Ubuntu Medical: Centralised patient databases in the African context

Andy eventually got me to sit down and give some prelim views. The trickiest thing, if you REALLY want to make a difference in South Africa is planning. There are a couple of lovely third world things that get in the way:

*Politicans
*Egos of management
*Distribution
*Concentrating on PATIENT MANAGEMENT, not financial management.
*Training
*Training
*Training

For instance, if the open source community can help with the situation I'm about to describe, and just this, you have no idea how much of a difference it will make to primary healthcare in this country. Build the "system" so it can be grown, sure. But little steps is the only way you'll get anywhere in a third world country.

Here's the situation. Primary healthcare patients (GP-based needs, meant to go to clinics, both rural and metro BEFORE they get referred up to secondary and tertiary centres - where they would get seen by specialists and clog up already clogged hospitals) HAVE to carry around a green piece of cardboard - their clinic card.

This card links to a manually filed medical history inside the clinic archives. To get to a hospital, you're meant to get referred - thus creating the link. If you don't, hospital doctors are practicing blind, because there is absolutely no way to retrieve paper-based files from clinics around the country.

And most patients believe they can just pitch up at hospitals with primary care problems (translation: trivial from a hospital's point of view). Small wonder we're understaffed? Especially Baragwanath.

Hospital doctor's don't need every little bit of previous scrawl - but there are some critical pieces of information that should be kept centrally on a patient database - and easily accessed at critical times. Such as: Patient diagnoses (incl the controversial HIV + - status, in code), current medication / dosages, allergies and relevant major tests (eg. CT SCAN, ECG, major blood work).

Solve that problem and you've taken a huge leap forward.