He@lth 2015 Seamless Continuity of Care Ministry of Health and Quality of Life Government of the Republic of Mauritius He@lth 2015 2 | P a g e He@lth 2015 Contents 1. The eHealth Context 5 2. The Current State of ICT in Health 11 3. Principal Intervention Areas 18 4. Recommended Technology Systems 25 5. The eHealth Action Plan 31 6. Conclusion 33 3 | P a g e He@lth 2015 4 | P a g e He@lth 2015 1. The eHealth Context Healthcare is the world’s most The eHealth revolution is also the key information intensive industry. Every to enhanced protection of privacy. Only Electronic health day the industry produces massive in an electronic world is it possible to information is volumes of data which, properly used, ensure that identifiable patient records fundamental to can improve clinical practice and are accessible to providers on a need- better health services outcomes, guide planning and resource to-know basis. Access to all or parts of delivery, planning allocation, and enhance accountability. an Electronic Health Record (EHR) can and protection of There will be no quantum leap forward be protected, and the identities of in health care quality and efficiency those who have looked at an EHR are privacy, otherwise without high quality, user-friendly known. Such protection is impossible impossible with health information compiled and with paper records, particularly in paper-based records. delivered electronically. hospitals and other institutions. 1.1 The Health Sector in Mauritius The general state of health in of cost throughout the country at the The general state of Mauritius is good- people live longer point of use to all its people. health is good and and fewer children die in their infancy; Mauritius is now life expectancy, in the last 30 years, At primary care level, the state health has increased from 63 years to 71 services have 135 facilities (Including aiming at attaining years and first year infant mortality is Area Health Centres, Medi-clinics, a health indicator 14 deaths for every 1000 live births. Community Hospital and Community levels that can be These indicators are better than those Health Centres) which provide matched only by for developing countries. The rate of medical, nursing, dispensary and developing countries. population growth is also low owing support services at local level. In to sustained governmental efforts and addition, there are 5 regional hospitals general access to educational and and 2 district hospitals with over 2500 employment opportunities. beds. Separate specialist hospitals include a mental hospital with 811 Mauritius is now aiming at attaining beds, and an Eye hospital, an Ear, indicators that are on par with the Nose and Throat hospital, a Cardiac developed world. Centre and a Chest hospital which Health services in together have over 200 beds. Mauritius are OVERVIEW OF CURRENT HEALTH provided free of cost SERVICES The regional hospitals and primary at the point of use to With 856 doctors, 3,000 nurses, about care centres or facilities benefit from a all Mauritians. 56 dentists and 22 pharmacists, health wide range of clinical and non-clinical services in Mauritius are provided free support services including pathology 5 | P a g e He@lth 2015 laboratories, X-Ray, CT scan and MRI, population. It also ensures that the The public healthcare pharmacy, blood collection and health sector is consolidated and that services delivery transfusion, public health and hygiene, the health services remains accessible includes 135 facilities medical records and information to every citizen. at primary level and 5 services, catering, laundry, transport and cleaning. NON-COMMUNICABLE DISEASES regional hospitals and Although in recent years, the 2 district hospitals that PRIVATE SECTOR IN HEALTH infectious diseases of the past have can accommodate over The private sector absorbs over 30% of been largely eliminated, Mauritius now 2500 in-patients. the total expenditure on health and faces growing problems of non- There are several employs over 544 doctors and communicable diseases including heart specialist hospitals in provides primary and secondary disease, diabetes, stroke, cancer, services with 14 private clinics, nearly tobacco and alcohol related diseases addition. 600 beds, 31 private medical and mental illness. The aim is to laboratories and 291 private eradicate the diseases or to contain pharmacists. In a year, the private them at their present low level. The private sector sector has about 77,000 admissions for accounts for over 30% in-patient treatment, undertakes In adults aged thirty and over, 20 per about 30,000 surgical operations and cent have diabetes, 30 percent have of the expenditure on delivers over 2,500 babies hypertension, and 40 percent are health and employs overweight. 