CHAPTER THREE:
IDENTIFY THE EXISTING HEALTH TECHNOLOGIES
Health as existing new technology in health care
Ethiopia is at a pivotal moment in its efforts to improve the health status of its people and address health inequities. As the
country has made progress in reaching the health- related Millennium Development Goals, the government realizes that
these advances need to be accelerated if targets in the areas of maternal and child mortality and infectious diseases are to
be achieved.
Health is one potential existing new technology in Ethiopia to keep this progress. Health generally is defined as the use of
ICT for health and in a broader sense the World Health Organization (WHO) defines Health as ―a method concerned
with improving the flow of information, through electronic means, to support the delivery of
health services and the management of health systems.
For national healthcare systems it is used to improve the timeliness and accuracy of public health data reporting and to
facilitate disease monitoring and surveillance activities as well as supporting sector-wide planning by improving the
ability to plan, budget and deliver services.
Situations to use new technologies
The use of information and communication technology (ICT) to support healthcare services is rapidly increasing. Public
healthcare organizations, in most developing countries, are becoming increasingly reliant upon ICT to support healthcare
services by improving the ability to collect, manage, analyze and report information in all areas of health care.
Components of electronic health record system
There are many types of electronic health record systems used in healthcare facilities. However, in all HER systems, there
are two major components of the system: Administrative and clinical applications.
The administrative modules support patient registration, scheduling/ appointment, admission /discharge, financial and
other management processes whereas, the clinical modules enable the users to collect store and display clinical
information related to preventive and curative healthcare services.
Benefits of EMR
EMRs can help streamline current procedures and assist with reducing medical error, improving office efficiency, and
improving documentation. They can also facilitate techniques, such as patient-populations comparisons, which would be
difficult using hardcopy based record systems. Potential benefits gained from the implementation and use of an EMR may
be summarized into four categories:.
Examples of electronic health record
Smart Care is a computerized electronic health record system used to record/store,
process, retrieve and report patient‘s health information. The system is developed based on the new HMIS
implementation. This computerized health record system has different components (modules) that includes: registration
module, OPD module, Inpatient module, Tuberculosis module, Pediatrics module, HIV/AIDS module, ANC module,
Postpartum module, Labour Delivery module, Pharmacy module, Drug Stock control, Laboratory module, Finance
module and also eHMIS used to pool all data elements of the health management information system from the Smart Care
server that
is entered by all the different clinics and generate monthly, quarterly, annual reports.
Online training
Training is the giving of information and knowledge, through speech, the written word or other methods of demonstration
in a manner that instructs the trainee. Training usually means the act of being prepared for something, of being taught or
learning a particular skill and practicing it until the required standard is reached.
Referral linkages
Referral is a process by which a health worker transfers the responsibility of care temporarily or permanently to another
health professional or social worker or to the community in response to its inability or limitation to provide the necessary
care. Referral is a two way process and ensures that a continuum of care is maintained to patients or clients. It is done
from the community to the primary care health service and to hospitals and within hospitals and vice versa. It also
involves not only direct patient care but support services such as transport and communication.
Rationale for Referrals
The rational for referrals is the promotion of continuity of services.
Benefits of a good referral system
A good referral system increases the efficiency of the health system by maximizing the appropriate use of health care
facilities. It strengthens the peripheral health facilities and improves the decision making capacity of professionals at the
lower level of the referral network.
It also creates opportunities for balanced distribution of funds, services and professionals while at the same time
improving the effectiveness of the health system. In addition, a good referral system helps to promote cooperation among
primary, secondary and tertiary levels of care.
