Programme Updates

National E-Health Project with Bio-surveillance (Early Warning) System

Implementation of the National E-Health Project

The Ministry of Health’s National E-Health Project, featuring the Lightwave Health Information Management System (LHIMS), is transforming healthcare across the country and placing Ghana at the forefront of healthcare in Africa.

This project has positively impacted the provision of care for all sites onboarded.  The LHIMS application has integrated real-time state-of-the-art early warning disease surveillance, integrated management tools, and supporting dashboards unmatched anywhere on the continent.  . 

Hospitals and Health Centers in Ghana have finally seen the benefits of E-Health realized.

Patient information and data management is a major challenge for all hospitals. The LHIMS application is providing accurate and timely data for hospital administrators, management, providers and clinicians for vital decision making needs and positive outcomes for patients.  The need for a health information management system that addresses our hospitals key challenges is considered paramount for the future of healthcare delivery.  Such challenges include easy and timely access to the patient’s health record, having the record follow the patient from service point to service point seamlessly, ability to track and process revenue, build and file claims data, as well as meet reporting needs, and all of this in a secure and confidential environment.

For years Korle Bu Teaching Hospital (KBTH) and Komfo Anokye Teaching Hospital (KATH) have explored a variety of prospective solutions to overcome these challenges.  Local, European and Asian vendors have attempted solutions that have not met expectations. It is thus a positive and proud moment for me that the E-Health project has helped both these hospitals to their satisfaction and beyond.  We have received similar testimonials from hospitals and health centers regarding the LHIMS application.  These testimonials support:

  • Patient record portability to any LHIMS site, which assures continuation of care without the patient having to maintain and transport his/her folder.
  • Elimination of paper patient folders
  • Elimination of folder, container and storage space costs
  • Availability of real time data at point of care
  • Quick and easy access to patient Electronic Medical Records at all levels of treatment
  • Ability to access patient data and patient files in real time from any part of the hospital
  • Availability of real time data for management and clinical decisions
  • Improved revenue accuracy
  • Reduction in Patient waiting time at Outpatient wards
  • Reduction in Patient waiting time at Admission counters
  • Efficiency gains in patient wait times
  • Easy and accurate collection of NHIS Claims
  • Reduce human errors in data acquisition for DHIMS
  • Easily moving images from the imaging department to the consulting rooms, wards or operation theaters
  • Easy supervision and monitoring from the regional health directorate
  • Time saving by System generation of a number of management reports, KPIs and public health submissions
  • Provide an early warning system to predict disease outbreaks

Average annual savings of 50,000 to 300,000 along with a 35-40% improvement in patient wait times have been reported from health centers and district hospitals running LHIMS so far. Regional and Teaching hospitals are reporting over 40% improvement in wait times.

One Medical Superintendent, who was skeptical before the E-Health project was deployed in his health center, reports LHIMS has achieved better results at a significant cost reduction.  He also complimented the implementation and post implementation of the LHIMS support team. He continuously maintains that he had lost faith in Health Management Systems having tried out apparently similar software’s, and has had his confidence restored, thanks to the LHIMS application. Another Medical Superintendent mentioned that he would have no reservation recommending the LHIMS platform.

One hospital Medical Director reported significant increased efficiency in claims processing and records management processes.

The LHIMS application greatly enhances the pharmacy and medicine prescribing functions, allowing the prescribing provider to quickly identify the pharmacy counter best suited for the patient’s needs.

LHIMS has successfully integrated banking systems at many of the healthcare facilities utilizing the LHIMS application.  The LHIMS application has facilitated cash payments, reducing wait times at cash counters and eliminating any misappropriation of patient funds.

The LHIMS application not only has the capability to address routine medical services, but also complex specialty services.  Due to the seamless and instant availability of the patient’s digital health records across departments, coordination of care is greatly enhanced and quality of care is significantly improved for the patient.

