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MVP Open Mrs Update 052609

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MVP Open Mrs Update 052609

  1. 1. The Millennium Global Village-Net: Status and Lessons Learned Andrew S. Kanter, MD MPH a,b,c ; Jonathan Dick d ; Frederick Bukachi, MD PhD a,b,f ; Edward Johnson a,e ; Colin Borland b ; Schadrack Dusabe b ; James Wariero b , Sonia Ehrlich Sachs b a International Partnership for Health, NFP, Chicago, IL b Millennium Villages Project, Earth Institute, Columbia University, NY   c Department of Biomedical Informatics, Columbia University  d University of Chicago Medical School  e Wolfson Collage, Cambridge University f Dept. of Physiology, University of Nairobi
  2. 2. Millennium Villages Project <ul><li>Partnership between Earth Institute at Columbia University, UNDP, Millennium Promise and national governments. </li></ul><ul><li>Operates in 10 countries in 13 agro-ecological zones </li></ul><ul><li>Integrated development at $120 pc/y </li></ul><ul><li>Covers about 500,000 people </li></ul><ul><li>Each cluster of villages has around 40,000 people and 3-6 clinics </li></ul>
  3. 3. Millennium Villages <ul><li>Koraro, Ethiopia </li></ul><ul><li>Bonsaaso, Ghana </li></ul><ul><li>Dertu, Kenya </li></ul><ul><li>Sauri, Kenya </li></ul><ul><li>Kokoyah, Liberia </li></ul><ul><li>Mwandama, Malawi </li></ul><ul><li>Tiby, Mali </li></ul><ul><li>Timbuktu, Mali </li></ul><ul><li>Ikaram, Nigeria </li></ul><ul><li>Pampaida, Nigeria </li></ul><ul><li>Mayange, Rwanda </li></ul><ul><li>Potou, Senegal </li></ul><ul><li>Mbola, Tanzania </li></ul><ul><li>Ruhiira, Uganda </li></ul>
  4. 4. Vision: MGV-Net Information System <ul><li>All MVP sites </li></ul><ul><li>Common Dictionary </li></ul><ul><li>Integrated Locally </li></ul><ul><li>Automate Reporting </li></ul><ul><li>De-identified Data warehouse </li></ul><ul><li>Connect CHWs/ Community mHealth </li></ul><ul><li>Increase IT capacity </li></ul>
  5. 5. MGV-Net Information System
  6. 7. Comparable and Timely Data Month Year Cases Treated Smears Neg Smears Neg Smears Tx'd (%) 11 2008 308 408 481 455 292 (64.1758) 12 2008 248 251 428 393 176 (44.7837) 1 2009 644 789 514 457 183 (40.0438) 2 2009 541 561 816 728 142 (19.5055) 3 2009 292 343 443 406 79 (19.4581) 11 2008 115 159 175 168 118 (70.2381) 12 2008 97 111 152 136 77 (56.6176) 1 2009 99 108 142 123 56 (45.5285) 2 2009 64 68 161 143 36 (25.1748) 3 2009 43 38 123 115 26 (22.6087)
  7. 8. Status of Implementations (Sauri) <ul><li>Single Laptop as server, 1 additional laptop for data entry </li></ul><ul><li>As of end of March, 2009: </li></ul><ul><ul><li>7,097 patients </li></ul></ul><ul><ul><li>11,833 encounters </li></ul></ul><ul><li>Forms (fields entered/form): </li></ul><ul><ul><li>Adult (~17), Peds (~12), Antenatal (~14) </li></ul></ul>
  8. 10. Status of Implementations (Mayange) <ul><li>WAN with 1 server and 6 workstations </li></ul><ul><li>As of end of February, 2009: </li></ul><ul><ul><li>4,257 patients </li></ul></ul><ul><ul><li>5,026 encounters </li></ul></ul><ul><li>Mostly adults entered </li></ul><ul><li>New peds forms required by gov’t </li></ul><ul><li>No pharmacy yet </li></ul>
  9. 12. Status of Implementations (Others) <ul><li>Bonsasso, Ghana; Tiby, Mali and Potou, Senegal have OpenMRS on a server </li></ul><ul><li>Bonsasso doing vital statistics entry </li></ul><ul><li>Plan full encounter form rollout to Bonsasso, Nigeria and Mbola (Tanzania) this year </li></ul>
  10. 13. Terminology Service Bureau
  11. 14. Status of Terminology Service Bureau <ul><li>Centralized concept dictionary for all sites, with translations of concepts and User Interface messages </li></ul><ul><li>Crossmaps to SNOMED CT, RxNORM and ICD-10. </li></ul><ul><li>Runs on PHP and needs conversion to OpenMRS module </li></ul><ul><li>Needs subsetting </li></ul>
  12. 15. Status of Implementation in Ruhiira <ul><li>WAN across cluster of 6 clinics including one hospital. </li></ul><ul><li>As of April 30, 2009: </li></ul><ul><ul><li>20,000 patients </li></ul></ul><ul><ul><li>29,783 encounters </li></ul></ul><ul><li>Typical Month/Clinic (# of encounters): </li></ul><ul><ul><li>Adults (736), Peds (570), Antenatal (105) </li></ul></ul>
  13. 16. Challenges and Lessons Learned <ul><li>Human Capacity </li></ul><ul><li>Clinician Engagement </li></ul><ul><li>Reliable electricity </li></ul><ul><li>Computers </li></ul><ul><li>Connectivity </li></ul><ul><li>Gov’t Policies </li></ul>
  14. 17. Way Forward <ul><li>IDRC helping to fund eHealth Specialists and additional data entry clerks </li></ul><ul><li>More training </li></ul><ul><li>Better coordination with infrastructure rollout and management of power </li></ul><ul><li>Coordinate with HMN and others to define policies which support eHealth </li></ul>

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