Essential elements of a referral system
A group of organizations that in aggregate provide comprehensive health care services in a defined geographic area
A unit that coordinates and oversees referral activities
Designated referral focal persons at each health facility
Directory of services and organizations within a defined territory
Standardized referral format
Feedback loop to track referral
Documentation of referral
Therefore, a good referral system:
Will have a defined package of services provided at different levels of care
Encourages an environment in which the core referral hospital is viewed as a community resource
Should be responsive to local situation
Should include a properly functioning communication and transport system
It should also be inclusive of the private sector, non-governmental organizations and community based care including
social services
Reasons for Referral
The criteria for referral should be medical, objective and in the best interest of the patient or client. The following are
considered good reasons for referrals:
When a patient needs an expert advice as determined by the attending health professional
When technical examination is required that is not available at the referring facility
When a technical intervention that is beyond the capabilities of the facility is required
When patients require inpatient care that cannot be given at the referring facility
When the referring facility cannot no more accept patients due to shortage of beds and unavailability of professionals
Referrals are also made to the lower level health facilities and community based organizations in the best interest of the
patient depending on:
- The condition of the patient
- The capacity of the lower level health facility /community based organization
The New Health Tier System
fig 2: The New Health Tier System showing reporting relation ship
Roles and responsibilities in referral linkage
1. Roles and responsibilities of the referring health professional
Should know what, whom, when and where to refer
Should fill the referral form with all the necessary information and attach relevant documents
Explains to the patient the rationale, reasons for choice of doctor or facility, preparation, expected cost, and possible
outcome of referral
Should be available to answer queries from the referral coordinator or receiving facility about the referral if necessary
Secures result of the referral
2. Roles and responsibilities of the referral coordinator
Responsible for both referrals out and received referrals
Facilitates scheduling based on the level of priority for consultation, i.e. emergency, urgent and routine cases Utilizes
the following communication methods: letter, telephone, email, photocopied reports sending, personal
contacts, etc.
Ensures the availability of service or professionals at the receiving health facility before referral
Facilitates transportation for emergency cases
3. Roles and responsibilities of the referring facility
Performs a situation analysis regarding the process of referral in the facility
Ensures that staff are well aware of the referral system
Ensures continuous supply of standardized referral forms are available
Keeps directory of health services and facilities in the defined geographic area
Ensures proper recording of all referral activities Devises mechanisms to track
referrals Provides transportation in emergency conditions Assigns referral coordinator with clear roles and responsibilities
4. Roles and responsibilities of receiving health professional
Responds promptly to consultation requests
Reports in detail all pertinent findings and recommendations to the referring
health worker and may outline opinion to the patient (feedback with all required
information and recommendation)
Communicate with the patient or family
Does not attempt by word or deed to undermine the role of the referring health worker
5. Responsibilities of the receiving facility
Conducts situation analysis of the current referral process to identify gaps and strengths
Assigns referral coordinator with clear roles and responsibilities
Devises follow up plans and ensures the plans are communicated to the referring facility /professional
Ensures staff at points of entry clearly understand the referral process
Provides continuing education about the referral process to staff and the community
Ensures referred patients are seen by appropriate professionals
All investigations and documents attached with the referral form from the referring facility should be considered to
protect patients from unnecessary cost
Ensures that all prescheduled referrals are attended without undue delay Mobile health technology mHealth or mobile
health is a medical and public health practice supported by mobile
devices, such as mobile phones, patient monitoring devices, personal digital assistants
(PDAs), and other wireless devices. It involves the use and capitalization on a mobile
phone‘s core utility of voice and short messaging service (SMS) as well as more
complex functionalities and applications including general packet radio service (GPRS),
third and fourth generation mobile telecommunications (3G and 4G systems), global
positioning system (GPS), and Bluetooth technology.
The goal of mhealth is to improve the delivery of healthcare through quality and
access, Care-coordination, Lower rehospitalizations, Improve outcomes, Lower
infection rates and Monitor patient status in real time.
