One step foward and three backwards

A story appeared in yesterday’s press regarding the financial support for the development of a Health Management application by a local doctor. I’m going to apologise in advance for what I’m about to write… sorry guys but I just can’t help myself.

After three years of proving at Goroka General Hospital how an Open Source alternative can save PNG Health a stack of money and without compromising on deliverables, the powers to be remain fixated on pushing ahead with solutions that in my opinion are unsustainable.

Yesterday’s story as it appeared in The National:

(For my comments see end of post)

New computer programme for health data management

By Bosorima Robby
A REVOLUTIONARY step in computer programming undertaken by a private company will now make the management of medical issues such as budgeting and resource allocation easy.
This has also been given a financial support of K250,000 by the Health Department as a step in the right direction to improving the health systems with proper management and accountability of resources that are allocated to each hospital as received from the Government.
Owner of Simmet-nga Ltd, Dr Simon Mete, said he developed this software when he saw that patient records were the only way for hospital managers to pinpoint areas that needed funds and human resources to provide better services.
The software will assist hospital managers set realistic approaches to budgeting to ensure positive outcomes and that resources are used according to the data received.
Dr Mete said because the software contains patients’ personal information, the data will be protected by a password and will only be accessible by the senior executive management.
He said this will help keep records together and make them available to doctors to update their patients’ medical histories.
The data that will be uploaded into the database will come from all the daily admissions into each hospital.
The patients will be assigned medical numbers for identification when they go to hospital to make it easier for doctors to know about a patient’s medical history and to treat them accordingly.
Dr Mete said the first hospital to trial this software was the Mt Hagen General Hospital in 2000.
The programme is currently being trialed at the Kundiawa, Wabag, Mendi, Goroka, Port Moresby, Alotau, Popondetta, Kerema, Vanimo and Daru hospitals.
Health Secretary Dr Clement Malau said the Health Department was aware of this software programme and has had several talks with Dr Mete on the usage of the software in all the country’s hospitals.
He said he was very optimistic of the fact that this was a homegrown product and hoped that it would work out in the future to prove that Papua New Guineans are capable of creating and developing such initiatives.
Dr Malau said he was happy that as part of its mission and vision to support local intellectuals, the department has agreed to support Dr Mete’s initiative.
He said Dr Mete had been using his own resources to try out the software and was hopeful the data would be linked to all the other hospitals and the national health information systems.
The software is currently suited to the country’s stage of development, with the aim to develop to cater for any future development stages

And here’s a few pointers for PNG Health decision makers to reflect on:

• Were other options investigated, evaluated and feasibility studies conducted in the lead up to the decision to pursue this solution?
• A Computer Program is one thing – a Computer Programme is something entirely different.
• I’m curious what it is that is so “revolutionary” about an Admissions and Discharge Register?
• Will the K250,000 also cover training, software licensing and hardware costs associated with deploying this solution throughout the country?
• Has a budget been allocated to individual Hospitals to implement this system?
• What is the Total Cost of Ownership (TCO) ?
• Has anyone taken the time to investigate some of the existing ERP and HIS applications readily available through the Open Source Community? 100 times the functionality for a fraction of the cost!
• If you were sick would you go and see a Computer Programmer for medical attention?
• Dr. Simon Mete is Director of Medical Services (DMS) at Port Moresby General Hospital. Could there possibly be conflict of interest?
• Why is it that when there’s a genuine need for something in PNG that folks tend to grab on to the 1st thing that comes along?
• When we construct a building we usually have architects do a proof of concept – we then take this through a few iterations before we lock in on a suitable design – then we build. In IT things are not that much different really.
• New software developments would do wise to focus on browser based solutions.
• Will this software run on PC’s other than Microsoft? What about those Hospitals currently running Ubuntu desktops eg: Goroka General Hospital.
• Was there a consultative process with Hospitals around the country in the lead up to choosing this software?
• Nowadays data privacy/security issues need to be addressed with encryption in addition to passwords. (Handing out passwords to protect sensitive health data could easily lead to issues around confidentiality).
• To rely on a medical number alone to uniquely identify patients could prove disastrous and will compromise data accuracy and integrity.
• Most Microsoft Windows installations around the country and especially in Government are currently unlicensed. If the true cost of Microsoft and other software were understood and calculated – folks would realise very quickly how unsustainable proprietary solutions are for the PNG market.
• As far as I’m aware this software is not and has not been trialled at the Hospitals listed above – certainly not at Goroka!
• The golden window of opportunity within PNG Health to build a National Health Information System (NHIS) that is integrated, feature rich and cost effective is slowly closing!