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MVP Open Mrs Update 052609

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The document summarizes the status and lessons learned from the Millennium Global Village-Net (MGV-Net) information system, which was implemented across multiple Millennium Village Project sites in 10 African countries. It provides details on the implementation status at several sites, including patient numbers and forms completed. It also discusses challenges faced, such as human capacity, clinician engagement, unreliable electricity, and the need for better government policies to support eHealth. Moving forward, it recommends increasing support for eHealth specialists, training, and coordination with infrastructure projects to address the challenges identified.

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The Millennium Global Village-Net: Status and Lessons Learned Andrew S. Kanter, MD MPH a,b,c ; Jonathan Dick d ; Frederick Bukachi, MD PhD a,b,f ; Edward Johnson a,e ; Colin Borland b ; Schadrack Dusabe b ; James Wariero b , Sonia Ehrlich Sachs b a International Partnership for Health, NFP, Chicago, IL b Millennium Villages Project, Earth Institute, Columbia University, NY Ìý c Department of Biomedical Informatics, Columbia UniversityÌý d University of Chicago Medical SchoolÌý e Wolfson Collage, Cambridge University f Dept. of Physiology, University of Nairobi
Millennium Villages Project Partnership between Earth Institute at Columbia University, UNDP, Millennium Promise and national governments. Operates in 10 countries in 13 agro-ecological zones Integrated development at $120 pc/y Covers about 500,000 people Each cluster of villages has around 40,000 people and 3-6 clinics
Millennium Villages Koraro, Ethiopia Bonsaaso, Ghana Dertu, Kenya Sauri, Kenya Kokoyah, Liberia Mwandama, Malawi Tiby, Mali Timbuktu, Mali Ikaram, Nigeria Pampaida, Nigeria Mayange, Rwanda Potou, Senegal Mbola, Tanzania Ruhiira, Uganda
Vision: MGV-Net Information System All MVP sites Common Dictionary Integrated Locally Automate Reporting De-identified Data warehouse Connect CHWs/ Community mHealth Increase IT capacity
MGV-Net Information System
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Comparable and Timely Data Month Year Cases Treated Smears Neg Smears Neg Smears Tx'd (%) 11 2008 308 408 481 455 292 (64.1758) 12 2008 248 251 428 393 176 (44.7837) 1 2009 644 789 514 457 183 (40.0438) 2 2009 541 561 816 728 142 (19.5055) 3 2009 292 343 443 406 79 (19.4581) 11 2008 115 159 175 168 118 (70.2381) 12 2008 97 111 152 136 77 (56.6176) 1 2009 99 108 142 123 56 (45.5285) 2 2009 64 68 161 143 36 (25.1748) 3 2009 43 38 123 115 26 (22.6087)
Status of Implementations (Sauri) Single Laptop as server, 1 additional laptop for data entry As of end of March, 2009: 7,097 patients 11,833 encounters Forms (fields entered/form): Adult (~17), Peds (~12), Antenatal (~14)
Ìý
Status of Implementations (Mayange) WAN with 1 server and 6 workstations As of end of February, 2009: 4,257 patients 5,026 encounters Mostly adults entered New peds forms required by gov’t No pharmacy yet
Ìý
Status of Implementations (Others) Bonsasso, Ghana; Tiby, Mali and Potou, Senegal have OpenMRS on a server Bonsasso doing vital statistics entry Plan full encounter form rollout to Bonsasso, Nigeria and Mbola (Tanzania) this year
Terminology Service Bureau
Status of Terminology Service Bureau Centralized concept dictionary for all sites, with translations of concepts and User Interface messages Crossmaps to SNOMED CT, RxNORM and ICD-10. Runs on PHP and needs conversion to OpenMRS module Needs subsetting
Status of Implementation in Ruhiira WAN across cluster of 6 clinics including one hospital. As of April 30, 2009: 20,000 patients 29,783 encounters Typical Month/Clinic (# of encounters): Adults (736), Peds (570), Antenatal (105)
Challenges and Lessons Learned Human Capacity Clinician Engagement Reliable electricity Computers Connectivity Gov’t Policies
Way Forward IDRC helping to fund eHealth Specialists and additional data entry clerks More training Better coordination with infrastructure rollout and management of power Coordinate with HMN and others to define policies which support eHealth