As per the goals we had set for this project at the hospital administration level, we have achieved the following Gains from HIS/EHR Roll outs in Teaching, Regional and District Hospitals:

  1. Going Paperless has saved patients as well as the hospitals a lot of time and a lot of money
  2. Improvement in efficiency of processes has been reported from the hospitals which have resulted in shorter wait times and smaller queues at admission counters. Hospitals have reported an improvement in patient care as well as patient safety. It has been further reported by the Teaching hospitals that
  3. clinical decision making has improved,
  4. patient compliance via follow ups has been enhanced,

iii. Patient safety has improved with a visible reduction in human errors due to mismatch of diagnosis and prescriptions

  1. Clinical research is being better facilitated
  2. There is a reduction in rejected claims by NHIA
  3. Hospitals revenue leakage has been brought under check

vii. Administrators are finding it easier to track hospital operations

  1. The improved adherence to treatment protocols is helping save lives and prepare Ghanians for a healthier future.
  2. The enhancements in the transparency of the departments as reported from several centers has benefitted patients also. Now they have to make less visits to the hospitals and experience a lot less stress.
  3. Patient Satisfaction with the services at the hospitals has improved

Portability of Medical Records

The Patient Health Record is now available at the point of care wherever a Ghanaian citizen is present physically. No more creating new folders and having the patient details and case history existing in silos which are never revisited.

The Patient Health record within the e-Health project is based on the 3 pillars of Security, Reliability and Availability. It is encrypted, shadow copied on multiple secure servers, locally available at the facilities so internet issues do not cause problems with treatment, and made available at every health facility when the patient arrives on demand. LHIMS is also capable of maintaining the provision of care remotely, using real-time backed up data, if the event of a local failure. This bi-directional feature of the LHIMS system provided the greatest opportunity for a successfully patient outcome.

KATH and Kumasi South Regional hospital are only 30 minutes from each other. Patients regularly turn up at KATH after being referred from KSRH. In the past, this caused patients a lot of stress at KATH as they had to create a new folder and doctors had limited information about them. Now the entire digital health folder of the patient from KSRH (or any other LHIMS connected site) is available to the doctors and staff at KATH (or any other LHIMS connected site) when the patient arrives. Similar experiences are seen across Ghana where the eHealth project has been rolled out by now. The MOH plans include providing this “patient health record portability” capability to all health centers across the country.

Move towards real time disease surveillance

Another challenge the Ministry of Health has wanted to address for many years is improvements in the timely alerting of suspected communicable diseases.  The key objective is to identify and alert on potential epidemic conditions in real-time as opposed to the use of stale or aggregated data.  Providing actionable epidemic information in a timely manner creates the best opportunity for minimizing the impact on the entire population.

The purpose of real-time surveillance is to advance the safety, security, and resilience of the Nation by leading an integrated bio-surveillance effort that facilitates early warning and situational awareness of biological events

When we initiated the eHealth project, it was understood by Joint External Evaluation (JEE), that the Surveillance system in Ghana has demonstrable capacity but that Surveillance is not optimally “real time “.

During our Phase 1 pilot with LHIMS, we observed that Real time surveillance can be achieved with a high level of sensitivity and also assure specificity.

As per the Disease control head at GHS, the LHIMS system is poised to revolutionize disease surveillance in Ghana.  During the pilot phase, using LHIMS they were able to see alert conditions as they unfolded, in real-time.  LHIMS has proven capable of tracking, and alerting, symptom sets (case definitions) of data being input by a doctor, in real-time, to the disease surveillance team.  Once a pre-defined threshold, for a given set of symptoms, is reached the system automatically sends an alert to the disease surveillance team, allowing them to take an immediate action.  The impact on the reaction times for controlling disease outbreaks is enormous.  Enacting response measures such as quarantine and isolation protocols, changed from days or weeks to minutes or hours.

The Disease Surveillance Unit have pointed out only a single limitation of LHIMS, and that is the small number of healthcare facilities where it is deployed.  As per their head, LHIMS has shown to be a valuable system for the Country to invest in and fully support the Ministry of Heath’s plan for a nationwide rollout.  Once the system is widely deployed Ghana’s Disease Surveillance Unit will be able to detect alerts anywhere in the Country.  This level of disease surveillance capability will create a whole new “gold standard” and putting Ghana at the forefront early-warning disease prevention.

Benefits observed by NHIA/ NHIS

The LHIMS solution allows for real-time validation for a patient’s NHIA insurance status. Confirming a patient’s coverage eligibility at the time of registration saves time and money by eliminating claims from uncovered patient visits.

LHIMS builds the NHIA claim at each “point of service” during a patient’s visit. This means the claim is prepared when the patient encounter is completed. All completed claims are ready for review and submission based on facility process. This has greatly improved filing time and accuracy. In fact, NHIA reported nearly a 30% cost savings due to improvements in accuracy and filing timing at sites running the LHIMS software during the Phase 1 rollout of the implementation in Centra Region.

