JAMAICA IS on the cusp of a digital data revolution in healthcare. I was recently at The University Hospital of the West Indies (UHWI) where my company is implementing the Health Information Management System (HIMS). I was heartened by the enthusiasm of the health workers there when Minister of Health and Wellness Dr Christopher Tufton and his team toured the facility to see the progress of digitisation. I was even more pleased to learn that he, too, was excited by what he saw and had plans to fully digitise public health facilities – both hospitals and health centres.
While an overall digital network is great for progress, within that we have to drill down to ensure that we are achieving all the possible benefits of digitisation. It is not only about linking a hospital’s internal systems and smoother intake and registration for patients – although those are definitely great benefits.
At its core, digitisation is supposed to result in an overall improvement in the healthcare status of individuals and a country as a whole. In order to achieve this, one has to ensure that the patient is fully engaged and able to participate.
Digital data can work for the system and the patient by creating an entire patient care ecosystem which would include the sharing of insurance claims data, regardless of plan and provider, the patient’s electronic medical records (EMR) to ensure all caregivers are on the same page with even overseas medical treatment included in the EMR and the ecosystem. To achieve this, private medical practitioners, private and public sector hospitals and health centre data will have to be provided in a single location so that all providers and the patient have access to the data. The patient’s EMR, of course, is the place for this data merger.
In addition, an alert system would need to be created so that all providers in a patient’s care team are notified of any significant health-related update for the patient. For example, an admission, discharge, transfer or major diagnosis that will require long-term holistic care such as cancer. The patient’s access to this data can be through a patient portal provided by their primary caregiver.
BUILT-IN ARTIFICIAL INTELLIGENCE
The general idea here is for the entire record to follow the patient, regardless of caregiver. For this approach to eventually work the way it should, we must begin to think of creating health records at birth and that record would follow a patient throughout his/her life. This data would enable doctors to help patients prevent disease and provide more personalised care. It can also help with health research, which in turn provides for the development of evidence based interventions. The HIMS system has built-in artificial intelligence (AI) and machine learning to help to interpret the data.
The single most important component for this initiative to be a success is to create a strict way to establish patient identity and matching. The HIMS at UHWI provides a unique Universal Medical Record (UMR) number for each patient which can achieve this goal. We can also look at using the taxpayer registration number (TRN) or the birth entry numbers as possibilities or simply as a starting point to create that unique UMR number.
This digital transformation can result in significant health rewards in addition to financial savings. At an event some weeks ago, Dr Tufton indicated that productivity issues and healthcare go hand in hand, and right now the country is experiencing losses in productivity due to illness and over “the next 15 years [this cost could be] as high as $47 billion”. He added that non-communicable diseases (NCDs) feature greatly in this scenario, with medical costs of diabetes and cardiovascular disease alone expected to be $29.8 billion in the next 15 years. The approach I have outlined has prevention at the heart of it and so can significantly drive down the cost of care.
The digital systems we have can already achieve these goals. The important thing is for us to focus on digitising and therefore linking our facilities. Cooperation with private and public sector healthcare-related entities will also be key. I see no difficulty with us achieving this in the not so long term.