Local+and+global+areas+of+impact


 * __Local (L)__** __and //Global (G)// Areas of Impact – Paper 3 Case Study__

//**Education (G&L)**// · The network administrator has to be educated in how to maintain the network · The healthcare workers are responsible for the upkeep of the IT systems in Village A and B, thus they need to be educated in how to maintain those systems · Education and training to medical and paramedical staff on the existing IT systems · Doctors need to be educated on how to find reliable sources and advice on the internet to diagnose patients 1270726072 · Tele-learning of staff member · Training, tutorials, simulators
 * "Hospital Technician Education Requirements and Career Information." //Degrees, Schools, Online Courses and Careers - Over 20,000 Articles//. Web. 13 Apr. 2010. []
 * This is a basic rundown of the educational requirements needed to become a hospital technician. This can be used as evidence when arguing that hospitals in developing nations might have to employ foreign doctors or have their doctors educated overseas. user:annapettersen
 * The following article: [] describes how users and employees can find reliable health information on the Internet. It is mentioned that users should use medical gateways and reputable health databases before searching on a general search engines, such as Google. An example of a medical gateway could be the NHS National Library for Health (NLH).
 * An example of the use of simulation in the health care sector could be from the New York HHC, which could eventually inspire the Oobunta Hospital and clinics. The following article: [] train doctors and nurses as individuals who then are expected to make life saving decisions and perform skills as a team under high pressure conditions. The article furthermore states that "simulation training allows the entire team to practice, perfect and master procedures and communication skills without risk to patients".
 * "We know that nearly 70% of medical errors in hospitals occur partly as a result of failures in communication and coordinating among clinical team members during the delivery of care."
 * HHC simulation Center will e.g. have 9 adult mannequins that have heartbeats, breath, sweat, and can even talk through remote microphones used by the instructors. 1270726072

The development of more effective communication and access to the hospital will improve the ‘business’ factor of the establishment. Also, the hospital may be forced to employ persons who are familiar with the IT systems, or at least temporarily employ someone to educate the current staff on how to use them effectively.

· Improvement of health services by the use of IT solutions in both the provincial headquarters and also the surrounding rural areas. · Mobile phones and the Internet could revolutionize the way people receive treatment · Dealing with paper records and electronic health records · The use of IT in healthcare varies within the provinces, which means different types of network settings have to be considered as well as IT solutions: o Oobunta Hospital: access to Internet, e-mail and private online medical expert system o Village A: access to six desktop PC’s – used for patient and financial record keeping o Village B: One computer: used for patient record keeping, no Internet access o Village C: no IT facilities other than cell phones
 * Health (L)**
 * According to a recently written news article from NY times telemedicine has the potential to improve quality of care by allowing clinicians in one “control center”, which could be the main Oobunta hospital, to monitor, consult and even care for and perform procedures on patients in multiple locations.Furthermore it states that " A hospital unable to staff its intensive care unit with a single critical care specialist can have several experts monitoring their patients remotely 24 hours a day. " However according to a study mentioned in the article the tele-medicine also have disadvantages. Doctors and nurses resisted this technology as they felt their contact to the patients decreased and nurses felt that someone was looking over their shoulder all the time, hearing from the remote clinicians too much, giving them an increasing workload. http://www.nytimes.com/2010/01/07/health/07chen.html 1270726072
 * An article posted on the CNN website states that cell phone technology is helping developing nations prepare for disease threats such as a new strain of swine flu, an outbreak of measles or the increased spread of HIV. The used this open source software program from the internet called EpiSurveyor. It frees health care workers from hiring programmers to create electronic surveys. Data gatherers can customize their questionnaires online, download the questionnaires onto a cell phone that has Internet capability, poll patients and do direct analysis, all through a touch pad on a cell phone. An example of the use could be, when the government didn't know that vaccine supplies were low. Using EpiSurveyor, health care workers discovered that 60 percent of their vaccine stockpiles in remote areas were missing. They mobilized a response within three weeks, he said. [] 1270726072
 * The Oobunta Hospital and clinics could implement e-records for the patients. However they need to consider the disadvantages to electronic medical records. One could be that start up costs are enormous. They not only have to buy equipment to record and store patient charts, which is much more expensive than paper and file cabinets, but efforts must also be taken to convert all charts to electronic form. In this case integrity of the converted data could be a question. Furthermore training on electronic medical records software adds additional expense in paying people to take training, and in paying trainers to teach practitioners. [] 1270726072

"Until recently the population in the province had suffered from a poor provision of healthcare with many people not living beyond their 50th birthday. Recent developments in education, transport and IT have brought some improvements to the health of the people."

