SmartCare - AbsoluteAstronomy.com

The SmartCare electronic health record system (EHR) has been developed and deployed by The Ministry of Health (MOH) Zambia, in collaboration with the Centers for Disease Control and Prevention (CDC) and many other implementing partners.

SmartCare is:

A fully integrated electronic health record system to provide continuity of care

A clinical management information system at the facility and district (management/admin) level

A key component in 'one National M&E system'

Programme vision

Every Zambian receives cost-effective, confidential, quality health care whenever and wherever they need it.

Every man, woman and child has an electronic health record;

Every point of clinical service can access and update this record;

Every clinician understands the value of this record and is committed to maintaining it;

Each clinical facility, District, Provincial and the national Ministry of Health HQ routinely monitors & evaluates reports from this data, and uses this information to optimally allocate human and other resources, and to assure continuous systematic improvement in health services.

Programme mission

To enable the delivery of cost-effective, confidential, quality health care for everyone, everywhere, every time, by improving health records and related health information systems.

System innovations

Distributed database system: Given resource constraints in developing countries such as Zambia where electricity is still not available in some parts of the nation, having Internet access throughout the nation will take many more year. SmartCare data is held at each facility in a distributed design; unlike centralized designs of most systems. Internet is not essential, merely an added benefit.

Smart Card: SmartCare uses client carried smart cards or staff carried flash drives for a lower-tech connectivity solution that works today. An individual's health information is stored on a very compressed, secure smart card to maintain continuity of care between visits, health services and health facilities. The individual's health record is also stored on the health facility installation database for backup and generation of facility level and health management information system reports.

Touchscreen: Making the data capture task bearable can be the most challenging part of EHR design. SmartCare extends a successful Malawi idea, where touchscreen data entry by existing staff lowers this barrier. The software works well with a touch screen monitor enabling the clinician to view and record patient data. This tool, in combination with client specific data, can provide decision support for over-extended clinicians, and clinician assistants. Clinicians can ‘read and touch’ to enter data; no typing is required. See the image at top for example screen with touch screen technology enabled.

GIS data visualization: Aggregate health data stored at health facilities can be visualized in GIS maps. This includes live patient data as well as static data from health surveys.

Deployment status in Zambia

Ministry of Health, Zambia has deployed SmartCare in > 200 facilities (clinical and district/provincial/national levels), in all districts (mid-2008); patient enrollment >200,000

Partners are supporting deployment in government and private facilities (for instance: ZPCT >44, CIDRZ >56, AIDSRelief >12), but government deployment & enrollment rates are increasing most rapidly

Future plans in Zambia

Capacity building and systems strengthening by developing SmartCare Training Videos, Certification

Completion of ambulatory service modules e.g. OPD, family planning, and children’s clinic

Systems integrations with other health record systems in Zambia ex: ZEPRS

Integration of drug stock management system

Customizations

Ethiopia - Electronic Health Record System called SmartCare-Ethiopia. The system is currently being piloted in one of the hospitals (as of December 2007)