View this page "Q1: How do you use data?"

[mspohr]

Please take a few minutes to tell us how you use your EMR data?

Click on http://groups.google.com/group/emr-data-use-workshop/web/q1-how-do-you-use-data
- or copy & paste it into your browser's address bar if that doesn't
work.

[Andrew Mugisha]

EMR data is used first of all as a bac up to thepaper data in patient files and can be retreved for any clarifications. Monthy/ Bi-monthly/quarterly/ and annual M&E reports are all compiled using EMR-Data, Specific patient data analysis to show trend whetherethere is improvement or not for example The CD4 count before atart onART and after, it is expected that CD4 count would increase after start of ART with time nomarlly. so contrally to this would indiate further investigaton e,g adherence factors etc..., EMR-data is also used for Logistics supply and Drug stock infromation so Logistics reports are compied using EMR-Disensing data...., Progress reports and activity, Adherece trends and all much more data analysis is made possible using EMR-data...

Andew

[mspohr]

We have received good response to the questionnaire so I thought you
might like to take a look at what people have entered. There is some
very interesting material for discussion here.


Click on http://groups.google.com/group/emr-data-use-workshop/web/q1-how-do-you-use-data?hl=en

[Alim]

Dear all,

You will have received a welcome message from Mark Spohr already, and
an invitation to answer a few questions on a Google form. Thanks to
those who've completed the form already; for those who haven't, your
inputs are needed! Click on http://groups.google.com/group/emr-data-use-workshop/web/q1-how-do-you-use-data

- or copy & paste it into your browser's address bar if that doesn't
work.

For those of you who haven't participated in a workshop with us
before, I'd like to take this opportunity to brief you on some
important differences from other events you may have attended.

First, the workshop takes place in Dar Es Salaam from 9-11 December,
but our preparations begin via wiki and mailing list interaction NOW,
so that we can make the most of our limited time together in Dar.

You may have heard of "unconferencing", or "barcamp" approaches to
meetings. Our approach is similar, being heavily interactive and
participant-driven: much of the agenda as well as the content will be
generated by you. Therefore your active participation (and
preparation now) is not only welcome, it makes the workshop happen.

We prefer to keep presentations to a minimum, both in number and
duration. Learning happens much faster, and better, with the chance
to engage with each other and the content. While you've been asked to
put some powerpoint slides together, we will draw on them for the
workshop in short, sharp ways, mostly in smaller breakout groups. And
some ideas will break out to the entire group as well.

If you haven't done so already, help us and your fellow participants
to get the workshop preparations off the ground - let's start off by
completing the Google form. We'll be collating and sharing responses
with you, for further development of topics and input.

kind regards
on behalf of the workshop organizers
Alim

--
Alim Khan
World Health Organization
Geneva, Switzerland

[oyo]

Hello,
Makerere University Walter Reed Project (MUWRP) works withing the
Ministry of health (MOH) setting in Kayunga district of Uganda. Data
generated from the MOH sites are used be both MOH and MUWRP. Periodic
data retreaved from patient registers is used for monitoring of
activity, planning, and desision making both at MOH and MUWRP. MUWRP
however uses the same data to account for the financial support
recieved from PEPFAR during the financial year.

The use of an EMR will ease the process of report generation.
Alfred

[carabin]

Is it possible for this year to share again on "Patient
Identification" ?
Thanks

On 18 nov, 16:18, Alim <Kh...@who.int> wrote:
> Dear all,
>
> You will have received a welcome message from Mark Spohr already, and
> an invitation to answer a few questions on a Google form. Thanks to
> those who've completed the form already; for those who haven't, your

> inputs are needed! Click onhttp://groups.google.com/group/emr-data-use-workshop/web/q1-how-do-yo...

[Denis Kaffoko]

it would be good to share about patient identification but with  more emphasis on double deeping,for those on drugs (ART) and maybe how unique numbers can work like in the whole country,if the patient in one clinic is on ART his/her id in unique for the client in the whole country and and the numbering is systematic inthe whole country
thankz

--
Denis Kaffoko
+256 782763811
+256 712510064
Data manager
IDC
Mbale Regional Hospital

[William Watembo]

Just a quick reply.