Mhealth Includes the use of mobile devices in:
Collecting aggregate and patient-level health data
Providing healthcare information to practitioners, researchers, and patients via Short
Message Services (SMS) platforms such as mHero
Real-time monitoring of patient vital signs and direct provision of care
mHealth Applications
Rapid collection/sharing of current data via mobile phones
Public health and lifestyle messages over mobile phones
Medication alerts using mobile phones
UNIT- FOUR:
APPLAY THE FUNCTIONS OF TECHNOLOGY
4.1. Introduction to Mobile/smart phones and tablets
In the past, mobile phones were mostly about making phone calls. They had a number pad, a digital phone book
and a pick-up/hang-up button and not much more. Now smart phones offer so much more – they‘re really fully-
fledged computers that you can fit in your pocket. They can run programs and games; access the internet, send
email and much more.
Nearly all smart phones now use touch screen controls. Instead of having hardware buttons like before, one side
of the phone is taken up mostly by a touch screen that you control using taps and gestures. There aren‘t even
any number buttons; when you want to make a call, a number pad will pop up on the touch screen. Becoming
familiar with a Smartphone can take a little bit of practice. But when you do become familiar with it, you‘ll find
that a Smartphone can do more than you ever thought possible on a mobile phone.
4.2. Mobile/smart phones and tablets function
A smart phone can: Make voice calls (of course!) Make video calls Access the internet and browse the web
Take photos, and upload them to the web Navigate with GPS if the phone has GPS built-in Play back music and
video stored on the phone (and connect to a PC to copy media to it) Manage your contacts and appointments
Send emails Play in-built games Run new applications and games downloaded for the internet.
4.3. Utilizing mobile phone plans
Many mobile phone plans – pre-paid and post-paid – now include a data component. For example, an Every Day
Connect plan from Telstra will also include data as part of the plan. In addition, on many post-paid services you can
purchase a data pack as an add-on to your basic mobile plan. The data component of the plan will be limited to a set
amount of downloads each month (listed in megabytes/MB or gigabytes/GB). This works very much like your home
internet plan. One important thing to note is that on most mobile data plans, you will be charged extra if you go over
your limit. So you need to read the mobile agreement carefully and check your usage levels regularly. Many mobile
providers also allow casual data usage on a pay-as-you go basis if you don‘t have an explicit monthly quota on the
plan. This is usually charged at a higher rate than if you have a data component built into the plan.
4.4. Identifying Phone Model Differences
Just because two phones might run the same operating system, doesn‘t mean the phones are identical: There are
physical differences: the weight and the screen size There are performance differences: the speed of the
processor and the amount of memory (much like on computers) There are software differences, with different
manufacturers loading different programs onto phones.
4.5. Mobile/smart phones and tablets utilization in health service provision
4.5.1. Tablets
Maximize portable technology in the patient encounter by supporting Point of Care documentation, Real-time care
coordination, Labs & Imaging, Patient education, Therapy benefits, Access to past medical history and Countless
additional benefits.
4.5.2. Smartphone’s
Smartphone’s are ubiquitous in healthcare and supports Care coordination, External device connection for testing and
diagnostics, Blood pressure monitoring, Blood glucose levels and Use of smart apps
4.6. Introduction to technology
Technology is wide-ranging term used to describe not just the computers you have, but also the software, printers and
other devices that you use to support your business. This can also extend to include online services and websites, such as
Facebook and YouTube and other application specific websites.
4.7. Functions of technology in organizations business Technology,
When used to support business needs, should be considered as an asset to be invested in, not a cost to be borne. When
implemented properly, good technology investments result in a measurable return on investment (ROI). That ROI might
well be achieved through lower running costs, better productivity, better customer service or simply increased sales due to
increased capacity. When we came to healthcare, healthcare industry is experiencing a steady and stable transformation
across the world. And Information Technology (IT) is playing a core role in every aspect of healthcare.
4.8. Functions of Information Technology in health care includes
Automated Operations to make monthly calls and feed information to maternal women Seamless interfacing
with third‐party databases manage voice recording with ease
Ability to obtain real time and updated information to provide reliable service Improve productivity with
comprehensive reports
ensuring faster adaptability of advanced technologies
Reduction of service costs and
Provision of quality healthcare at affordable prices