Dr. Swende, CMD, Benue State University Teaching Hospital, Makurdi
A recent study has shown that many countries are adopting e-Health practice to improve on the delivery of health care services to the people. However, as an emerging field in the intersection of medical informatics, public health and business, this healthcare practice that is supported by electronic processes and communication, remains relatively new in Nigeria, especially considering that the discovery of e-Health itself dates back to as recent as 1999. In this interview, the Chief Medical Director of the Benue State University Teaching Hospital (BSUTH), Makurdi, DR TERRUMUN SWENDE, speaks on the benefits, the challenges and the efforts by his teaching hospital to embrace e-Health practice. He spoke to our Correspondent in Makurdi.
Excerpts from the interview:
How can ICT be used to promote health care delivery?
ICT as you know, has had a very positive development in most sectors of human endeavors, including the health sector. There is a wide range of applications of ICT that health can use to start with. For instance, if we were in a more developed country, booking to see a doctor can be done online as far as it is not an emergency situation. Much of that has not been done here as just smaller hospitals can do that for now. When you come to the hospital setting proper, one of the major advantages of ICT is what is called electronic medical records, where people can walk into the hospital just the way you walk into a bank and transact their business using MasterCard or ATM card. That can also be done in the hospital too. When you come in, as far as you are registered, you do not need to join long queues to get the physical paper records. Your doctor is on the computer and once you give him your card and he plugs it in, your details comes up; he consults you using a computer, he does not need to fill paper form to give you for the laboratory. Once you get to the lab and you give your number to them, as they key it into the system, your investigations come up. If it’s something that can be done quickly, they run the test and before you get back to your doctor, they will send the results back this is the same for X-Ray and the rest. The doctor can then look at it and give you the necessary treatment. The beauty of e-Health is that it cuts down the waiting time. More often than not, someone comes to the hospital and the hours they use to get your file will not take place again as things move faster if you can get this record electronically. It simply means that when you visit the hospital again, the issue of missing records or missing file will not occur. In the healthcare settings, we also conduct research very often. When we want to retrieve files of patients or documents of patients to conduct research, it becomes very difficult as a good number of them are lost, but with e-Health, the records on a particular issue are gotten without stress. The arrangement is such that we bring all data of people that have been managed with that condition together so it makes things easier for you to move.
Again, if the entire country is running with ICT or e-records, when one travels to any part of the country, such person’s medical records can be easily assessed on demand. Sometimes, we have to transfer records of treatment and that is not only in the hospital setting but if the entire country were also ICT complacent in electronic records of treatment, if I travel, for instance, to Sokoto, and have a health challenge there, it makes it easier for the caregiver to communicate with the caregiver here in Benue: this client of yours is here with me and we need to have his medical record, and he gives them access to them so as to pick up from there and continue treatment. So, there are many advantages. There is also what we call telemedicine. That is, if the medical team in Markudi is sent to Gboko town to give health care there and on arrival, they discover they need assistance from the teaching hospital here in the capital, they can communicate through teleconferencing to get other opinions from senior colleagues and other specialist in the case field and then go ahead to do what he or she needs to do real time. And other medical professionals will also be able to guide these ones here and give suggestions where necessary through the video conference. So, this is very possible. You’ve also heard of e-consultations where the patient is in a distant town and the medic is giving treatment from a very different location through video conference call. The possibilities are massive. You see, in ICT, you can enhance efficiency in any aspect of the hospital. For example, if you deploy ICT software properly, you can manage human resources and also payment of salaries. All that can be very simple and straightforward, instead of the long tedious thing they do presently.
You can manage your inventory in stores. As you buy like 3000 drugs, you save them up in the system and so with each one you dispense, the system tells you what is left until you reach a critical level where the computer will remind you that this drug will be out of stock soon hence, you have to re-order. The same software can help you take note of expiry dates of each drug you have over the counter like some of these big hospitals.
Even in the finance department, imagine how you bring cash to transact. The chances that the cashier will differ the money is high; the chances of error or fake money are also high, but when we go purely digital and people are using card, errors are minimal because as the patients are paying, it is going straight to your account. So, from a wide range, ICT is beneficial.
Is BSUTH operating e-health system?
What we have in BSUTH for now, I will describe as rudimentary. For instance, in the NHIS (National Health Insurance Scheme) clinic, we have deployed some of that. That is what we are using for our complex billing and a whole lot of things. If you come to our finance, we have some of those ICT solutions that help us in certain areas. But where we are hoping to reach is the hospital-wide electronic medical records including consultation where everything you do once you come, is ICT-driven. Where we are now is a good starting point, but a far cry from where we want to be.
What are the specific challenges of e-Health policies in the BSU teaching hospital?
There are several challenges. First is to get the ICT solution on ground. In the past, the hospital had tried to get in the assets installed electronic medical records. I think we have done so. The hardware is already installed, but then we got stuck. Part of the challenges we had was one, most of the staff on ground were not ICT compliant and it means we need to do a lot of training to get them on board. You can imagine that if a physician has been seeing patients all along and documenting on paper, it will be a great challenge to get him to overnight start doing so using the computer. Same goes for every functionary at the hospital. Of course, at the level of software, there were also hitches. But we are hoping to actually overcome all of these. All of these are also finance-driven. We need to make substantial expenses especially at the initial stage to be able to move. Another thing is, we need to deploy either tablets, desk\tops or laptops at every point pen and paper were used, and this comes with a huge cost. Those were the initial challenges, but if these challenges are overcome, the benefits are enormous. The proficiency it will bring will be profound and phenomenal, and it will help our Healthcare delivery better.
