Tom’s work at the hospital

On arrival to Papua New Guinea we got the chance to get a meeting and tour with Dr. Ben who not only serves as the Director of Medical Services but also about a dozen other hats at the hospital. What I loved about this meeting was I got to explore the “why” of what is an extremely difficult transition for any hospital from paper to electronic medical records (EMR). Thanks to my past employers for drilling into me to always gather business value points for what always can be difficulties along the way of any IT project.

First, without EMR, patients are responsible for carrying around their own paper records and often when they come in, especially in an emergency, they may not have the information of previous health visits. Second, no-one wants to come to the hospital only to find they have run out of the medicine they need. This problem has a few pieces to it because the hospital can request the government to help with medications but then it can take several months to find only half of your asks were fulfilled and so need to privately purchase the rest. So, the hospital needs to know to ask months in advance of an actual need. Finally, to get to know what and when to ask for, they need to know what they have today first. This is where I would come in.

The EMR system needs to have every drug in every drawer, shelf, and can-o-worms I could find in that hospital. Then it needed to be separated into each of the batch ID’s per the government certifications, and finally to get all that organized and entered into the system. As previously said, there are only a handful of doctors at the hospital and these folks would need to take their free time to enter this and with it being such a big job and a new IT system that didn’t always work perfectly, it’s tedious to say the least. It was tedious when the first drug we came to was amoxicillin and I found there were a set of sub-categories of this drug and then at least two dozen different batches that one drug needed to be broken down into and recounted. Multiply that by a warehouse of over 800 drugs. a pharmacy of 500 more, and then smaller but individual needs for another several hundred drugs at each other location (Nursery, Pediatrics, Medical, Surgical, OR, ER, … you get it).

Fast forward 4 weeks later and after a ton of help from Dr. Daniel, Dr. Spencer, Gideon (my rockstar helper above), the rest of the Pharmacy Staff, the IT team, ward nurses, even Alana and the kids pitching in — I’ve had several very happy doctors see me in passing and thank me immediately for already being able to find more of the drugs they actually have in stock and where to find them.

The other pain point here is the classic phrase, “without data, all you have is another opinion.” The missions hospital is seen by the government as THE hospital for the province area and so although the government does provide assistance, Ben has said it is drastically drastically lower than its counterparts. But what if instead of just requesting a more balanced level of funding, the hospital is able to show in hard data just how many people are being served, the broader population covered, the other hospitals people pass in order to come to this one, the unfulfilled government drug requests, etc. This is the longer term vision I can’t deliver in our short few weeks here, but I’m excited that with the foundation of the drugs being discoverable and making the system much more usable by the staff, the other downstream data points can help be delivered as well. The pharmacy staff welcomed me to come to their daily devotional in Tok Pissin and even got me a really generous gift of coffee beans from each of the three regions they come from and oranges from the supervisor’s own garden.

P.S. It’s now a new pet peeve in trying to read thousands of dusty labels on injection vials, I dread anytime I have to question whether the drug company decided to use a 3 point font and if that is a zero or an O, a 1 or an I.