THE Ministry of Health and Child Care (MoHCC), is rolling out “Impilo,” an Electronic Health Records (EHR) system, which is meant to improve efficiency in the health sector through enhancing data collection, management, patients’ care as well as improve communication between health practitioners and patients.
By Michael Gwarisa
According to the Ministry of Health, they intend to have fully deployed the system in the entire healthcare sector by December 2023. The roll-out of the Impilo is being supported by key specialized systems like the Laboratory Information Management System (LIMS), the Logistics Management System (eLMIS) and DHIS2. Having developed a solution for EHR – EPMS integration, the MoHCC is set to also implement it across all Electronic Power Management Systems (EPMS) sites as part of EHR rollout.
Apart from the EHR, the Ministry of Health is also expanding various call systems to manage health information, putting together aggregated systems to ensure facilities can analyse and report using a system called the DHIS2 for management of logistics. The system will facilitate the harmonisation of procurement of equipment and hardware in the healthcare sector to deal with healthcare fraud and corruption. Furthermore, consultations are at an advanced stage on the development or adoption of an identity management solution or of a health specific Unique ID as mandated by the Cyber security and Data Protection Bill which will soon be signed into Law.
However, while the Ministry of health has made these strides and is clear on their vision to fully digitise the healthcare system, the vision cannot be fully realised in the absence of uninterrupted power supply. Zimbabwe has of late been experiencing lengthy power cuts and these threaten to derail health achievement if not addressed. The impact of EHR system outages can be harmful to patients and organizations, especially if backup plans are weak and lack the necessary infrastructure recovery measures.
In Zimbabwe, the Ministry of Health and Child Care has invested in power back up facilities through the United Nations Development Programme (UNDP) -Global Fund Solar for Health project (S4H), to hedge the healthcare sector against catastrophic and unproductive power outages. The power backup is currently powering hospitals and internet connectivity in around 1,045 health facilities around the country.
Davidson Tsikirayi, the Health Information Officer for Chivi District Hospital said the power backup through the Solar for Health project has ensured the Electronic Health Records (EHR) runs smoothly without any interruptions.
Before we had solar, we experienced a number of challenges. Whenever there was a black-out of electricity, we would stop working or probably rivet to doing the work manually. The work would pile up and we would struggle to clear the backlog. This at time forced us to come to work at night to clear the work. Now we don’t stop working,” said Mr Tsikirai.
Chivi District Hospital is the base for health information for the district. Every health record from the district is captured in the health information department at Chivi Hospital and relayed to the Provincial Medical Director (PMD) before being sent to the head office in Harare.
Healthcare facilities have an exceptionally low tolerance for power disruptions. Even minor fluctuations can impact sensitive communications, records management and security. Uninterruptible power supplies can provide critical emergency power and connectivity to ensure uptime to other areas of the facility.
“In this era of pandemics, there is what we call as the ministry, Weekly Diseases Surveillance systems where diseases such as Cholera, Measles, COVID, Snake bites, rabies cases etc are captured and recorded. This data is recorded every week and is fed into the system. Before the Solar, when grid electricity went off, the staff had to do manual filing and paper based format which as a ministry is not in line with our vision. We want to go paperless by 2030 through EHR,” said Chivi District Medical Officer, Dr Onward Tendaupenyu.
“These days, information is needed in real time to help authorities to come up with solutions to certain health challenges. If as Chivi we have got a Cholera case, the Minister would want to hear about it within 24 hours. If there is solar, they can update through DHIS which is our operating system we use as a ministry.”
In Bulawayo and Matebeleland provinces, a number of facilities, both primary and tertiary healthcare, have successfully rolled out the EHR system. Matebeleland South Provincial Medical Director (PMD), Dr Andrew Muza said only one district out the seven district in the province was yet to implement the EHR system.
“The Ministry has rolled out the EHR system. We are trying to go paperless, we want to capture health data in electronic format where someone is able to fill their records even away from physical sites from where the services are accessed. For us to be able to realise the gains from this important innovation, we need to have a good solar and power backup system. As I am speaking, about six out of our seven districts have already rolled out the EHR system. We have installed hardware and software at our facilities,” said Dr Muza.
In urban Bulawayo, facilities such as Thorngrove Infectious Diseases Hospital and Pelandaba Clinic are already enjoying the benefits of smooth EHR services at the back uninterrupted solar power backup energy.
Bulawayo has 19 Clinics and the city intends to open two new clinics to make them 21. According to Dr Edwin Mzingwane Sibanda, Director Bulawayo City Health, most if not all of these clinics in Bulawayo have got solar services under the S4H programme and they have all been linked to the EHR system.
“The solar plants are actually helping us with the Electronic Health Records. They keep us connected because we know that we want to be a paperless world. If we are going to have paperless administration, we obviously going to need continuous connectivity and continuous connectivity requires uninterrupted power supplies,” said Dr Sibanda.
Meanwhile, since 2009, the Global Fund has approved over US$2 Billion to support Zimbabwe’s health interventions, mainly HIV, Tuberculosis and Malaria. The interventions used to have Health Systems strengthening as a standalone grant. However, since 2015, this has been integrated into the other three diseases grants, now known as the Global Fund’s Resilient and Sustainable Systems for Health (RSSH). Out of the US$2 Billion that has been approved since 2009, the Global Fund has to date disbursed US$1.9 billion to Zimbabwe.
The Solar for Health project is brainchild of the Global Fund’s RSSH grant that supports infrastructural activities, supply chain activities mainly pharmaceutical supply chain and lab supply chain activities.
Emmanuel Boadi, the UNDP Programme Manager, Global Fund project said health information
was essential for quality health service delivery and the Solar for Health project has strengthened the healthcare sector’s capacity to fully deploy digital health services without any interruptions.
“For quality health service delivery, electricity is very important. We need power all the time to power the cold-chain, for the laboratories, for testing as part of quality health service delivery. You need power to make sure that all your health products are stored in the World Health Organisation (WHO) recommended conditions. We also need power for the health information because we need timely data to analyse and inform decision making,” said Boadi.