In Kenya, it started off with the 11-digit code for VCT and which has
been adapted for HIV/ART as follows. 0-12-345-67901 where the first
digit represents Province (1 to 8), the next two represent the
district, the next three represent the facility code and the last 5
represent the individual patient code and this ID stays unique for the
patient for ever. However, you can appreciate and anticipate the
confusion brought about when patients transfer out to another facility
and also from the fact that this system is limited to government
facilities only. I believe the same system applies in Uganda.

[jules bashi]

Thanks for response, William i think the best to evoid problem it's preferable to keep the same code when transterring patient to another facility and use a symbol which can show that it's about a transfered patient. Dans le désert, on peut toujours tomber sur une oasis ====================================== Jules BASHI B., MD, MPH, Infectious Disease and Tropical Medecine (Resident) Expert in Health Information System  --- En date de : Jeu 20.11.08, William Watembo <wat...@gmail.com> a écrit :

[Denis Kaffoko]

Hello

 

This is good,to tell honestly Uganda as a country had failed to develop a unique patient ID

but with this idea am going to sell to them,yes i see challanges with it,when it comes to transfering to another facility mainly,another thing if i may ask,does each facility level based clinic start numbering from 1,2.........n,then another facility does the same or there is some specific way,

 

Because if am to apply it in Uganda,for example we don't have provinces but we have regions,so i would start with the region code,then put the district code,then put the facility initials/code right then put the patient number,i honestly see this can work for my country,yes there are many facilities offering ART services but each can develop a three code identification,

 

hah another challange,there are clients who register in two different faclitities for the same services

how do you handle these?

 

otherwise this is good stuff.

 

thanx

 

[Denis Kaffoko]

Hello

Jules says the patient should keep the original ID when transfered to another facility but use a symbol,

yes this can work,but please elaborate more on this,how can we practically implement this,

 

for example,if say client is transfered to like 5 clinics,so this client has passed through all these clinics,how should this symbol be used to reflect all the clinic the client has passed through without changing the orignial ID

codes?

 

thanks

Denis

[EagleWings]

Hello Jules and William,
Kindly permit me to join into your discussion. In Nigeria, our IP
started a project using 11-lettered code consisting of alphabets and
numbers, as patient unique ID. For instance, we have CRS-002-00025.
This meant a client in Cross River State the next secondary facility
after the only tertiary facility in the state (001 - tertiary facility
like the teaching hospitals and federal medical centres, 002, the
secondary facilities like the general hospitals, and 003 code for
Primary Health Centres). Actually our IP (implementing partner) has
been given mandate by the Government of Nigeria (GON) through the
national planning commission to intervene in secondary and primary
health centres. Currently only the secondary sites offer ART and have
ART unique IDs. The PHCs are only giving PMTCT Prophylaxis so far.
This unique ID remains with the client wherever the client is
transferred to; whether a facility supported by our IP or not.
If I may ask, have you had challenges with numbers when different
service delivery points assign their own unique numbers too? For
instance, the client gets a Unique ART ID, and then the pharmacy
assigns theirs, the lab assigns theirs, VCT assigns theirs?

Thanks & Kind Regards,
Shehu

On Nov 20, 3:53 pm, jules bashi <julesba...@yahoo.fr> wrote:
> Thanks for response,
> William i think the best to evoid problem it's preferable to keep the same code when transterring patient to another facility and use a symbol which can show that it's about a transfered patient.
>
> Dans le désert, on peut toujours tomber sur une oasis
> ======================================
> Jules BASHI B., MD, MPH,
> Infectious Disease and Tropical Medecine (Resident)
> Expert in Health Information System 
>

> --- En date de : Jeu 20.11.08, William Watembo <wate...@gmail.com> a écrit :

>
> De: William Watembo <wate...@gmail.com>
> Objet: [EMR Data Use] Re: Reminder: EMR Data Use Workshop - What do you need?
> À: emr-data-u...@googlegroups.com
> Date: Jeudi 20 Novembre 2008, 15h39
>
> Just a quick reply.
>
> In Kenya, it started off with the 11-digit code for VCT and which has
> been adapted for HIV/ART as follows.  0-12-345-67901 where the first
> digit represents Province (1 to 8), the next two represent the
> district, the next three represent the facility code and the last 5
> represent the individual patient code and this ID stays unique for the
> patient for ever. However, you can appreciate and anticipate the
> confusion brought about when patients transfer out to another facility
> and also from the fact that this system is limited to government
> facilities only. I believe the same system applies in Uganda.
>

