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Collaboration in Healthcare - Everyone Matters



"Neil Jordan, Worldwide General Manager of the Health Industry for Microsoft. Doctors, specialists and other healthcare professionals need to be able to share the most up-to-date information, whether they are in a hospital or clinic, treating a patient, travelling between facilities or teleworking. They need communication and collaboration tools that help them connect with each other and with critical information to improve their performance and reduce errors."


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“make them use it” is not a valid EMR adoption strategy



"Of course we are all aware that a traditional EMR rollout is a huge financial commitment (thus raising the financial risk considerably, in addition to the operational risk of upending the healthcare organisation for a minimum of two years while the project is implemented). In many cases, those risks are well flagged and whilst typically underestimated, they have at least been given strong consideration. However the biggest risk to such a project is usually one that doesn’t receive much attention – user adoption"


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EMR Implementation – Big Bang or Phased Approach?



"One question that we have come across with clients time and time again is “How should we implement an EMR?” This usually refers to whether a hospital should take a Big Bang approach to the implementation of Electronic Medical Records or phase it in over time. One of the largest concerns with hospital management during the implementation of an EMR are..."


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The Impact of Civil Registration in Developing Countries

The Impact of Civil Registration in Developing Countries

“To make people count, we first need to be able to count people,” – Dr. Lee JongWook, Director General, World Health Organisation (WHO)

Author: Guest Contributors/Monday, August 15, 2016/Categories: Insights

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The impact of civil registration on a country’s population is difficult to overstate. At the personal level it establishes and protects an individual’s legal identity. Without the relevant documentation a citizen would struggle to open a bank account, vote, access health, education and social services. At the state level, civil registration and central statistics determine planning for and analysis of these services. And yet, approximately 230 million children worldwide are unregistered – primarily in sub-Saharan Africa, Asia & the Pacific. According to the World Health Organisation, more than 100 developing countries lack adequate systems to register births, deaths and marriages.

“To make people count, we first need to be able to count people,” – Dr. Lee JongWook, Director General, World Health Organisation (WHO).1

Each facet of registration goes beyond its immediate effect, having both a primary and secondary level of impact. Birth Registration not only confers legal identity to a child but assists in protecting children from human trafficking, protects girls from early/forced marriages, helps to determine refugee status and grants children humanitarian assistance. In many countries a child will be unable to sit secondary school level exams or be tried appropriately as a juvenile in the justice system without this proof of age.

The registration of deaths with characteristics and causes empowers national bodies to combat specific disease. For example, in South Africa births and deaths have traditionally been documented thoroughly in terms of numbers but this data neglected to include cause of death. “Once this shortfall was remedied, it led to a shift of policy with respect to responses to HIV/AIDSs.”2 Similarly, adequate registration can assist in combatting maternal mortality –a leading cause of death among adolescent girls in developing countries (WHO) – and infant mortality rates. The secondary impact of adequate death registration is the legal rights it grants remaining family members such as inheritance, property or custody rights. The property and custody rights of women in particular are also deeply impacted by marriage and divorce registration.

And yet, we’ve only touched on the effect that the full cycle of civil registration has on a country’s population and the individual citizens. “Complete civil registration allows Governments to more quickly and effectively manage problems of citizens affected by natural disasters, conflict, internal displacement and refuge. It will also allow better analysis of and policy formulation to address issues of marginalisation and social exclusion of certain groups in society.”3

The Drive to Modernise

Without a centralised, computerised registration system a given government is forced to rely on citizens to provide their personal data at each ad hoc point and time of contact with a public authority. As a result, data gathered can be of poor quality, inaccurate or contradictory.

“Moreover, it is, for example, not possible to compile optimum nationwide statistics for development and planning purposes. The establishment of a centralised civil registration system is thus the basis for the creation of a streamlined and rational administrative infrastructure. This enables the public authorities to give the citizens the best possible service.”4

The challenges associated with the modernisation of civil registration in developing countries have led to (among other international conferences on the topic) three Conferences of African Ministers Responsible for Civil Registration, supported by the World Bank and WHO. As a result of these conferences, as well as ongoing analysis, one primary goal was established by the WHO & World Bank Group in the Scaling Up Investment Plan 2015-2024: the universal civil registration of births, deaths (to include cause of death), vital events and access to legal proof of registration by 2030. Along with this goal, the following targets have been set:5

Vitro Software - WHO & World Bank Group in the Scaling Up Investment Plan 2015-2024

Recommendations by The United Nations for a Vital Statistics System include the following:

  • Single database providing a single source of truth.
  • Integration of all items of interest for registration & vital statistics.
  • Single registration form (facilitating the single database system).
  • Access restricted to authorised staff with passwords.
  • This DB should be the single source for extracting files and issuing certificates.
  • Pilot studies should precede full implementation.6

The U.N. also emphasises the opportunities to introduce and develop civil registration through maternity and child health services. “Scaled-up coverage of maternal, newborn, and childhealth (MNCH) services, combined with the introduction of new technology, is providing many opportunities for strengthening Civil Registration and Vital Statistics (CRVS)”7

Conclusion

The pervasive impact of civil registration across a society requires acknowledgement and awareness building. Ultimately, the solution lies in a civil registration system that provides a centralised, computerised database of population but crucially, also incorporates developmental goals. This requires a level of flexibility in the building of a system that accounts for both the primary impact of civil registration (recording of vital events on forms and apps) but also the secondary level of impact described above; a simple example of this could be the building in of intelligence to the system so that it alerts the civil registration authority to the registration of an underage marriage.

A system that combines both the benefits of an electronic patient chart at the maternity/paediatric stage while also filling the need for a centralised, computerised civil registration system is in a unique position to offer an enhanced solution. Increased efficiency and seamless communication at a minimum, this begs the question, what else could such a combination achieve? This would have the potential to transform a nation’s healthcare and civil registration departments in a two-for-one system.

For years and years the challenges have been identified and talked about. The conversation needs to focus on solutions, ones that can be quickly implemented, are financially viable, are easy to use, are scalable and can integrate with a multitude of existing systems. Governments ultimately need to see a return on their investment; a system that can seamlessly work together, to address electronic data capture for both civil registration and healthcare is a logical route. The flexibility and adaptability of the Vitro platform lends itself to helping governments to address the challenges in automating the civil registration process with the advantage of clinical data capture for healthcare. Vitro Software Civil Registration

Maria Shanahan - Client Relationship Manager

Maria has been working in Project Management for Vitro Software since 2013. Having a master’s in Equality Studies with a focus on human rights law, Maria has a particular interest in development. With a second master’s in Information Studies including a focus on Research Methods & Statistics, Maria also has a keen interest in civil registration. As a Client Relationship Manager, Maria works closely with clients to liaise with in-house technical teams and project manage the roll out of Vitro software for organisations in Ireland and abroad.

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