3.7.2. The LabPush
system in Swaziland
Mobile technologies are widely available and can play an
important role in health care at the regional, community, and individual
levels. In Swaziland, although National laboratoryis usually able to accomplish
the requested test and produce the result within two days after receiving the
samples, the time for the results to be delivered back to clinics is quite
variable depending on how often the motorbike transport makes trips between the
clinic and the laboratory. (Hao et al., 2015)
In the pilot study conducted by Wen-Rui Hao and others in
2014, to assess factors facilitating and hindering the adoption of mobile
devices in the Swaziland healthcare through the evaluation of the end-users
experiences, the Taipei Medical Universityperform a feasibility studyfor the
development of a system that will allow the physicians to receive laboratory
test result on the mobile phone through SMS. The research team
conductsinterview with medical staff and come out with a software requirement
document that serve as input to the software development team.According to the
users' requirement, ten laboratories test has been considered the most urgent
to be communicate by the medical staff. Those one should be notify to
clinicians prior the receptions by the traditional ways (Motorbike mail) of the
full report details on paper.(Hao et al., 2015)
Due to the limitation of internet access in health facility
the SMS has been chosen as the better way of notify lab result through the
country. The system will be installed at the national laboratory and the
notification are sent to the remote clinic through SMS. The SMS should also
contains the patient information and the code number for the laboratory test
which should be enter in the system and submit after the validation. A mobile
phone with a SIM card was provided to each participating clinic, and the use of
this mobile phone was restricted to only receiving laboratory results via SMS.
Missing lab result can be requested to the National laboratory that can be
resend by SMS that improve follow up of missing lab result(Hao et al., 2015)
At the end of the pilot study, the participant has recognized
the improvement of communication of laboratory result between the National
laboratory and the clinics. But the participant has expressed the concern about
the workloadwith the introduction of the labPush system since they have to
transcribe the result from the phone to the paper based log book to keep
thehistory of the patient result test.(Hao et al., 2015)
3.7.3. Design of an
application for the chemotherapy treatment process at University Hospital of
Geneva
Decision support, order entry, drug and care administration
with their respective documentation cannot be seen as independent actions,
especially in term of medical approach and patient safety. Chemotherapies
errors in the process cited above can have dramatic effectson the patient life.
In this study, Stéphane Spahni and otherspresent the overall approach
leading the computerization of order entry, drug and medication
administration.The research team conduct also the first evaluations about the
potential benefits of the computer-aided controls during the care
administration phaseat the University Hospitals of Geneva (HUG). (Spahni et
al., 2007)
In an effort to minimize the potential for
chemotherapy-related errors, the HUGinitiated a project that start with the
centralizationofthe pharmacy and the laboratorydata to manage the preparation
of the right chemotherapies provide to the patient. All the related actions
involved the laboratory test and the preparation of the right chemotherapies
arecalled the protocol. HUG as already at the time of the study an in-house
developed computerized patient record (CPR) systemdeployed in thirtyfacilities
and runs on more than 4,500 personal computers.After setting up a global
database, an application has been developed over this data repository for
managing the request of new preparations, for organizingthe concrete
preparations and managing the traceability before, during and after the
production process. The Application has 3 main modules: the prescription side,
the pharmacy side and the drug administration or the nursing side.(Spahni et
al., 2007)
The prescription side is the features of the system that help
the oncologist to follow their patients and the current status of all running
protocols.It is a powerful feature that allow the management of the patient
treatment and the following up of the associated side effects through the
production of alert such as the overlapping dates, regimens and some anomalies
in the laboratory results. The pharmacy side allow the management of most of
the logistics needed to produce drugs from raw substances since some regiment
are produced specifically by the HUG's central pharmacy.The protocol production
for a patient is computerized during the drugs validation and laboratory
analyses.(Spahni et al., 2007)
The Drug administration side, is the complex side of the
system, it gives for each patient the treatment to follow, the side effects of
the treatment and the precaution to follow. The bedside traceability of patient
in the ward and the nurse who gives treatment is also managed by this module. .
This module is deployed on the pocket personal computer (PC) The patient, the
nurse and the treatment are both identified using an international numbering of
objects code called GS1 that can be read by the Pocket PC.(Spahni et al.,
2007)
After the evaluation of the impact of the introduction of the
system, the benefits in patient safety, the acceptance by the users and the
integration of the system in the workflow process of the hospital has been
observe as positive outcomes.However, it must be emphasized that the
formalization and the validation of all processes, including each protocol,
require a significant amount of time, especially from oncologists.(Spahni et
al., 2007)
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