E-Health, an idea and some plans – part 2

By Emmanuel Narokobi

Following on from my last post on this topic. Dr. Rooney has emailed me the brief on the E-Health idea and plans as presented at the recent PMG Medical Symposium in Rabaul. See below the brief on which they did their presentation:


An Innovative Collaborative Telepathology Network Project (CTNP) to accelerate pathology diagnostic services in Papua New Guinea

Dr Ian K Garbett 2, Dr Jacob Morewaya 2, Dr Poyap J Rooney 2, Dr Seth Fose 2, Dr P Golpak1,Dr F Bannick 1, Dr Li Jin 3

1 Department of Anatomical Pathology, Port Moresby General Hospital, 2 Division of Pathology, University of Papua New Guinea, 3 Consultant histopathologist, visiting Chinese Medical Team 2006-2008

There is a rapidly growing global mandate for the use of eHealth, that is, Information Communication Technologies (ICT) to transform health care. This was made explicit by the World Health Assembly resolution 58.28 in 2005 to grasp this evolution in technology and apply it to make a difference to patient care.

Papua New Guinea stands on the brink of this huge opportunity as it starts to increase its ICT diffusion through satellite, land line, fibre optic and mobile networks which are bridging the gaps created by its remote geography and the relative isolation of the Capital where its pathological expertise is concentrated. eHealth strategies demand a paradigm shift to a new conception of citizen to academia.

The National Government, in its Pacific Digital Strategy has seized this opportunity with programs such as the Rural Internet Connectivity (RICS)

Successful Telepathology programs have been established in the Pacific:
•    Solomon Islands Telepathology Program 3
•    U21/Swinfen Charitable Trust/Queensland Centre for Online Health collaboration at Tabubil 4, 5, 6
•    Fiji School of Medicine

For example the Solomon Islands program achieved a mean first response time of 12 hours after image submission 3.

With digital image capture and its transmission to a virtual platform diagnosis, education and training is freed from constraints of distance and human resources through global connectivity.
Using the newly established Papua New Guinea Academic Research Network (PNGAR Net), the CTNP aims to create a network within Papua New Guinea to:

•    To provide, a rapid, accurate and quality assured pathological diagnostic service to transform the care of the patient with cancer in remote, rural Papua New Guinea
•    Expand and strengthen the knowledge, skills and awareness of the community, health care workers and doctors to cancer and its treatment

To maximise sustainability this will be performed in a participatory manner. Involvement of sector wide agencies and imaginative collaborations will be highlighted.
The first national eHealth questionnaire will be distributed during the symposium to start this process; please complete this during the week.

1.    “eHealth Tools and Services. Needs of the Member States” Report of the WHO Global Observatory for eHealth, World Health Organisation 2006
2.    data from Globocan 2002, IARC
3.    Brauchli et al J Telemed Telecare 2004; 10 Suppl 1: 14-17
4.    Swinfen R, Swinfen P. Low cost telemedicine in the developing world. J Telemed Telecare 2002; 8 (Suppl 3): 63-5
5.    Wootton R, Jebamani LS, Dow SA. E-health and the Universitas 21 Organization: 2. Telemedicine and underserved populations. J Telemed Telecare 2005; 11:221-4
6.    Wootton R, Swinfen PA, Swinfen R, Warren M, Wilkinson D, Brooks P. Medical Students represent a valuable resource in facilitating telehealth for the underserved. 7th International Conference on Successes and Failures in Telehealth. August 2007; p149


3 thoughts on “E-Health, an idea and some plans – part 2

  1. Hi,

    All good stuff but what about we start with an Electronic Patient Records System within the Hospital system rather than dreaming about pie in the sky. Not one PNG Hospital currently has a Patient Records System. (Every time a patient is admitted a new paper file is opened). Ah yes… I almost forgot there is one being pushed by the AUSAID crew at present – a single user system that basically tallies admissions and discharges – not much else. This system developed by a local doctor in his spare time in Filemaker for better or worse runs on a Microsoft platform – now there’s real pie in the sky – a solution which cannot be financially sustained by the current Hospital IT Budgets. Why? PNG Hospitals currently do not have an IT Budget!.

    Open Source… now there’s a viable option for PNG (Full stop).


  2. Good Point Rob, I guess the reason why this project is being pushed is because all these doctors involved a based in the pathology lab. So hence their interest in developing their sections capabilities.

    An Electronic Patients Records System (EPRS), would go a hell of a long way to not only assisting better diagnostics and health care for individual patients but just long term planning all round for hospitals.

    Like anything in the public sector in PNG, it is those that push the hardest that get anywhere.

    But getting back to your EPRS, the issue in the end is more about human resources than an IT budget or cheaper internet. Hospitals in the west before computers ran on records written down in books. If its too costly too buy PC’s and get software and get internet and power etc. Why don’t we just get doctors to get into the habit of keeping log books of patients.

    These log books could then be sent to central provincial locations for entry into software at the end of each month all around the country. I know it sounds like a step backwards but seems to me like the cheapest and most effective way to do the EPRS. And from the start it would be a good exercise in just getting doctors to start keeping records and if it has to be written down then there will be no excuse whatsoever for it not being done.

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