> On 20/11/2008, Denis Kaffoko <deniskaff...@gmail.com> wrote:
>
>
>
> > it would be good to share about patient identification but with  more
> > emphasis on double deeping,for those on drugs (ART) and maybe how unique
> > numbers can work like in the whole country,if the patient in one clinic is
> > on ART his/her id in unique for the client in the whole country and and
> the
> > numbering is systematic inthe whole country
> > thankz
>

> > On Thu, Nov 20, 2008 at 2:01 PM, carabin <julesba...@yahoo.fr>

> > Denis Kaffoko- Hide quoted text -
>
> - Show quoted text -- Hide quoted text -
>
> - Show quoted text -

[Kolawole Falayajo]

Institute of Human Virology, Nigeria (and IP in Nigeria) supports 38 ART sites across 23 states. The Federal Ministry of Health in collaboration with other IPs developed a format for unique ID for patients that are enrolled in ART sites across the country. This is the 11 alphanumeric code that Shehu mentioned. The first is the state code which basically borrows from the state code that is already being used by the Federal Road Safety for vehicle number registration. The second part is a unique facility code. There is no formal directive from the FMOH on what these codes are for all facilities in the country. We decided to assign codes to facilities that we support in serial order of activation. In other words, the first facility that we began to support in 2005 is given the facility code 001, the second is given 002 and so on..

 

The third part of the ID is a serial enrollment number which is assigned to patients serially as they enroll. This has worked for us so far. The idea behind having a unique ID for a patient in a National ART program is to be able to uniquely track that patient in any facility in the country and strengthen the network and referral system. But in a case where the unique ID is not yet finalized nationally, it will be difficult for a client to retain that ID when transferred to another facility (even though that is the best and required in an integrated national electronic system)

 

In our expérience other IDs may be assigned at different service points in the facility, but it is the unique ID given at enrollment by the M&E unit that identifies the patient regardless of the other lab / pharmacy IDs. Thank you.

 

Kolawole Falayajo

[Whitaker, Patrick]

Building intelligence into identifiers is considered a practice prone to breakage and compromised security.  If the issue is insuring uniqueness, perhaps a solution is generating the numbers centrally with local patient assignment. A USG summary of identifier issues, albeit dated, is available here:

 

http://www.ncvhs.hhs.gov/app0.htm

 

Patrick

Patrick Whitaker
Technical Officer
Health Care Informatics Unit
Health Statistics and Informatics Department
World Health Organization

Tel. direct: +41 22 791 1372
E-mail: whit...@who.int

 

---

From: emr-data-u...@googlegroups.com [mailto:emr-data-u...@googlegroups.com] On Behalf Of Kolawole Falayajo
Sent: 20 November 2008 18:38
To: emr-data-u...@googlegroups.com
Subject: [EMR Data Use] Re: Re : [EMR Data Use] Re: Reminder: EMR Data Use Workshop - What do you need?

[jules bashi]

The Idea of unique ID is good and really easy to manage (even if the patient is transfert, the transfert information can be capture in other variable in the patient data). Onather problem is have we to generate the ID patient at the central level or can we conceive the possibility "decentralization" of ID attribution?

Dans le désert, on peut toujours tomber sur une oasis ====================================== Jules BASHI B., MD, MPH, Infectious Disease and Tropical Medecine (Resident) Expert in Health Information System

--- En date de : Ven 21.11.08, Whitaker, Patrick <whit...@who.int> a écrit :

[Amenye, Essau [Constella Futures]]

That sound good however on Tanzania Strategic Information aspect in particular AIDSRelief supported Local Partner Treatment facilities are using NACP CTC2 Database (MS Access) which has the Identifiers for data export into CTC3 database which used to, merge the entire Database for all Local Partner Treatment facilities which are providing HIV/AIDS Services at Central Level. Through the use of Identifier all name and key Personal information are removed automatically as part of System Security.

 

Best Regards

__________________

Essau H. Amenye,

Deputy Strategic Information Advisor, 

AIDSRelief Project,

SRA International

(formerly Constella Group, LLC)

Box 7523,

Arusha, Tanzania

Mobile Number: +255755979598
Email: eam...@constellagroup.com

Website:http://www.constellagroup.com

 

 

 

---

<BR<BR

[Jackson Kubuke]

The patient identification, it is very easy by linking the codes with the one collated from National Bureau of Statistics. More will be shared during the workshop.
 
