The Ministry of Health and Child welfare recently announced that plans are underway to digitize the country’s medical records. The pilot phase of the project is supposed to be launched in six months’ time with the assistance of both the United Arab Emirates and Estonian governments.
This is welcome, if not long overdue, development considering that paperless record keeping is one of I.T’s earliest promises. It also comes as a bit of a surprise that out of all the ways in which these two generous countries could assist our health care system, they chose a project which some of our own numerous and largely unemployed I.T professionals could arguably put together on their own. On the other hand, most public hospitals cannot afford a “wet floor” sign, much less a team of programmers; therefore I guess it is best not to look this particular gift horse in the mouth.
Electronic record keeping will go a long way in improving our healthcare delivery systems. Of course, a lot of private practices have already adopted it but their systems are largely incompatible with one another which hinders the ability to access patients’ record across different institutions. This new development is essentially the ministry’s blessing of the technology and the system chosen by the government will be the default standard for all health providers increasing the likelihood of compatibility across different providers both public and private.
More efficient record keeping and access
Digital storage allows information to be accessed much faster. Instead of having to search through rows of shelves and cabinets which you can only hope were properly maintained by the previous person, you can just search using the patient’s national identity number or any other suitable identifier. Electronic file storage also significantly reduces the cost of record keeping. Fewer people and storage space are required to store and maintain patient data.
Longevity of records
If such a system is implemented the situation will improve from the present where most of the population is expected to keep its own health records (at home) usually on frail school exercise books. In the rare instances where the institutions actually store their own patient data, they often do so poorly. In order to ensure that paper records last as long as their owners the storage facilities need to have proper climate control after all common paper is not the most durable of materials. Most of our medical facilities cannot afford bandages much less, what is basically, air conditioning for files. It is also common albeit embarrassing knowledge that every now and then our hospitals face rodent problems. Electronic record keeping will ensure that a patient’s medical history is safely stored until such a time that it is actually needed instead of being reduced to confetti in the intervening period.
Consolidation of records
Centralized storage of patients’ records will allow the complete and uninterrupted recording of their medical histories throughout their lifetimes. As I have mentioned above, most public institutions employ a very primitive record-keeping system – an ordinary school exercise book which stays in the patient’s possession. These books are frequently lost and replaced. Unfortunately the same cannot be said about the contents. In the rare situations where the records are stored and maintained by the health service providers, they end up getting fragmented and scattered across several different institutions.
Better tracking and management of outbreaks
Zimbabwe is occasionally affected by cholera and typhoid outbreaks. Most of the time it takes one or two of the infected to die before the authorities realise that there is a problem. Mass digitization of patient data will allow algorithms to be unleashed on the data, which can then detect outbreaks and potential epidemics early on. This can reduce the number of deaths from these otherwise treatable diseases.
Cheaper and efficient public data collection
Collecting data is still a time consuming and labour intensive process. This is because the collectors still have to sift through large stacks of paper records from different institutions. Centralized and digitized record keeping will allow anyone who wants to glean statistics from all this data to do so at the click of a button. In this way data that is crucial for public planning such as child mortality rates, immunisation rates is easily available.
Do we have the infrastructure to support such a system?
Such a system will not only require expensive devices through which to access it but also a reliable internet connection. Internet connectivity is a noteworthy problem in the country since even the service providers themselves appear to regard it a nonessential luxury even though more and more crucial services rely on it. Think about all the times you could not complete a debit card purchase because the “network” was down. Even buying prepaid ZESA tokens in shops at certain times of the day can be a nightmare because of random network outages. It would be a pity if we were to introduce such a system only to revert to writing on paper whenever too many people are on YouTube, congesting the network.
Zimbabweans are not yet as vocal about their privacy as their counterparts from more developed countries. However, I daresay that most people would prefer that their medical histories be closely guided secrets between them and their physicians. This will increasingly become a problem as corporations and other entities try to find ways of exploiting people’s health data. With insufficient legislation to protect people’s information, both the government and the private sector will do their best to get their hands on it for one purpose or another. Just imagine the wealth of data that medical aid and insurance firms can glean from all these records. We can end up with situations where medical aid and funeral policy premiums are not charged consistently across customers but are instead adjusted based on your health data.
We already have some unscrupulous companies which ask unnecessarily intrusive questions about your health as part of the job interview process; I guess they will be trying to minimise the amount of paid sick leave that they will have to fork out in the future. As if this is not enough evidence of how much some people will want access to your health information, we also have some organisations which are currently subjecting poor scholarship applicants to military-style medical evaluations as part of the application process.
In addition, the government of Zimbabwe has in the past openly expressed admiration for the mass surveillance and privacy invasion policies of countries like China and Russia. Clear legal frameworks must, therefore, be put in place and communicated to prevent misuse and exploitation of patient data before such a system is deployed otherwise we are all in for unpleasant surprises in the future.