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Increasing Healthcare Delivery by 270% to Underserved Communities

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Increasing Healthcare Delivery by 270% to Underserved Communities WHITE PAPER Digital Health Intel® Health IT Value Model (HITVM) for Developing Nations Intel® Atom™ Processor-Based Netbook PCs Increasing Healthcare Delivery by 270% to Underserved Communities Using a Scalable ICT Solution A practical, disciplined approach that increases capacity and optimizes resources has moved beyond its pilot phase and is scaling successfully In Nigeria, mobile healthcare Challenge: Reaching Rural maternal health) and 6 (combat HIV/AIDS, Populations with Limited Resources malaria, and other diseases).1 But within teams armed with innovative, The healthcare challenges presented the Federal Capital Territory (FCT), appropriate ICT expand health- by communicable diseases, increasingly residents of over 800 villages had little or no access to primary healthcare. Health care capacity and increase high rates of chronic diseases, and aging populations present formidable difficulties officials struggled to measure the impact healthcare delivery to under- for middle- and low-income countries, es- of health programs and to optimize the severely constrained healthcare worker served rural and urban areas and pecially considering the limited healthcare resources available. These countries will resources available. There was minimal boost disease reporting rates. see elderly populations increase four-fold capability to gather and use healthcare data in a timely manner to recognize Since the pilot phase proved to 813 million by 2015. While developing nations struggle to meet healthcare-relat- disease trends and act quickly to alleviate effectiveness and efficiency ed Millennium Development Goals (MDGs), problems (such as disease outbreaks) or mobilize the appropriate resources by increasing patients seen by 80 percent of deaths in these areas are due to chronic disease. In Africa, Sub- where needed at the right time. 270% and disease reporting by Saharan nations are hardest hit and, with- Regional officials estimated that adequately 900%, it’s been successfully out healthcare reforms that build greater serving the population would require 434 capacity and access to services, are subject Primary Health Centers (PHCs), but only scaled to include more mobile to wide-reaching negative social and 179 existed, many of which were operat- teams, more communities, more economic implications. ing at sub-optimal levels or located long distances from rural populations. Such a primary healthcare clinics, In early 2009, the Nigerian Federal Capital Territory Millennium Development Goals large expansion of the number of tradi- more hospitals, and more trained Unit (FCTMDGU), health officials, and Intel tional PHCs was clearly cost prohibitive. Effectively meeting MDGs and treating clinicians—now reaching over Corporation began discussing ways that Information and Communication Technol- chronic illness would require a very dif- 400 communities and expanding ogy (ICT) could be used to improve health ferent approach, and it was clear that ICT could play a major role if it could be to 113 Local Government Areas. and healthcare delivery in rural areas. The FCTMDGU was committed to pursuing effectively implemented to deliver a improvements in Millennium Development more cohesive continuum of care. Goals 4 (reduce child mortality), 5 (improve Increasing Healthcare Delivery by 270% to Underserved Communities Using a Scalable ICT Solution These discussions led to the Mailafiya • Utilize standards and open source Health Program, a public-private partner- technologies wherever feasible, to ship between the FCTMDGU and Intel keep costs down and enable easy scaling Corporation. Mailafiya, which means of successful solutions. “Giver of Health,” is a strategic program • Link any new services or capabilities that harnesses ICT to increase access to to the existing public health services health services for rural and under-served structure, to maximize effectiveness urban populations in districts surrounding and minimize adoption costs. Abuja. “We knew that we had challenges in meeting the Millennium Development • Clearly define project outcomes and Goals 4, 5, and 6,” says Isa Ari, coordinator timelines for all internal and external of Millennium Development Goals for the stakeholders. FCT. “Even collecting baseline data was With these strategies in place, the FCT difficult. So we asked our team, how can Conceived to address the and Intel team began designing what we innovate to achieve these goals? The would become a mobile PHC services health services delivery resulting Mailafiya Health Program is a delivery system that was well integrated complete health delivery service using needs of the remote, poor into the existing PHC system. ICT that