eHEALTH e HEALTH

AT FrenchMedicalInstituteForChildren (FMIC)

AZIZAHMADJAN GeneralDirector&CEO,FMIC G l i &C O C Date:January23,2010

30yearsofwar Dilapidatedinfrastructures Acriticalhealthsituation Asevereprecariousnessofthe population AppallingIndicators:

Infantmortalityrate(per1000livebirths)129 Under5mortalityrate(per1000livebirths)191 Maternalmortalityratio 1600 Totalfertilityrate 7.2 Totalpopulation(million) 24.5 Childrenunderage5(million) 4.9

INTRODUCTION TO FMIC
The French Medical Institute for Children (FMIC) acts as this fifth-tier, providing a benchmark for health service delivery in Afghanistan. FMIC has evolved from a unique partnership between the French NGO, La Chaine de LEspoirei, the Aga Khan Development Network (AKDN), the French Government and the Government of Afghanistan. Afghanistan Currently it is 85 bed and with state of the art diagnostic and laboratory services with access to all groups of patients in OPD and in-patient is only peads

VISION & MISSION OF FMIC

VISION: FMIC will develop into a sustainable institute of excellence providing exemplary and safe care, teaching and research, which positively impact the health d h hi h iti l i t th h lth indicators of Afghanistan, and surrounding regions. Mission: FMICs mission is to provide compassionate, p p accessible and cost-effective, quality care and the partners aim for it to become a role model for hospital care in the country. h

e-HEALTH AT FMIC
The Teleradiology model developed between Aga Khan University (AKU) Karachi and French Medical Institute for Child health (FMIC) with the help of Roshan Telecom.

E-Health E Health link was also established with AKHS, A in 2008 to support Bamyan AKHS hospital in order to improve its services and building capacity, the main objective of this establishment is to evaluate a model for Telehealth activities between Provincial hospital in Afghanistan (Bamyan) and a tertiary hospital in Kabul (FMIC).

e-HEALTH AT FMIC
In year 2009 FMIC has sent 87 CT Scans MRI 131 MRI Received 90x-rays from Bamyan Hospital 90x rays Training sessions 20 for Bamyan Hospital Nursing Education Services (NES) of FMIC. The Tele-link is also being utilized for management

Below are the details of sessions conducted for NES during the year 20082009.
S.NO S NO 1. 2. YEAR 2008 2009 NO. NO OF SESSIONS 07 13 NO.OF NO OF STAFF COVERED 44 120

Vision
Continuing Medical Education
eHEALTH e HEALTH

Health Care Delivery

Operationally relevant

Research& Research & Development

TECHNOLOGY USED IN FUTURE

HOW e-HEALTH WORKS

FMIC
Test Performed Consultation Request

AKU

Result Given

Consultation Response

Upload Studies Download Results through web based software 2Mbps(1E1)DirectDataLink

Download Results

e-HEALTH USAGE AT FMIC

AKUH Karachi- On-line diagnosis of CT Scans from FMIC Kabul AKUH Karachi- Continuing Medical Education from FMIC Kabul

EXISTING & FUTURE NEEDS

Improving care provision E-health requirements (Teleconsultations Telehistopathology, E-health (Teleconsultations, Telehistopathology Clinical Pharmacy (E-Pharmacy) Enhancing learning opportunities opport nities 1. Creating links with other AKDN Institutions 2. Internet availability 3. Connecting all AKDN centers and community-based workers to FMIC 1. 2. . 3. Improving information management E-Management Exchange of information between AKDN institutions c a ge o o at o betwee N st tut o s Sharing of resources

REQUIREMENTS OF RESOURCES
The following resources needed for continuity and sustainability of the project:

D di t d facilities for the training and education Dedicated f iliti f th t i i d d ti Broad band bandwidth. Tele-consultation rooms and facilities digital stethoscope, digital ECG machine and digital auto or ophthalmoscope ophthalmoscope For electronic medical record or health record system, a comprehensive comprehensi e HIMS and EHR. EHR For online library Required funding for the program.

CHALLENGES
Expanding e-health services requires an expansion of the number of health providers that are linked

Lack of Public policy Lack Upgrading Technological Systems Quality tele-link facility The cost of implementation is a significant barrier. Dependence on donor funding/lack ofresouces Change i Management (Fear of Doctors) Ch in M t (F fD t ) Training of the health workforce and retention in rural areas is a long-term strategic goal that is seen to be difficult due to the need to have an impact across the country including in rural and hard-to-reach areas.

COST & BENEFIT ANALYSIS PROJECT

Cost benefit analysis is a qualitative research to identify the potential benefits of automation of Clinical Laboratory
The critical issues to be studied :

Computation of cost. The cost includes the direct C t ti f t Th t i l d th di t or monetary cost of providing the services. The cost of time is another important component. The estimation of benefits like the direct benefits in terms of patient attended. The benefits of time saved. The benefits to the recipients. The investment in computerization and other related costs. The cost and benefits to the doctor / patients / p administration and management.

LEARNING FROM e-HEALTH

e-Health is a way to ensure provision of care, capacity building i H lth i t ii f it b ildi in Afghanisatn If E Health could be used properly its outcomes can be effective and E-Health innovative Throughout the globe, different government are encouraging ee healthcare Implementing E-health strategy in Afghanistan will be the step towards p g gy g p changing the nature of health care. e-health overcomes barriers posed by the security situation and the rural-urban divide. The pervasive issue of maintaining medical equipment in developing countries can now be improved b th use of e-maintenance. t i b i d by the f i t

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