In Zanzibar, as elsewhere, providing adequate and quality health-care services is often hampered by a lack of accurate and complete records that would otherwise enable health providers to follow patients along a continuum of care (CoC) and treat them accordingly. Patients often attempt to keep their own records in notebooks, but these are easily lost and damaged, and consequently the historical care record disappears.
In partnership with Mnazi Mmoja Hospital (MMH) and the Zanzibar Ministry of Health, Vecna Cares piloted CliniPAK, an electronic medical records (EMR) system that captures patient data at the point of care and provides patients with access to their patient history via their mobile phone. By closing the information loop between patients and hospitals in this way, Vecna Cares aimed to improve health outcomes by providing both clinicians and patients with the information needed to make data-driven evidence-based decisions about their care.
During the implementation of this project, healthcare providers within reproductive and child health (RCH) clinics and maternity wards were trained on how to register mothers and record their care using the CliniPAK system on a tablet. Additionally, records team personnel and some hospital directors were trained on how to generate reports for decision-making.
The mobile platform component sends follow-up reminders and other health messages to patients via SMS.
The project has had several successes along the project pathway. To date:
- Over 9,000 patients have been registered on the CliniPAK EMR system. The high volume of patients indicates the uptake of the system by clinical staff and highlights the consistent uptime of a digital system in a low-resource setting.
- The mobile application has sent health messages to over 1,700 patients – roughly 25 per cent of the EMR patients. This number is significant because it emphasises not only the limited availability of mobile devices in Zanzibar, but also the importance of the SMS messages when a device is available.
- A total of 70 nurses have been trained on EMR system use and mobile application support.
- Seven system administrators have been trained in application support and maintenance.
- Four hundred and eighty antenatal mothers have received vital clinical information and 1,262 discharged patients have received postnatal care information – both via SMS.
- The digital system also contributed to several strategic management decisions within the hospital, including transition to a fully paperless patient information system.