Bolstering Use of Smartcare Electronic Health Records System
Like any good health worker, Banji Kaumba worried when she could not help patients because she was unable to access their records.
Working as a medical records clerk at the Monze Mission Hospital in the Southern Province of Zambia, Kaumba said keeping voluminous files of patients’ medical history was difficult because papers got lost, torn or damaged due to handling.
“It was time consuming for all of us the patient, the doctor and I, to look for a single file. Sometimes even if we found it, information was missing. This meant opening a new file and gathering new information as all the history was gone. ”
Kaumba said this changed after she was trained in the use of SmartCare - an electronic health records system which archives a patient’s medical history on a small automated portable card.
SmartCare has four main objectives: to provide greater continuity of clinic based care; increase the privacy of sensitive medical information (such as TB or HIV status); reduce the burden of paperwork on health staff and improve the quality of information and decision support for patients, while providing automated information flow into the government’s existing Health Management Information System (HMIS) categories.
In addition to making storage easier, Kaumba says having information on one card enabled her become more efficient in report writing.
The computer programme is simply designed with a touch screen to reduce the learning curve and also enable clinicians with little computer literacy or exposure, to navigate it.
“I had no idea about data entry but after the training, my job is easier; I don’t waste too much time looking for files or information. I am able to generate reports on time because all the information is in one place and easily accessible. I am more efficient and able to serve my community better.’’
Kaumba is one of the 141 health information officers from district offices and health facilities across Zambia, whom the Ministry of Health has trained to use SmartCare, with the support of the United Nations Development Programme (UNDP) which is temporarily managing the Global Fund to fight AIDS Tuberculosis and Malaria (GFATM) grants.
With the GFATM grants, the Ministry has rolled out the SmartCare trainings over a two year period at a cost of more than US$121,000.
As part of the closure plan for the ‘Round 4’ HIV grants and in preparation for implementation of grants for the three diseases, UNDP and the Ministry of Health conducted a joint assessment of the service delivery of the three diseases.
The assessment found that the SmartCare programme was not being used consistently. The recommendation was that there be mentoring for underperforming facilities and the number of health centers using SmartCare be increased to 469, in line with the national scale-up plan.
With the support of UNDP, the Ministry of Health has since procured 300 computers to be distributed to 268 sites.
Mark Anaba, a registered nurse at the Mukuni Rural Health Centre in Kazungula said storing information on a Smartcare card allows patients to access medical care wherever they are. He said the card also allows doctors to see the type of treatment being offered or that was offered in the past, without necessarily relying on the patient's verbal information.
“This meant people were not getting early treatment, or their treatment was not as effective as it could have been because their medical history was not available to the doctor. With the Smartcare card, treatment can now be accessed at any health facility that has the programme,” Anaba said.
Being a border trading town, Kazungula has a mobile population. As such, patients often had to travel back to the health centers where their files are kept when they fell ill.
A new user of SmartCare, Georgina Sakala, says the cards are widely accepted because they are similar to the bank ATM cards which many people are familiar with. “We keep our SmartCare cards in the same way as our ATM cards – in places where it is safe and convenient. It’s a big help to us,” Sakala happily said as she beams with smile.