can reach the poor effectively. communities and to fast Even in the pilot phase, the program Maintaining Focus on the reached 336 communities.” Due to the track progress on Millennium Right Objectives and Building program’s success in the pilot phase, an Effective Solution Development Goals 4, 5, it has subsequently been expanded and 6, the Mailafiya Health to 90 more communities. The Mailafiya Health Program initially con- sisted of six mobile medical teams, each Program is showcasing the Using ICT in a Carefully composed of a doctor, a nurse, a commu- positive impact that ICT Designed Program to Address nity health worker, and a driver. (After the Health Disparities completion of the pilot phase, 6 additional can make on improving mobile teams were added.) In addition to In determining how ICT could best be off-road trucks, basic healthcare tools, healthcare delivery. applied to Nigeria’s healthcare challenges, and drug kits, each team is equipped with the FCT and Intel took a careful approach cost-effective Intel-powered netbook PCs to analyze and design an appropriate pro- and software that enable data collection gram to ensure that objectives were clear, into an Electronic Health Record, including any solutions would be scalable, and suc- patient IDs and patient pictures captured cess metrics were well defined upfront. A using the Intel-powered PC’s camera. The number of key strategies were identified: teams also carry an automated lab system • Base plans on a robust value model. for on-site diagnosis and treatment plan- To establish appropriate objectives and ning. These ICT tools help teams improve keep program design focused on them, drug dispensing, treatment follow-up, and planners utilized the Intel® Health IT Value referrals. The improved data flow enables Model (HITVM) for Developing Nations.2 the right healthcare interventions at the The Intel HITVM helped planners choose right time and has revolutionized the way from established value categories to healthcare is being delivered to under- achieve agreement on key objectives served urban and rural areas. Instead of that were aligned to healthcare- the FCTMDGU working on inaccurate, lag- relevant MDGs. ging indicators, more accurate and timely healthcare data has greatly improved • Standardize on Electronic Health delivery of healthcare services and optimi- Records (EHR) and Electronic zation of resources in these communities. Registries for reporting MDG This means significant improvements in performance, to reduce costs over the allocation of healthcare workers and time and greatly improve data quality and availability. 2 Increasing Healthcare Delivery by 270% to Underserved Communities Using a Scalable ICT Solution medications to communities based on near Millennium Development Goals MDG KPIs real-time data regarding community needs and health profiles. MDG 4: Child Mortality Children under five mortality rate • Number of cases of guinea worm disease identified Each facet of the program was carefully per 1,000 live births • Increased number of cases identified where child is designed to maximize both effectiveness suffering from malnutrition and extensibility: • Percent increase in birth weight of infants recorded • Percent of babies who are administered the DPT Project scope, milestones, and dura- (Diphtheria, Pertussis and Tetanus) tion. The program team used the Intel HITVM as a means to determine the Children one-year old immunized • Number of vaccines administered per day against measles • Percent of children identified with measles program’s focus, scope, and milestones. • Number of children referred to secondary care Not only did this guide the project’s development, but it also enabled the clear MDG 5: Maternal Health presentation of the program’s value to Maternal mortality rate per 100,000 • Number of births recorded both internal and external stakeholders. live births • Number of births where a midwife or clinician A proof-of-concept duration of one year was recorded as present was selected with a view to roll out on a • Percent of planned deliveries recorded national scale if successful based on pre- MDG 6: Disease agreed objectives and success metrics. Tuberculosis prevalence rate per • Number of patients referred from primary care 100,000 population Community leader involvement. Using • Percent increase in tuberculosis cases identified the Intel HITVM as a basis, workshops People living with HIV, 15-49 years old, • Percent increase in people educated on safe were held with various stakeholders percentage sex practices including internal stakeholders (such as • Number of condoms distributed • Number of new HIV/AIDS cases identified Ministry of Health and FCT officials) and external stakeholders (such as village tribal Figure 1: Key Performance Indicators for Millennium Development Goals 4, 5, and 6 leaders and participating
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