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MVP Open Mrs Update 052609

  • 1. The Millennium Global Village-Net: Status and Lessons Learned Andrew S. Kanter, MD MPH a,b,c ; Jonathan Dick d ; Frederick Bukachi, MD PhD a,b,f ; Edward Johnson a,e ; Colin Borland b ; Schadrack Dusabe b ; James Wariero b , Sonia Ehrlich Sachs b a International Partnership for Health, NFP, Chicago, IL b Millennium Villages Project, Earth Institute, Columbia University, NY Ìý c Department of Biomedical Informatics, Columbia UniversityÌý d University of Chicago Medical SchoolÌý e Wolfson Collage, Cambridge University f Dept. of Physiology, University of Nairobi
  • 2. Millennium Villages Project Partnership between Earth Institute at Columbia University, UNDP, Millennium Promise and national governments. Operates in 10 countries in 13 agro-ecological zones Integrated development at $120 pc/y Covers about 500,000 people Each cluster of villages has around 40,000 people and 3-6 clinics
  • 3. Millennium Villages Koraro, Ethiopia Bonsaaso, Ghana Dertu, Kenya Sauri, Kenya Kokoyah, Liberia Mwandama, Malawi Tiby, Mali Timbuktu, Mali Ikaram, Nigeria Pampaida, Nigeria Mayange, Rwanda Potou, Senegal Mbola, Tanzania Ruhiira, Uganda
  • 4. Vision: MGV-Net Information System All MVP sites Common Dictionary Integrated Locally Automate Reporting De-identified Data warehouse Connect CHWs/ Community mHealth Increase IT capacity
  • 7. Comparable and Timely Data Month Year Cases Treated Smears Neg Smears Neg Smears Tx'd (%) 11 2008 308 408 481 455 292 (64.1758) 12 2008 248 251 428 393 176 (44.7837) 1 2009 644 789 514 457 183 (40.0438) 2 2009 541 561 816 728 142 (19.5055) 3 2009 292 343 443 406 79 (19.4581) 11 2008 115 159 175 168 118 (70.2381) 12 2008 97 111 152 136 77 (56.6176) 1 2009 99 108 142 123 56 (45.5285) 2 2009 64 68 161 143 36 (25.1748) 3 2009 43 38 123 115 26 (22.6087)
  • 8. Status of Implementations (Sauri) Single Laptop as server, 1 additional laptop for data entry As of end of March, 2009: 7,097 patients 11,833 encounters Forms (fields entered/form): Adult (~17), Peds (~12), Antenatal (~14)
  • 10. Status of Implementations (Mayange) WAN with 1 server and 6 workstations As of end of February, 2009: 4,257 patients 5,026 encounters Mostly adults entered New peds forms required by gov’t No pharmacy yet
  • 11. Ìý
  • 12. Status of Implementations (Others) Bonsasso, Ghana; Tiby, Mali and Potou, Senegal have OpenMRS on a server Bonsasso doing vital statistics entry Plan full encounter form rollout to Bonsasso, Nigeria and Mbola (Tanzania) this year
  • 14. Status of Terminology Service Bureau Centralized concept dictionary for all sites, with translations of concepts and User Interface messages Crossmaps to SNOMED CT, RxNORM and ICD-10. Runs on PHP and needs conversion to OpenMRS module Needs subsetting
  • 15. Status of Implementation in Ruhiira WAN across cluster of 6 clinics including one hospital. As of April 30, 2009: 20,000 patients 29,783 encounters Typical Month/Clinic (# of encounters): Adults (736), Peds (570), Antenatal (105)
  • 16. Challenges and Lessons Learned Human Capacity Clinician Engagement Reliable electricity Computers Connectivity Gov’t Policies
  • 17. Way Forward IDRC helping to fund eHealth Specialists and additional data entry clerks More training Better coordination with infrastructure rollout and management of power Coordinate with HMN and others to define policies which support eHealth