Federated States of Micronesia Department of Health and Social Affairs efforts to connect its geographically disconnected and isolated hospitals

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Federated States of Micronesia Department of Health and Social Affairs efforts to connect its geographically disconnected and isolated hospitals
 

– Reported, April 04, 2012

 

Almost every island country in the Paci? c with limited resources and scattered geography faces the challenge of having a centralized health information system for gathering, processing and storage or archival of vital health data. The term “data cemetery” was coined by others to mean that most Paci? c Island countries
were able to collect information but unable to make any sense from what they collected. Contributing to this predicament was the practice by many island countries including the Federated States of Micronesia (FSM) to operate on stand-alone computers rather than on a network in order to guard against system –
wide malfunction.
The FSM is made up of four states (Pohnpei, Chuuk, Kosrae and Yap), spreading over a vast area of the North Paci?c. All states except Kosrae have remote outer laying islands/atolls. The FSM has a federalist system of government with the states having a great deal of autonomy. This structure gives each state the ? exibility to assess its own needs and to funnel its resources based on each individual state’s priorities. However, there is a need to be able to report, assess and make decisions at a national level, especially in the area of health, because of the crucial role the central government plays in the development of the nation. This need prompted the FSM National Department of Health and Social Affairs (DHSA) to move away from the standalone-computer model and began the implementation of a robust and secure local area network and a wide area network.

In 2003, the FSM Department of Health and Social Affairs undertook a project involving an implementation of a robust and secure local area networks and a wide area network, establishing a network grid that connected the National to the four States’ hospitals. This provided the staff across these entities with a
uni? ed electronic mail system for communication and information sharing tools both within and between each organization. Though connected, they are independent of each other. This means that each state health service has its own control over any network resource it wants to add on to its network whether
it be a new user or a computer or a printer. Once added, those resources then become part of the whole network resources that can be accessed and shared between the states. However, when any of the state’s connection goes down, it does not affect the others. This was the ? rst time a layout of a wide area network like this was ever put in place in the FSM.

In the same year, necessary equipment including PCs and networking devices were purchased and small networks were established at each of the state’s hospitals’ medical records room. These networks replaced stand alone personal computers that were vulnerable to breakdowns and loss of data. The networks enabled multiple entry points improving timeliness and elimination of back-logs combined with centralized daily backups provided the necessary safeguard against factors that caused intermittent loss of data.

This established wide area network provides an environment for centralized registry and other web-based operation. Currently, the Immunization Registry (Webiz) that keeps vaccination records of all school aged children and adults in the FSM operates on this platform. The addition of Webiz to the network has enabled instant access of health workers to children’s’ immunization records, regardless of the child’s home island.
Prior to this, information was hand carried from island to island by request and it created un-necessary delays. It has also eliminated the multiplicity of records for the same individual when they moved from one island state to another. Reports produced from the registry provide an accurate snap-shot of the coverage
and how well immunization is carried out in the FSM. Emails and information portals at each site using MS SharePoint 2007 and replication of selected data
elements from inpatient and outpatient registries at each State to the National data servers are also running on the same system. This network is designed and built to accommodate additional communication activities such as voice and video conferencing (currently only a chat service is available) and further up to
date reporting at National level.

The main achievements have been connectivity between the States and the National Health of?ce in Palikir providing instant electronic communication and data transmission. Another achievement is the provision of outpatient and inpatient registry system that collects data at each state which is then
replicated on a weekly basis to the National of?ce. This has enabled generation of various reports by the FSM Statistician of? ce. Sample reports include:
1. Top 10 diagnosis for the FSM collectively as well as by State
2. Noti? able disease list and other communicable diseases .
3. Health systems and status indicators (i.e., hospital stay).
4. An auto alert system based on noti? able disease is in place to alert designated medical personnel of a possible diagnosis and preventing a possible out-break.
5. Immunization record which can be easily accessed over the department’s network both at the national level and the state level.

Credits: Norleen Oliver and Sepehr Sohrab

More Information at:
http://www.pacifichealthdialog.org.fj/volume16_no1/Connecting%20the%20Disconnected.pdf

 

 

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