A FORTNIGHT ago I wrote about how the Zambian health sector can be improved through technologies. I was impressed last week to learn about the progress they are making through a system called smart care electronic health record system.
SmartCare is a fully integrated electronic health record system, clinical management information system and a key component in ‘one National Monitoring and evaluation system’. This system will help reduce long queues and missing medical files at health centres once implemented in all clinics and hospitals nationwide. This is a clear sign that we are slowly heading towards a paperless generation. The introduction of Electronic Health Records (EHRs) in replacing paper records will greatly help decongest our stuffed rooms that keep patients records.  It is difficult keeping voluminous files of patients because papers get lost, torn or damaged due to handling, sometimes patients would have to open a new file each time they visit the health institution.
SmartCare was developed to improve continuity of care and provide timely data on maternal and child health, HIV/AIDS, tuberculosis and malaria interventions for public health purposes, including Health Management Information System (HMIS) trend reporting and analysis for health officials and clinicians.
The smart care card is similar to the bank ATM cards but using a SIM chip to store data; a soft copy of a patient’s health record is saved in the database of every facility the patient visits. Data is never lost even if the client has lost their card, they can simply visit he health institution and their data will be accessed on the computer by simply searching for their details, ensuring continuity of care. unlike centralized designs of most systems. Internet is not essential, merely an added benefit.
This will help doctors to see the type of treatment being offered or what was offered in the past. With regards to security, no one can be able to read the information on the smart care card apart from the hospitals and clinics that have access to it. It carries an encrypted copy of a patient’s health history.
The smart care computer programme has a user friendly interface designed with a touch screen to reduce the learning curve and also enable clinicians with little computer literacy or exposure to navigate it. That will not mean they will instantly do away with the manual filling system, The information I received was that the electronic system and the manual system at the moment will be used together so that In an instance where there is a system or power failure, people would quickly switch to the manual way and then update the information once the system is up again.
SmartCare has four main objectives: to provide greater continuity of clinic based care; increase the privacy of sensitive medical information (such as TB or HIV status); reduce the burden of paperwork on health staff and improve the quality of information and decision support for patients, while providing automated information flow into the government’s existing Health Management Information System (HMIS) categories. With funding from the U.S. Centers for Disease Control and Prevention (CDC) and in partnership with the Zambian Ministry of Health, Jhpiego has been supporting efforts to expand, refine and introduce the SmartCare card system nationwide.
The Ministry of Health has so far deployed Smart Care in over 800 facilities since 2005 & enrollment rates are increasing rapidly. The UNDP and the Ministry of Health conducted a joint assessment of the service delivery of the three diseases. The assessment found that the SmartCare programme was not being used consistently. The recommendation was that there be mentoring for underperforming facilities and the number of health centers using SmartCare be increased in line with the national scale-up plan.
In the first quarter the MINISTER of Health Dr Chitalu Chilufya stressed the need for strengthened health information system as an integral component in enhancing patient confidentiality, efficiency and quality of service delivery. He said this when he officiated at the launch of Smart Care Electronic Record System at the Women and New Born University Teaching Hospital in Lusaka.
Dr Chilufya explained that the paper filing system has failed to attain high levels of confidentiality because it was easy to access compared to an electronic record system that required passwords and keys to unlock. The minister has since directed all senior medical superintends to work with SMART Care Zambia to ensure that health facilities go paperless for the purpose of efficiency and quality of service.
Just recently the ministry of health again launched the Zambia Integrated Health Situation Room, a data visualization platform that draws from multiple sources, produces powerful analytical outputs for programmes. PRESIDENT Edgar Lungu added that the launched Zambia Integrated Health Situation Room was a special tool for health workers to achieving all aspects of quality service delivery in the country and that the Government is taking serious milestones to improve health service delivery to the people of Zambia. SmartCare is also being used in Ethiopia and South Africa.

For comments and contributions or if you have a question or topic you would like us to cover in this column, email me on [email protected] Text or Whatsapp +260977258265.

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