Challenges: Towards Adoption of FOSS Medical and Health Information Systems in Pakistan Fouad Riaz Bajwa FOSS Advocate & Secretary International Free and Open Source Software Foundation (www.ifossf.org) OSHCA Conference 2007 Kuala Lumpur, Malaysia.
The situation of FOSS in Pakistan Introduction to the Healthcare Sector Use of Health Information Management Systems Understanding the value of Free and Open Source Software Healthcare Information Management Systems Shaukat Khanum Memorial Cancer Research Hospital Casestudy Agenda
Gives you access to ICTs and enables the opportunity to: develop local skills to learn and use software and computer hardware modify and innovate software code reuse and redistribute the software programs share the benefits with everyone generate further knowledge or let others do so establish communities of learning and practice both locally and globally Free and Open Source Software
FOSS Ecosystem in Pakistan Demand Government of Pakistan Enthusiasts Sustainability Academia Private Sector Availability Civil Society Supply
Linux Pakistan (LUG) – 1999 Open Source Resource Centre (OSRC) at the Ministry of Information Technology – January 2004 Free and Open Source Software Foundation of Pakistan (FOSSFP) – February 2004 Ubuntu Linux Pakistan Team - 2004 National Free and Open Source Software Campaign'05 FOSS in Pakistan
Linux Pakistan Nationwide Community 3500+ Members Extensive support discussions on mailing lists Extensive support discussions on mailing lists OSRC 4 Open Source ERP Systems for Business and Industry Open Source Toolkit (Totally Open) Extensive FOSS Training Programmes 29 Cities throughout the country FOSS Statistics
FOSSFP National FOSS Campaigns in support from UNDP-APDIP, International Open Source Network and Government of Pakistan 7000 People Training on FOSS 506 organizations made aware of issues 4800 certified on using Ubuntu Linux Desktop Ubuntu Linux Pakistan Community 60 active Volunteers 20 Localization Volunteers 800 Mailing List Members FOSS Statistics
'a state of complete physical, mental and social well being, [which] does not consist only of the absence of disease or infirmity' http://en.wikipedia.org/wiki/Health Defining Health according to WHO
Health can also imply good prospects for continued survival The Role of NGOs in Community Health in Pakistan. SEDC 2006. http://www.sedc.org.pk Generally
The country lacks social security and public health insurance support Healthcare assistance is more of a personal effort than a state supported public facility A very small portion of society has either corporate medical allowances or unlimited Government Medical Support. A major portion of society is left at the stake of their personal conditions Social Security and State Support
Key Healthcare Issues in Pakistan • The country does not have a Healthcare Management System in place thus stakeholders cannot directly visualize the importance of automated healthcare information management.
Question of the day! Why did the first Free and Open Source Software based Healthcare Information Management System fail in Pakistan?
FOSS Implementation Failure Casestudy Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC)
SKMCH&RC Background • SKMCH&RC is a state-of-the-art cancer hospital and research centre located in Lahore, Punjab and is a project of the Shaukat Khanum Memorial Trust, a registered charitable organization • The institution is the brainchild of Pakistani cricket superstar, Imran Khan. • The inspiration came after the death of his mother, Mrs. Shaukat Khanum, from cancer.
Shaukat Khanum Memorial Cancer Hospital & Research Centre (SKMCH&RC) • SKMCH&RC acts as a model institution to alleviate the suffering of patients with cancer through the application of modern methods of curative and palliative therapy irrespective of their ability to pay, the education of health care professionals and the public and perform research into the causes and treatment of cancer.
SKMCH&RC's Research in 3 streams i) epidemiology, which seeks to understand the lifestyle and environmental causes of cancer; ii) molecular biology, which will enable the development of better ways of predicting treatment responses and disease outcome i.e molecular markers; iii) clinical trials, which is primarily focused on the evaluation of existing and new therapies.
Yesterday • The US State Department donated the VA VisTA to SKM in its early days. The components of this assistance inlcuded: • Financial Assistance • Capacity Development of SKM Professionals • Technology Transfer • Maintenance
Today • The Management Information Systems (MIS) Department has developed a state of the art hospital information system. Through this system, the research team has been able to handle the logistics of a large hospital, documenting a wealth of patient information.
What went wrong? Reason #1Lack of Trained Human Resource • The two employees of the centre that were trained in USA by the donor left the hospital between 2-4 months of return back. • They were hired by other companies in USA that were implementing the VA VisTA.
What went wrong? Reason #2Lack of Local Implementation Strategy • VA VisTA was only implemented in two departments of the 27 Department based institution. These included: • Out Patient – Registration & Clinical Scheduling • Pharmacy
What went wrong? Reason #3Lack of Graphical User Interface GUI • Back then, VisTA lacked a GUI. • The system was too generic. • The system had too many screens to carry out very simple work.
What went wrong? Reason #4 Lack of sustainable expertise • Once the initially trained people were gone, there were no more expertise available to manage implementation of new modules of the system for various other departments. • VisTA was no more usable for the centre.
Possible Solutions • Buying from management • Encourage End-User Involvement • Dedicate Personnel for Upgrade Management • Encourage the development of communities of learning and practice • Establishing Support and Management teams or organizations • Communicate with larger user community
Interviewee • Muhammad Idrees KhokarManager MIS SKMCH&RCidrees@skm.org.pk
Further Reading • The Role of NGOs in Community Health in Pakistan: • http://www.sedc.org.pk • Shaukat Khanum Memorial Cancer Hospital and Research Centre • http://www.shaukatkhanum.org.pk/ • An Open Source Health Care Management System for Pakistan : • http://www.uet.edu.pk/icost2006 • INK mPC Laptop: • http://www.ink-media.com
Q & A Session Thank You!