In the United States, electronic medical records (EMR) have removed the tedium of filling out replicate health forms at every doctor visit. But now the same is true for low- and middle-income countries like Swaziland in southeastern Africa where MEASURE Evaluation, a USAID-funded global program, is helping make digital health systems a reality.
I work with local partners in Swaziland to plan and support the implementation of EMR and integrated health information systems (HIS), which are key in the treatment of HIV patients to ensure they do not drop out of the healthcare system.
Along with a team of technical specialists, I create guidelines and protocols to protect patient privacy and confidentiality when medical records go digital. So far, three health facilities have a functioning EMR system, and a dozen more are lined up to launch by the end of September 2016.
EMRs mean more than convenience—they mean a higher quality of care with less cost to the patient and the system. Each visit is better coordinated, with no duplication of services. This is especially true of patients who undergo a series of treatments and referrals, such as HIV patients. With integrated health information from multiple sources, decision makers will have a larger pool of health data to work with, something that is especially important when tracking infectious diseases.
Systems that ensure medical professionals can easily refer patients help the sector achieve the President's Emergency Plan for AIDS Relief (PEPFAR) 90-90-90 goal by ensuring patients continue to receive medical care instead of dropping out of treatment. The goal’s targets are that 90% of people living with HIV know their HIV status, 90% of people who know their HIV status are accessing treatment, and 90% of people on treatment have suppressed viral loads.
Digital health records help foster more trust between patients and providers. Although digital records can be copied or altered just like paper records, MEASURE Evaluation is ensuring protocols are in place to make EMR data more secure. These data are often sent via Wi-Fi hotspots from one point of care to the next, making the information potentially vulnerable to hackers. The work MEASURE Evaluation is doing to support the health sector in Swaziland ensures such vulnerabilities are addressed before there is a breach.
We shouldn’t wait until data are compromised to be thinking about safeguards, so we’re developing guidelines and protocols—and making them understood by health care workers—to protect medical records from security challenges that come with the use of information technology. MEASURE Evaluation is using the success of the processes used in Swaziland as a foundation for discussions to implement such processes in other low- and middle-income countries supported by USAID.
EMR and HIS projects like the one in Swaziland help people get the right services, at the right time, and in the right place, which ultimately saves time, money, and lives.