Health Information Systems
At the request of the MSPP and the Centers for Disease Control and Prevention Global AIDS Program in Haiti (CDC GAP), I-TECH began developing iSanté in 2005. Use of iSanté data not only has the capacity to improve clinical decision making and quality of care at site level but can also be leveraged to make data-driven, population-level public health decisions. A recent example of this is the research on the implementation of Option B+ in Haiti presented at the International AIDS Society Conference in 2015 (See “Attrition from antiretroviral treatment services among pregnant and non-pregnant patients following adoption of Option B+ in Haiti”). iSanté is used at 115 hospitals and clinics around Haiti and includes more than 700,000 patient records. The system includes patient care summaries, population-level data dashboards, automated program reports, epidemiological monitoring, and indicator reporting, and is linked to computerized lab results. 30 sites use iSanté interoperably with the open-source lab information system OpenELIS which I-TECH developed in Haiti in partnership with LNSP.
I-TECH also provides TA to health care providers and records officers to use iSanté at point-of-care. In 2012-13, with impetus from the Haitian Ministry of Health and funders, I-TECH supported some iSanté sites to move toward POC implementation. This involves providers using iSanté during patient visits to enroll patients, review health history, capture clinical assessments and treatment plans, and record drug and laboratory orders. A recent evaluation, “Report on Best Practices in ‘Point of Care’ Implementation of iSanté and OpenELIS Data Systems,” has expanded the current knowledge of iSanté’s use at point of care (POC) as well as highlighting the benefit of iSanté use to care and treatment.
In partnership with the National HealthQual Committee which includes CDC and MSPP/UGP, I-TECH reinforces data quality and data completeness through system modifications, training, and onsite TA. I-TECH has developed national standardized training modules on data management and the iSanté system. View poster, "An Innovative Tool for Supporting Quality of Care and Programme Reporting: The Haiti HIV Electronic Medical Record Project" (PDF). To further this agenda, a recently awarded National Institutes of Health (NIH) R-34 grant will allow investigators to explore the potential role of EMR alerts and healthcare providers in ART adherence counseling in Haitian HIV primary care clinics and conduct a preliminary clinical trial of the enhanced EMR.
I-TECH’s goal has always been for iSanté to be fully owned, managed, and maintained in Haiti. There are eight principle areas of EMR management that need to be transitioned: governance (policy framework, decision making structure), software design and development, system administration (servers, helpdesk), implementation (deployment to sites), training, equipment and materials, infrastructure (electricity, internet connectivity), and data use and analysis. I-TECH is working with the MSPP to develop a transition plan for each area and is reinforcing MSPP capacity to ensure a smooth transition. The MSPP is making great strides to ensure the success and ownership of iSanté with recent achievements and progress on the PEPFAR sustainability agenda.