Digital Health Technology in Suriname Being Used to Manage Patients in Remote Communities

With the support of a PAHO/WHO grant for Information Systems for Health (IS4H), a new solar-powered, web-based patient management information system has been developed by Medical Mission (MM). This NGO has provided for the past decades primary health services to very remote communities in the Suriname hinterland.

The digital and mobile health technology system will link and track patients who receive health services from the MM's 50 clinics. Also the system will enable an improvement in the quality of data used for decision making by their health care providers and program managers. When fully operational, it will allow real time data to be collected, registered and reported. Additionally, the system will facilitate more prompt and efficient action in response to public health emergencies and disasters.

Leah Richards, HSS Advisor of PAHO in Suriname monitors new digital technology to manage patients

Medical Mission's project was one of the winners of the call for proposals for the implementation of IS4H projects promoted by the Pan American Health Organization.

The MM patient management information system contains 5 modules: electronic medical records (EMR), drug management, laboratory services, patient waiting room management and consolidated health reports. The EMR provides the medical doctor, who in general is not on location, access to patient records whenever needed, while the drug management module monitors drugs dispensed to each patient as well as overall stock at each clinic. Through the laboratory module, patient data is linked with results from lab tests. The patient waiting room module gives an overview of the number of patients in the waiting room and their average waiting time, while consolidated health reports for each clinic can also be retrieved from the information system. A mini webserver will be installed at outpatient clinics and the server will be connected to a host, based at MM's central office in Paramaribo.

The aim is to provide as many of the 50 outpatient clinics in the districts and the interior with this new information system. "We currently have a data system…," says Melvin Uiterloo, Public Health Officer of MM. "in which all 50 clinics e-mail part information to us, we print it out and re-enter it in the computer. So we do not make good use of our human resources. We came up with the idea of having people in the field enter the information directly into a web-based system. Now it is possible to record patient data. The doctor can see more often what is going on, even if the patient comes to Paramaribo. We now have a better view of how the delivery of medicines is and how much medicines to order each month and to which outpatient clinic they should be sent. We have a better management system, we have insight into which lab tests have been performed," says Uiterloo. He sees the new information system as an opportunity to improve the service to people in the interior of Suriname.

In November 2019 Ms. Leah-Mari Richards, Advisor, Health Systems and Services of PAHO Suriname made a project monitoring trip regarding the implementation of this new digital health technology (web-based patient management information system). She was accompanied by the project led Mr. Uiterloo. The first field-testing of the information system was done in two indigenous peoples villages: Powakka and Pikin Saron in the district of Brokopondo, approximately one and a half hour's drive from Paramaribo. The patient waiting room of Pinkin Saron was crowded, because the doctor paid a visit. The villagers were waiting patiently for their turn to be helped by the Health Assistants who are under the supervision of a doctor and are trained to work with the system.

Both the Health Assistants of Pikin Saron and Powakka faced some challenges with entering the data on an Ipad charged by solar panels. "We use low voltage devices because we have solar panels and an inverter. That's why we cannot install a computer, but only use iPad that uses less power," Uiterloo explains. Ms. Rieneke Joghie, health assistant in the village of Pikin Saron is not that handy with the system yet. "Sometimes the iPad is stuck and then I need a little more time to search patient data. Certain people cannot wait and leave. Eventually they will come back. For the rest it works. It is a matter of getting used to it". On site, Uiterloo showed the health assistants how to operate the system efficiently.

Richards, was pleased with the progress thus far in implementing the system. "What we have found through this grant is the need to approach implementation slowly – testing the system and how it functions with internet connection and electricity issues, but also, testing the receptivity of this new way of working among the staff of Medical Mission. We are taking time to train the staff to operate the system so that over time, they can capture the data in a faster way," says Richards, elaborating further on the health information system and what she has seen in the field.

This support to Medical Mission in the area of IS4H is instrumental to the wider transformation that is underway at a national level to use technology more efficiently, to capture data, track patients, and improve overall patient management in Suriname. Medical Mission's project was one of the winners of the call for proposals for the implementation of IS4H projects promoted by the Pan American Health Organization.