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INTPART-International Partnerships for Excellent Education and Research

Designing Information Systems for Strengthening Patient Based Care in Resource Constrained Settings

Alternativ tittel: Designing Information Systems for Strengthening Patient Based Care in Resource Constrained Settings

Tildelt: kr 2,7 mill.

Presentasjonene fra dette prosjektet var hovedsakelig rettet mot utviklingen av 'frugal' designstrategi i en internasjonal setting som skulle introduseres til studenter, akademikere, industri og helsepolitikere på statlig og nasjonalt nivå. Studentutveksling og ny kursdesign ble en viktig del av den gjensidige læringsprosessen for å muliggjøre mer robuste og skalerbare systemer i både Norge og India. En PhD student fra PGIMER var sentral for en vellykket implementering av "living lab" på 2 steder i Chandigarh, India, støttet av DHIS2-teamet på UiO med sin indiske partner HISP India samt uvurderlig støtte fra PGIMER. Etablering av " 'living lab' fungerte som et knutepunkt for å teste designstrategier i virkelige omgivelser. Erfaringen, sett fra et medisinsk perspektiv ble presentert på siste workshop. Blant de nevnte fordelene var økning av pålitelige data, oppfølging og sporing av individuelle pasienter, lett å søke poster og enkelt å generere rapporter. Skiftet fra papirsystem til aggregerte rapporterer, case-basert data og enkel overvåkning har ført til flere feilfunn. Systemet er til stor støtte i en ?evidence? basert beslutningsprosess, dets analytiske egenskaper og interaktivt instrumentpanel oppfyller faktisk alle grunnleggende krav til primærhelsevesenet. Som et resultat av prosjektformidlingsaktiviteter ble det innført en ny strategi for distribusjon av prosjektresultater, der utvikling av AMR (Antimicrobial Resistance) Surveillance system ble igangsatt. Dette arbeidet pågår fortsatt.

The design and development of a 'patient centric system for primary care settings in the Indian context 'is fully operational in the primary health care clinic in Chandigarh. A living lab, a core concept guiding the project, was established and made operational through this project. Research outputs: 1 book, 6 lectures and 3 articles for international conferences and journals for multi-disciplinary audiences. Two IFI Masters students successfully completed their thesis based on this project. PGIMER doctoral student will be submitting his thesis in July based on this project. 5 more research papers are under production. A course module on Public Health Informatics for medical/public students were build and is actively used. At external level further impacts may be earlier detection of epidemies by reporting real time patient data from slum areas to the authorities. At the UiO internal level possible impact is building competencies across the workforce.

Many LMICs are seeking to strengthen PBCS within their public health settings. Contributing to this is the drive towards Universal Health Coverage (UHC).UHC, which seeks to provide financial risk protection to all citizens, requires collecting patient and encounter based information, including costs, to help monitor and measure progress towards achieving UHC. As NCDs like diabetes and hypertension is rapidly increasing, UHC requires collecting data for such diseases that go beyond the traditional concerns of maternal and child health services that exist in LMICs. The project focus is on learning to design PBCS and incorporate this learning in post graduate health informatics curriculum. This curriculum includes design approaches, implementation concerns, using information for action, capacity strengthening & regulatory concerns. There is limited experience and understanding in LMICs of how PBCS can be designed and used, especially within the primary health care sector. Transitions from existing aggregate and also often paper based HIS to such PBCS is a non-trivial challenge. The near absence of regulatory environments to ensure privacy and protection of patient data represents another significant challenge, especially now when there will be a proliferation of private and global providers in addition to the State. Infrastructure and capacity constraints, especially in the outreach areas of the primary health care sector, provide severe challenges to the creation of such PBCS, which are fundamentally dependent on the Internet to enable connected care. These technical and institutional challenges have been understood in Norway with more than 3 decades of experience in this area. The project seeks to transfer these learning to the Indian context through joint research, curriculum development, student exchange and joint workshops to be held in Norway and India. The involvement of the private/NGO sector will be sought to strengthen larger dissemination of results.

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INTPART-International Partnerships for Excellent Education and Research