42 percent of men are over 540 doctors. THE MINISTRY OF HEALTH AND smokers and 16 percent of adults are QUALITY OF LIFE heavy drinkers. The typical diet in The Ministry of Health and Quality of Mauritius is high on salt and fat and Life (MoHQL) is the agency responsible low on vegetables, fruits and fibre. A high intake of salt for health status of the population. It This pattern of health risks gives rise to and fat coupled with a operates under the portfolio of the an increasing level of NCDs and a low input of Minister of Health and Quality of Life. growing avoidable burden on the vegetables, fruits and The aim of the Ministry is to improve health services. fibre has given rise to the quality of healthcare delivery with an increasing level of a view to increasing patient’s CURATIVE SERVICES satisfaction and enhancing social Greater emphasis than ever before has Non-Communicable equity through the provision of a wider been laid on curative services in the Diseases. range of health services to the whole past two years to bring Mauritius up- THE ISLAND OF RODRIGUES The population of 35,000 of Rodrigues has access to hospital and community health services. Recent improvements in facilities include the introduction of the NCD mobile screening services, an Intensive Care unit for the Queen Elizabeth hospital, haemodialysis services, a physiotherapy unit and a new incinerator for the hospital. The incentives to attract staff to work in Rodrigues have been improved and specialist services expanded with plastic surgery being provided in Rodrigues for the first time this year. 6 | P a g e He@lth 2015 to-date in medical technology for The management of Accident and The health services diagnosis and treatment of disease. Emergency Services has been operate through 5 The principal major projects in reformed to reduce waiting time and regions, each having its progress are the reconstruction of the increase the effectiveness of services own Health Advisory Dr Jeetoo hospital, new outpatients using a triage system of assessment and treatment services at Victoria with a fast track for urgent cases, Board to advise on Hospital, new national centre for elderly and children. Catering, health needs, mental health and regional mental reception, cleaning and complaints effectiveness and health services, extension of the procedures have been improved too. efficiency of services cardiac unit at Victoria and consumer matters. Hospital,reconstruction of Souillac HEALTH SECTOR MANAGEMENT hospital, renovation of health centres, The health services in Mauritius and improvements to catering operate through five regions and with departments. separate arrangements for Rodrigues. The MOHQL is Each region has its own Health responsible for overall CT scan, MRI and nuclear medicine Advisory Board to advise on the health policy, planning and services have been introduced to aid needs of the region, effectiveness and management, resource accurate diagnosis of a variety of efficiency of services and consumer disabling and life threatening matters. The management of the allocation and conditions. High technology treatment regions is the responsibility of regional regulation, together has been expanded to meet growing health directors. The Ministry of with parliamentary needs including a major expansion in Health and Quality of Life (MOHQL) is and international heart surgery at the Cardiac Centre, responsible for overall policy, planning matters. haemodialysis in four regions, and management, resource allocation transplant surgery, lithotripsy for and regulation, together with eradicating kidney stones, cobalt parliamentary and international radiotherapy for cancers and more up- matters. to-date equipment for theatres and Mauritius has a 3-tier intensive care units. healthcare services delivery comprising 1.2 MAURITIUS HEALTHCARE DELIVERY Primary (Area Health FRAMEWORK Centre, Medi-Clinics, The Healthcare delivery framework patients who have direct access to Community Health can be considered at three levels them. They comprise the following Centres, Community Primary facilities Hospitals and Family Secondary Area Health Centre Health Clinics), Tertiary Medi-Clinics Secondary (Regional Community Health Centres and District Hospitals) PRIMARY HEALTHCARE PROVIDERS Community Hospitals The primary healthcare providers are Family Health Clinics and Tertiary usually the first points of contact for (Specialized Hospitals) 7 | P a g e He@lth 2015 SECONDARY HEALTHCARE PROVIDERS TERTIARY HEALTHCARE PROVIDERS The secondary healthcare providers The tertiary healthcare providers are are usually the first referred points of usually the second referred points of contact for patients. However, in case contact for patients. However, in case of emergency
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