GPHC to in­tro­duce elec­tronic pa­tient records

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A per­cent­age of the $524.6 mil­lion that has been pro­posed for the Ge­orge­town Pub­lic Hos­pi­tal Cor­po­ra­tion (GPHC) in the 2019 na­tional bud­get is set to be used for the in­tro­duc­tion of elec­tronic med­i­cal records at the in­sti­tu­tion.

Minister of Pub­lic Health Volda Lawrence told the Na­tional Assem­bly on Thurs­day that the health sec­tor has started to test the Gov­ern­ment Health In­for­ma­tion Sys­tem (GHIS) at the East La Pen­i­tence Health Cen­tre, which is be­ing used as the pilot to roll out Guyana’s first pa­per­less health fa­cil­ity.

The GHIS, Lawrence ex­plained, is a sin­gle elec­tronic med­i­cal record plat­form that will cap­ture per­ti­nent pa­tients’ in­for­ma­tion, in­clud­ing de­mo­graphic data, med­i­cal his­tory, clin­i­cal treat­ment data upon en­try, thus elim­i­nat­ing the need for pa­per­based doc­u­men­ta­tion.

She noted that in 2019 the GHIS will be in­sti­tuted at the GPHC to al­low the Cor­po­ra­tion to com­mence and roll out the health man­age­ment in­for­ma­tion sys­tem through­out the hos­pi­tal.

Ad­di­tion­ally, a phar­macy in­ven­tory mod­ule, di­rectly linked to the es­sen­tial drugs list, will be rolled out to aid doc­tors in the pre­scrip­tion of drugs, and en­sure ac­count­abil­ity.

The min­istry has been at the cen­tre of sev­eral con­tro­ver­sies in re­la­tion to the pro­cure­ment of drugs.

Op­po­si­tion Par­lia­men­tar­ian Dr Frank An­thony had told the House on Tues­day that ac­cord­ing to Au­di­tor Gen­eral (AG) Deo­dat Sharma’s re­cently re­port, the Pub­lic Health Min­istry is guilty of break­ing al­most ev­ery sec­tion of the Pro­cure­ment Act. He added that the mal­prac­tice in pro­cure­ment “con­tin­ues un­abated” at the min­istry.

An­thony cited the con­tro­ver­sial con­tract awarded to New York-based firm HDM Labs Inc and said it was just the tip of the prover­bial ice­berg and he called on the gov­ern­ment to take ac­tion against the trans­gres­sor.

Among other things, the AG’s re­port stated that HDM Labs in­stead of an agreed two weeks, took six months to fully de­liver on a con­tract val­ued hun­dreds of mil­lions for “emer­gency” phar­ma­ceu­ti­cal sup­plies sought last year by the Pub­lic Health Min­istry. The process un­der which the con­tract was awarded was called into ques­tion as HDM did not bid dur­ing the ini­tial ten­der and later be­came the lone com­pany to bid when the con­tract was re­tendered. The higher prices quoted for the drugs as op­posed to those listed by the com­pa­nies that ini­tially bid for the con­tract was also high­lighted in the re­port.

Ac­cord­ing to An­thony, from 2015 to 2017 the gov­ern­ment spent vast sums to buy drugs and other med­i­cal sup­plies and many of the con­tracts were awarded on an emer­gency ba­sis so that the de­liv­er­ies were time-bound be­cause of short­ages in the health sec­tor. How­ever, he said what is “un­be­liev­able” is that $345 mil­lion spent over a pe­riod of time was paid for drugs that were not de­liv­ered.

In re­spond­ing to An­thony’s claims, Lawrence noted that a Pro­cure­ment Depart­ment was es­tab­lished in 2017.

To heck­les of “use it then,” the minister ex­plained that the depart­ment is still a work in progress and noted that mat­ters raised were “not swept un­der the car­pet as was the cus­tom of the pre­vi­ous ad­min­is­tra­tion” but were ad­dressed through let­ters to staff in­volved, which were copied to the Fi­nan­cial Sec­re­tary and Au­di­tor Gen­eral for ac­tion.

The minister fur­ther noted that the min­istry’s pro­cure­ment staff has so far been in­volved in two train­ing ses­sions—one hosted by the Na­tional Pro­cure­ment and Ten­der Ad­min­is­tra­tion Board and the other by the Pub­lic Pro­cure­ment Com­mis­sion.

“The staff was pro­vided with the req­ui­site knowl­edge in pro­cure­ment pro­ce­dures in keep­ing with the Pro­cure­ment Act,” she told the House, be­fore adding that a USAID Con­sul­tant is cur­rently in Guyana to as­sess the op­er­at­ing struc­ture of the min­istry’s pro­cure­ment unit, pro­vide hands-on coach­ing sup­port with na­tional pro­cure­ment plan­ning and con­tract man­age­ment, and as­sist with terms of ref­er­ence for a pro­cure­ment track­ing sys­tem.

The minister also noted that the staff quar­ters of the GPHC, lo­cated at Water­loo Street, will be com­pleted and fur­nished, works to re­ha­bil­i­tate and ex­tend the pre and post-natal wards at the ma­ter­nity unit will com­mence, the mental health clinic will be ren­o­vated and trans­formed into a mental health ward and a four-storey build­ing will be con­structed in the GPHC com­pound to re­lo­cate the main phar­macy and the med­i­cal records depart­ment.

A claim that a trauma cen­tre will be con­structed to elim­i­nate the in­ad­e­qua­cies of the 18 bed Emer­gency Unit that ex­ists at GPHC was chal­lenged by op­po­si­tion Par­lia­men­tar­ian Dr. Vind­hya Per­saud, who took the floor af­ter Lawrence.

Per­saud noted that there is no al­lo­ca­tion for this pro­ject and pointed out that Minister of Fi­nance Win­ston Jor­dan had ac­tu­ally said in his bud­get pre­sen­ta­tion that there is cur­rently “dis­cus­sion” on the pro­ject.

Af­ter the stress­ing that “con­struc­tion of a new ac­ci­dent and

emer­gency fa­cil­ity can no longer be de­layed,” Jor­dan in­di­cated that gov­ern­ment has “com­menced dis­cus­sions with in­ter­ested de­vel­op­ment partners to build a mod­ern, state-of-the-art trauma cen­tre that will al­low us to bet­ter man­age emer­gency cases, in­clud­ing ad­dress­ing pa­tient flow, iso­la­tion and ca­pac­ity.”

Lawrence, how­ever, pre­sented the cen­tre as a fully con­cep­tu­alised pro­ject, while stress­ing that its con­struc­tion “will see an in­crease in the num­ber of in-pa­tient ward space, with the num­ber of beds in­creas­ing from 483 to 1,000, more out­pa­tient clinic space and an in­crease in the num­ber of the­atres from 5 to 12, in­clud­ing two sep­a­rate the­atres for Ob­stet­rics and Gy­nae­col­ogy.”

Volda Lawrence

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