Thanks,
 
Jackson Kubuke 

 

 

---

Date: Thu, 20 Nov 2008 14:53:04 +0000
From: jules...@yahoo.fr
Subject: [EMR Data Use] Re : [EMR Data Use] Re: Reminder: EMR Data Use Workshop - What do you need?
To: emr-data-u...@googlegroups.com

[Bailey, Christopher]

Colleagues,

 

Clearly the issue of patient identification has emerged as an important area of interest and priority to a number of participants.

 

May I suggest that we create some time in the agenda of the meeting itself to take a deeper look at the issue?  May I further suggest that we consider the following aspects for deeper discussion?

 

1)       What are the data use implications of how patient identifiers are constructed?  What are beneficial uses?  What are inappropriate uses?  How can the ID be constructed to prevent inappropriate uses?

2)       So far, the main reasons that have emerged for using geographical and/or facility information in the construction of the identifier itself has been around the difficulty of managing number creation in a centralized way at the national level.  To take the contrarian view, are there examples when patient IDs have been successfully managed centrally at the national level without any identifying elements in the construction of the number itself?  Was this in an African setting?  If not, do the same principles apply?

3)       Do we also need to look at other forms of identifiers?  Facilities? Health services? How do personal IDs relate to other national ID efforts outside of the health sector?

 

Others?

 

I look forward to getting down to the details of peoples' different experiences once we are in Dar.

 

Cordially,

 

 

Christopher Bailey

Health Care Informatics

World Health Organization

 

---

</html

[William Watembo]

I believe Christopher has summarised the problem in a very concise
way. This is definitely going to be an interesting topic. In most of
the settings I have been, EMRs are used side by side with the
paper-based systems (at least at the national level). Anyway, more in
Dar..

[Joshua A. Kayiwa]

Hi all,

 

This is definitely a lively topic - concerning unique identification of patients. My strong conviction is that the initiative of  uniquely identifying the same patient accross clinics and service providers has will best come from the top - and preferably our Ministies of Health. We can get testimonies of countries that have implemented this successifully in Dar, but as Denis said, it has not yet been successiful in Uganda. Our practice has only been implemented at institutional level so far and this best benefit instutions with multi-sites accross the nation.

 

Hope to catch up with all of U guyz in Dec

 

 

Joshua

--
=========================
Joshua Abens Kayiwa

[Eagle Wings]

Thanks a lot Chris, for bringing this up,

   The issue of clients/patients on care and treatment getting "lost to followup" is a big challenge.  I believe you have concisely highlighted the issue we need to address by this.  We have had a challenge of intelligent clients "beating" this identification codes we endeavour to bring up.  One of the aims is security and accountability of clients being cared for.  We have had clients collecting ART drugs at two or more different sites because they registered under different names and different unique IDs.  These clients invariably cause shortages in resources available for those in need.  I believe we also need to incorporate security features like fingerprints or iris patterns to these patient identifiers - even thought it will be tasking and expensive.  What do you think?

 

Thanks again,

Shehu

Senior M&E Officer

GHAIN Project

Calabar

 

[Connected Thinking]

Shehu:
I noticed Desktop Virtualization is make strides in Ghana. You may
want to leverage that for you issues with Patients records i.e
a) Desktop Virtualization
Packaged desktop virtualization solution designed for the enterprise,
will enables your organizations to allow employee-owned laptops and
remote unmanaged personal computers to connect to the corporate
network through a fully locked down virtual desktop that does not
require additional servers. With an emphasis on enterprise security
and end-user usability, Virtual Desktop addresses the risks and
challenges that unmanaged computers present for network
administrators. desktop virtualization solution allows an unmanaged
computer to access corporate resources only through a secure
virtualized environment. Most importantly, when connected to the
enterprise, computers running desktop virtualization solution become
managed devices on the network, allowing the enforcement of corporate
security policies, thereby improving the overall security posture of
the organization.
b) Instant Access Capability : I.e having physicians have some sort
of badge or other caregivers can roam throughout a defined work area
and sign on to different workstations simply by tapping their passive
proximity badge against a workstation reader. This method can be easy
to adopt because it leverages the same badge that organizations use
for physical access. Caregivers can now use one badge for entry into
the parking lot, building access, as well as single sign-on to their
workstation.(smart card would work but maybe expensive)
c) SSO (Single Sign-on) : Delivers caregiver productivity and
satisfaction by making single sign-on virtually transparent within
existing workflows.


