Lightwave eHealthcare Services (LWEHS) was one of the several e-health service providers who responded to the publication of the Ghana E-Health Strategy in 2010. The proposal aimed at the establishment of a National Healthcare Data Centre, which brings together the functions of Health information Management and Disease Surveillance as a 24-hour comprehensive data centre, which will also serve as an early warning system for the health sector.
The proposal aimed at networking all hospitals, clinics and health centres across the country and all agencies under the Ministry of Health. This includes the installation of an Electronic Medical Records System and a Patient Management System to streamline the admission, discharge and transfer processes, which are integrated with the claims management system of the National Health Insurance Scheme. It also enables the operation of a Real-Time Bio-surveillance System.
In epidemiological models, the speed of response is often more important than the specific action taken (Barrett et al., 2005; Lipsitch, 2003). Whether the chosen action is vaccination, quarantine, and/or isolation, doing it earlier in the course of the outbreak lowers the illness and death toll. This model helps to identify the source of a disease and thus enable response mechanisms to be initiated before it becomes an epidemic.
PHASE ONE IMPLEMENTATION
In 2016 Lightwave eHealthcare Services was contracted by the Government of Ghana to roll out the system in a phased manner, starting with the Central Region. The following outlines the details of the first phase:
|Service Area||Work Details|
|Hospital Data Centre||A state of the art data centre facility operates 24×7, fully equipped for storage and maintenance of patient medical records.|
|NHIS linkage||A system / software to link with the NHIS to enable real-time validation of patients eligibility status with the NHIS system. It also enables same-day transmission of ‘post-discharge’ claims data to the NHIS claims system. This will curtail the delays in reimbursements to the Healthcare Providers. NHIS will become portable|
|Health Data Systems
|Electronic Medical Records (EMR), implemented at the Cape Coast Teaching Hospital and linked to the Central Data Repository, with records of all current patients, maintained in the Data Repository. The system also establishes Cost Centre systems which links all services – medical records, diagnostics, pharmacy, PACS and other revenue centres in the health facility.|
|Patient Management Systems||A robust Patient Management Software which automates the Admit, Transfer and Discharge (ADT) processes, for all encounters, and with linkage to all departments – clinical, pharmacy, ambulatory, claims, reporting etc|
|Bio-surveillance system||A Bio-Surveillance System – a ‘same-day’ early warning system to help prevent the spread of communicable diseases
Extensive work has been done under phase one not only to test the concept and feasibility but also to lay critical foundation towards a nationwide roll out of the system. Under phase one a comprehensive assessment of the work processes in the health sector covering all levels of health care at the regional level was undertaken. The assessment covered the various operational levels of the health sector in the Central Region. At each level, the organizational structure and governance of health service delivery was examined. The set up, works analysis and reporting requirements are also reviewed and specific interventions by the project is outlined and discussed.
Significant time and resources was devoted to customizing the software for each level of service. This took the form of series of engagements with each level of the service. Joint Application Design sessions for each category of users were undertaken, where the business requirements of the system was critically assessed and comprehensive user requirements gathered and used to customize the software for users in Ghana. A series of on the job training sessions were subsequently held for identified users in health facilities in the central region this was supported by an extensive deployment of hardware to ensure that the facilities are brought on line without any challenge.
Presently 25 health facilities including the Cape Coast Teaching Hospital are online and active. This covers 345 Doctors and 2,312 clinical staff across the region. Twenty Network Radio Masts have so far been installed. So far 379 computing devices have also been deployed. The table below provides an over view of the work done in phase one:
|Centers Online and Active||20|
|Online Clinical Staff||2,312|
|LHIMS Registered Patients||357,761|
|Local Area Network Hardware Components (Access Points)||133|
|Network Radio Masts (5 exceeding installation allowance)||20|
|Site Deployed Computing Devices||379|
|Site Software (customization, installation and licensing)||21|