=. Mean cost per BMT intervention patient was Rs. 4,103/= compared with a mean cost of Rs. 23/= for usual care patients. Probability that the BMT intervention was cost-effective, when compared with usual care, was 90% at a willingnessto-pay thresholds of Rs. 5 million/QALY, and 91% at 7 million/QALY. Similar results were obtained using multivariable analyses. Conclusion: Although BMT intervention was more costly than UC for a small sample, it was cost-effective at the selected willingness-to-pay thresholds, based on acceptable costs of changing 1 unit of QALY. Considering the high suicide rates in Sri Lanka and the significant impact of suicide on individuals and their families and friends, use of BMT is found to be cost-effective, compared with standard care.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"124 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2011-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116328583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}