Muhimbili National Hospital

Location

Dar-Es-Salaam, Tanzania

Segment

Healthcare - Hospital

Project Title

Implementation of Jeeva - Hospital Information System

Bed Strength

1300 Beds

Specialization

Gynecology, Obstetrics, Neurology, Trauma Care, HIV AIDS

Contact persons

Dr. David Tregoning - Executive Director and Prof. Andrew B M Swai - Director of Medical Services

Contact Details

Muhimbili National Hospital, Dar- Es Salaam, Tanzania

Client Profile:
Located in the capital city of Dar es Salaam, Muhimbili National Hospital is a 1,400-bed facility and the largest hospital in Tanzania. Serving four million people living in the Dar es Salaam region, the Muhimbili National Hospital is the main referral and teaching hospital, as well as the national reference laboratory for the country.

Abbott Laboratories and the Government of Tanzania announced a partnership, Tanzania Care, to modernize the country's public healthcare infrastructure and improve services and access to care for people living with HIV/AIDS and other serious illnesses. Axios, an organization dedicated to improving health care in developing countries, is serving as the implementing partner for Tanzania Care.

Tanzania Care involves the renovation and modernization of the Muhimbili National Hospital, and the extension of HIV Voluntary Counseling and Testing (VCT) services to the 21 regional hospitals in the country. One of the primary goals of the new program is to assist the national hospital in establishing itself as a "Center of Excellence" and restoring its role as the country's primary research, referral and teaching facility. This multi-year, multi-million dollar initiative will include apart from creating infrastructure for patients and clinical works and training the health staff, creating a management structure, department organization, budget process, planning cycle and financial controls within the Muhimbili National Hospital, Upgrading information technology, security, waste management and health information systems throughout the hospital.

The IT Saga
After an eight month tendering and evaluation exercise involving more than eight IT vendors from US, India, South Africa and Middle East Asia, Abbott Consulting Services, a subsidiary of the funding agency Abbott, chose Karishma Software Limited to implement the IT vision of transforming MNH as a Center of Excellence. Amongst the many key factors, which were considered for the evaluation, three factors were more important for the system to be selected for MNH.

• Ability to use the software with ease

• Comprehensive nature of the solution offered

• Comprehensive training scheme for the users

Accurate, timely and appropriate information is needed for a more effective, efficient and equitable healthcare system. However, reliable information is frequently inadequate. In most of the countries, health and management information system is not only ineffective but also inefficient. There is also a lack of data quality management.

Jeeva as a solutions looks at poor data collection and processing practices and unreliability and inadequacy of the data, or the lack of transforming data into information as a challenge. Designing the system in a way where the data is collected at the origin or the source and the data is validated as it moves up the information channel, give the IT system the reliability and the credibility factor.

One of the major obstacles in the implementation of quality improvement initiatives in low and middle-income countries is the lack of timely and appropriate information for local or frontline health services managers. Transforming data into useful information is one of the greatest challenges in the development of a well-functioning information system. Jeeva’s integrated approach, and phase wise implementation plan allows the users to build the complete IT strategy spread over a reasonable period of time.

One of the challenges in the development of healthcare management information system is how to find the optimal balance between comprehensiveness and efficiency. Karishma through its experience with more than 45 healthcare institutions and 23 hospitals has been able to strike the right balance between comprehensiveness and efficiency. Jeeva has more than 23 different modules spread over five major systems, which look at different perspectives from various stakeholders' viewpoint. The implementation, which looks and incorporates various standards like HL 7 (Health Level Seven), ICD-10, ICD-10-PCS and DICOM 3.0 has been designed to give the IT a global outlook and will make the same a part of center for excellence. The software has subsystems like Patient Management, Resource Management, Clinical Management and Financial and inventory Management. A comprehensive MIS looks at various parameters like revenue / cost / expenditure / resource in a very holistic way. The system generates more than 800 reports and answers more than 600 queries that are the cornerstones of the software. The ability to drill down the information from the summary to detail based on various facets including time and department will help the management exercise better control.

The intuitive nature of the solution – Jeeva, offered by Karishma appealed to the team which comprised of Director Consulting, Supply Channel and e-commerce of Abbott Laboratories, Managing Consultant from Abbott Laboratories Health Systems division and Director of Medical services from Muhimbili National Hospital. The way the software users like front office operators, ward nurses, pharmacists and laboratory technicians explained the features of the software and the process flow, gave a glimpse of the intuitive nature of the solution. Using judiciously the parameter

One of the main features of Jeeva implementation is the training methodology for users at different levels. Karishma will train more than 150 users over 100 sessions on the using and trouble shooting. Training has been devised for levels like operational, functional and strategic and for medical, non-medical and general users. The sessions will both be theoretical and practical and will not only help the users use the system but will also help them understand the process within their areas of operation. A comprehensive course has been designed for the system engineers who will run the system after the implementation. A learned worker is a more efficient worker, and this was one of the factors where Karishma scored over the other vendors.

MNH had zeroed-in on an IBM iSeries server for the implementation of the software. The main reason for the hardware were

• A rugged environment with a virus free stage

• Ability to deliver low total cost of ownership

• Contemporary technology with massive investment by IBM on the future

• Largest selling database DB2 as a native product

• Successful implementation stories of Karishma’s Jeeva on the iSeries platform

Being an IBM ISV partner, Karishma could derive on its strength for the implementation on the iSeries server. MNH is a 40-acre campus hospital spread over 70 buildings and the networking is going to be a challenge. This assignment is a challenge as this is one of the largest referral health facilities in East Africa and will become a forerunner for IT strategy for the countries of East Africa.

Engagement Overview:
To propel its growth plans and to integrate all the functionalities in the hospital, MNH entrusted Karishma the task of implementing Jeeva – Online Healthcare Information System customized to its needs. The scope includes implementation of the following modules: