Closing the patient care loop in community medicine

Community medicine provides comprehensive health services ranging from preventive, promotive, curative to rehabilitative services. In many countries today, healthcare professionals practicing community medicine are seeking ways to deliver better care to diverse populations and to improve overall care quality in both urban and rural settings.

To improve overall care quality, physicians seek a solution to these problems:

• Disjointed information flow — Primary care physicians often start the patient on their care pathway, but may not have access to complete information and test results generated outside their office. If a patient is referred to a specialist, to an outside medical facility, or to an imaging centre, the primary care physician must wait for results before they can recommend further treatment or close the patient care pathway. Lack of information may prevent the physician from making timely and well-informed medical decisions on behalf of their patient.
• Efficiency of care — In rural areas, or areas with geographically dispersed populations, primary care physicians struggle to meet the needs of their patient base. These health professionals need better tools to improve efficiency, allowing them to serve more patients while also raising the standard of basic healthcare.
• Connected care — Healthcare professionals lack access to collaborative resources. In rural and urban areas alike, physicians need a method to seek advice from other professionals. Despite the complexity of these problems, the solution must simplify the exchange of information amongst community care professionals.

A community medicine infrastructure fosters a collaborative healthcare model

Karos Health believes that a standards-based health information network can enable medical information exchange and bring healthcare providers and patients together in a collaborative healthcare model. Health networks enable information exchange, placing key patient information, test results, and even diagnostic images at care provider’s fingertips. All healthcare providers involved in the patient’s care pathway can access a patient’s complete medical record.

A new infrastructure leverages existing standards

Karos believes that building upon standards such as DICOM, HL7 CDA and technical frameworks such as Integrating the Healthcare Enterprise (IHE) will advance clinical information sharing. In particular, the IHE XDS integration profiles for cross-enterprise clinical and imaging information sharing address the complex interoperability and communication challenges inherent in bridging information from multiple existing information systems. Using this framework, patient information originating from various systems can be published, indexed, stored and retrieved from anywhere via a secure web connection. A solution that leverages the internet, existing networking devices and existing healthcare information systems will establish a cost-effective e-health infrastructure to serve urban and rural areas, ultimately providing community care professionals with the means to make better informed medical decisions and improve the quality of patient care.

Partner success provides proof of concept

The Province of Gauteng in South Africa plans to connect healthcare providers from 29 hospitals and 348 clinics. A population of over 10 million people is widely dispersed in areas where basic healthcare services and even electricity are limited. In a province suffering from rampant infectious disease, many patients must travel long distances to receive care.

Phase One of an e-health information network project is now complete, enabling patient tracking regardless of physical location, access to the patient’s complete longitudinal health record, and seamless sharing of diagnostic images and medical reports. Seeking a way to improve the care delivered to a large and diverse population, South Africa is targeting a progressive National Health Information System. The goal is to improve health in urban centres, develop health services in remote communities, and bring together healthcare providers through electronic information exchange.

The chosen solution, adheres to medical standards and ensures secure, reliable and accurate exchange of patient data via a web interface. To meet the demands of patients presenting at care providers from geographically dispersed locations, and to face the possibility of intermittent internet connection failures, the innovative architecture archives the entire patient record in a central repository while also allowing distributed caching of information. Each institution, clinic, and healthcare practice has its own local cache to ensure that the patient data is always available. Leveraging the internet and existing networking device wherever possible, the solution reduces interoperability costs, preserves legacy systems, and prepares for future changes and additions.

“With e-Health, the beneficiaries will be the poorest of the poor because you are now giving quality health care to those who could not (previously) access it.”

— Moretlo Molefi
Director of the Telemedicine Lead Programme, South African Medical Research Council (MRC)

— Kibily Demba Samake
17 December 2006, eHealth in Africa: A Vision for Healthier African, consulted 21 October 2006

How can Karos help?

Karos has the solutions and expertise to help you solve these problems. For more information contact us. We look forward to collaborating with you.