Because the LHIMS application checks the claims rules at each “point of service” inaccuracies are being detected immediately. The end results are only claims that meet NHIA standards are able to be completed. This feature removes an activity that would invalidate a proper claim. Thus fraudulent claims are being brought under check. The result is only covered services are paid.

The following gains

  1. Has made NHIA validation faster and easier for hospitals, patients and NHIA
  2. Claims turn around has improved significantly
  3. Fraudulent claims are being brought under check, allowing significant savings which can be reinvested towards improving the healthcare delivery systems
  4. Financial savings from cost containment measures which are improving the efficient management of total drug inventory
  5. Overall cost savings and revenue improvement.

Our Public Health Infrastructure is benefiting to help Ghana move ahead

  1. At this point in time, across the hospitals where the eHealth project has already been deployed, the MoH is already able to track some core parameters which benefit our people – like
  2. availability of empty beds,
  3. nearest access to specific tests and medical services,
  • availability of specialists and
  1. load on inpatient and emergency wards.
  2. A real time dashboard with these parameters being tracked along with 40 other useful parameters for public health teams is already deployed for use by Public Health teams from the E-Health project.
  3. As this project is deployed across the nation, this will enable the MoH to provide for real time dashboard in the future for the public, from which the general public can be made aware of bed availability in close by hospitals, test and service availability as well as warned about events of concern as they are all centrally tracked
  4. Drugs and pharmaceuticals constitute about 40% of the total health budget and drug sales make up 50% of the health revenue. Cost containment measures supported by the project are improving efficient management of total drug inventory.  We expect this to translate into less expenditure on total inventory while maintaining high levels of revenue. This will lead to a reduction in cost per patient in insurance claims and will increase scope for expansion of coverage thereby helping to meet government’s universal health coverage agenda
  5. Savings from early detection of disease outbreaks helps decrease the medication budget of Ghana. Using the LHIMS Bio-surveillance system in the eHealth project, we are already identifying Malaria clusters which have helped us in making informed decisions about controlling and managing the load on the hospitals and pharmacies. The same is being expanded to more diseases so medication budgets can be planned even better and purchases can be done at lower prices.
  6. As mentioned above, the eHealth project has allowed Ghana to fast forward towards the future of disease surveillance. If this system had been started 5 years earlier, Ghana would have been much less impacted by Covid.

Benefits of using a Holistic Healthcare Platform

Over the years the health sector has suffered from phenomenal inefficiencies in several areas of operation. The E-Health project planners understood that these problems could not be solved in a piecemeal manner. It requires systems to be put in place to improve the management of health data, from source to storage and to provide critical but easy access to information for decision-making. The MoH realized there was a need for a holistic solution to these problems which also strengthened epidemiological surveillance for early detection, effective containment and control of common emerging and re-emerging epidemic prone disease with special emphasis on prompt reporting and action at the district and sub-district level. The strategy also highlights the urgent need for sustained improvements in patient management systems as a key building block in the overall attempts to improve performance reporting and to reduce inefficiencies in revenue generation.

The E-Health project has been deployed as a holistic healthcare platform.  Electronic health information and patient management component which forms the foundation for world class patient care and real-time data collection for many different stakeholders including Disease Control.  Real-time data collection, from connected LHIMS facilities, has provided health stakeholders and disease control experts a unique opportunity to enable health policy decisions for the entire healthcare continuum in a manner never envisioned before.

The success of the first phase of this project was due to the unique solution and approach Lightwave eHealthcare Solutions Limited (LWEHS) was able to architect and deliver.  With LHIMS robust electronic medical record capabilities coupled with its state-of-the-art early warning disease surveillance system is truly unique within the Ghana healthcare continuum.

According to one Hospital’s CEO, after having been exposed to a number of health management systems throughout his career, stated Lightwave’s approach to healthcare technology and its platform is unique not only in Ghana’s healthcare landscape but anywhere in Africa.

According to senior personnel with Public Health in GHS, LHIMS has the potential to be a valuable system for the Country to invest in and they want the whole nationwide rollout to be carried out to ensure we will be able to detect alerts anywhere in the Country. There have been several strong recommendations towards using LHIMS as an approach to improve early detection of outbreaks.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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