Titus Ngeno
Software Architect
Titus...@Gmail.com

On Nov 29, 2:19 pm, "Eagle Wings" <eagle.wing...@gmail.com> wrote:
> Thanks a lot Chris, for bringing this up,
>    The issue of clients/patients on care and treatment getting "lost to
> followup" is a big challenge.  I believe you have concisely highlighted the
> issue we need to address by this.  We have had a challenge of intelligent
> clients "beating" this identification codes we endeavour to bring up.  One
> of the aims is security and accountability of clients being cared for.  We
> have had clients collecting ART drugs at two or more different sites because
> they registered under different names and different unique IDs.  These
> clients invariably cause shortages in resources available for those in
> need.  I believe we also need to incorporate security features like
> fingerprints or iris patterns to these patient identifiers - even thought it
> will be tasking and expensive.  What do you think?
>
> Thanks again,
> Shehu
> Senior M&E Officer
> GHAIN Project
> Calabar
>

> >  ------------------------------
>
> > *From:* emr-data-u...@googlegroups.com [mailto:
> > emr-data-u...@googlegroups.com] *On Behalf Of *Jackson Kubuke
> > *Sent:* 24 November 2008 14:25
> > *To:* 345 234
> > *Subject:* [EMR Data Use] Re: Re : [EMR Data Use] Re: Reminder: EMR Data

> > Use Workshop - What do you need?
>
> > The patient identification, it is very easy by linking the codes with the
> > one collated from National Bureau of Statistics. More will be shared during
> > the workshop.
>
> > Thanks,
>
> > Jackson Kubuke
>

> >  ------------------------------

>
> > Date: Thu, 20 Nov 2008 14:53:04 +0000

> > From: julesba...@yahoo.fr

> > Subject: [EMR Data Use] Re : [EMR Data Use] Re: Reminder: EMR Data Use
> > Workshop - What do you need?
> > To: emr-data-u...@googlegroups.com
>
> > Thanks for response,
>
> > William i think the best to evoid problem it's preferable to keep the same
> > code when transterring patient to another facility and use a symbol which
> > can show that it's about a transfered patient.
>
> > Dans le désert, on peut toujours tomber sur une oasis
>
> > ======================================
>

> > *Jules BASHI B., MD, MPH,*

>
> > Infectious Disease and Tropical Medecine (Resident)
>
> > Expert in Health Information System
>

> > --- En date de : *Jeu 20.11.08, William Watembo <wate...@gmail.com>* a
> > écrit :

>
> > De: William Watembo <wate...@gmail.com>
> > Objet: [EMR Data Use] Re: Reminder: EMR Data Use Workshop - What do you
> > need?
> > À: emr-data-u...@googlegroups.com
> > Date: Jeudi 20 Novembre 2008, 15h39
>
> > Just a quick reply.
>
> > In Kenya, it started off with the 11-digit code for VCT and which has
>
> > been adapted for HIV/ART as follows.  0-12-345-67901 where the first
>
> > digit represents Province (1 to 8), the next two represent the
>
> > district, the next three represent the facility code and the last 5
>
> > represent the individual patient code and this ID stays unique for the
>
> > patient for ever. However, you can appreciate and anticipate the
>
> > confusion brought about when patients transfer out to another facility
>
> > and also from the fact that this system is limited to government
>
> > facilities only. I believe the same system applies in Uganda.
>

> > On 20/11/2008, Denis Kaffoko <deniskaff...@gmail.com> wrote:
>
> > > it would be good to share about patient identification but with  more
>
> > > emphasis on double deeping,for those on drugs (ART) and maybe how unique
>
> > > numbers can work like in the whole country,if the patient in one clinic is
>
> > > on ART his/her id in unique for the client in the whole country and and
>
> > the
>
> > > numbering is systematic inthe whole country
>
> > > thankz
>

> > > On Thu, Nov 20, 2008 at 2:01 PM, carabin <julesba...@yahoo.fr>