__EXAMPLE: HealthNet__ This is the most developed Africa-wide initiative which aims at improving the practice of telemedicine among health professionals. This project by the non-profit-making organisation of scientists and medical researchers known as SatelLife. HealthNet has been implemented in 20 countries throughout Africa. HealthNet was conceived as a means of combating the isolation of health workers in the less industrialised world and the lack of information that impedes their work. The network provides email, electronic discussion lists, electronic medical publications, and access to medical databases and conferences. The Healthnet network started with dialup connections based on FIDO protocols for enduser connections and UUCP dial-up connections at intervals between national or regional nodes and STMP Internet gateways. This store-and-forward system has served well in Africa given its robust functionality with poor telephone line connectivity where such connectivity is viable. In countries/areas where the telephone infrastructure is unreliable or non-existent, HealthNet has used satellite ground stations. Through a combination then, of telephone infrastructure and low earth orbit satellite (LEOs) technology, HealthNet has facilitated rapid and low-cost communication through e-mail via national HealthNet nodes between health workers in Africa and between them and their counterparts in the rest of the world. Due to its widespread use, several telemedicine-related projects have depended on the use of the HealthNet network. The HealthNet system is used by government departments and agencies, medical facilities and schools, medical libraries as well as individual health workers. [] 1271394996

=BENEFITS OF EMR VIDEOS= = [|http://vimeo.com/6165919][] A PRETTY COOL VIDEO ON HOW EMR WORKS [] WATCH ITTT!!!! **1272273578**  =

Another video of how Iphone apps have helped doctors. 1272278020 media type="youtube" key="Q-E-B3Pc8mk" height="385" width="640"

The government has recently started improving Internet coverage, including WiFi and Broadband Wireless Access, as well as increasing the number of cell (mobile) phone providers licensed to operate in the country.
 * Politics and Government (L) **
 * Ababa, Addis. "BBC NEWS | Africa | Ethiopia's High Speed Hospitals." //BBC NEWS | News Front Page//. BBC News, July 2007. Web. 13 Apr. 2010. .
 * A hospital in Ethiopia is getting aid and technicians from India who are helping improve the technological standards of African hospitals. They are creating links between hospitals using a fast internet connection which allows for images to be viewed on screens in several different locations (this would be beneficial in the sense that if a doctor could not come to the hospital, they could provide advice from their current location). This Indian company plans on linking a total of 20 hospitals in Ethiopia into their high-speed network. user:annapettersen

Governments of African countries are attempting to close the gap in the health care system so it's more public friendly. But money is only one of the problems, to quote: "But health fees are not the only thing standing in the way of decent public health services. President Ernest Bai Koroma and top health officials recently toured hospitals around the country to check their readiness, and found a lack of running water and electricity, insufficient generators, facilities "acutely short of personnel" and inadequate beds and medical equipment, according to a government press statement." The Government is progressing slowing with more funding and managing human resources. In serveral years (Article estimated 8-10 years) the medical working condition should be able to catch up to the world's standards. [] [] user:ZetaZero

The development of more effective communication and access to the hospital will improve the ‘business’ factor of the establishment. Also, the hospital may be forced to employ persons who are familiar with the IT systems, or at least temporarily employ someone to educate the current staff on how to use them effectively.
 * //Business and Employment (G&L) //**


 * "The » Internet Access as a Hospital Service?" //Austringer//. Web. 13 Apr. 2010. .


 * This is a personal opinion on the open internet access some hospitals have developed in addition to their own networks for e-records. “There could even be some intra-hospital application, as if there were an instant-messaging-like interface to the nurses’ station” user:annapettersen
 * http://www.stbernard.com/docs/casestudy/iPrism_LodiMemorial.pdf


 * Talks about some issues a hospital faced when installing a network, and potential risks of doing such. user:annapettersen