Bytes and bandages: Bringing the health sector into the 21st century

In recent years Sri Lanka’s health authorities have moved forward with a variety of projects aimed at integrating digital technology into the health sector. In 2015 the government oversaw the operation of 12 e-health pilot projects around the country, which involved initiatives related to the introduction of a national health ID number for all citizens; the development of a Hospital Information Management System, a soon-to-be national database of medical data; and, on the policy side, the formulation of a draft national policy for e-health.

Despite this progress, considerable challenges to implementing nationwide digital health systems are still evident. While drawing up a national e-health policy document is a priority at the Ministry of Health, Nutrition and Indigenous Medicine (MoHNIM), support for the current strategies is somewhat limited. Indeed, some health personnel have expressed scepticism about the value of digitising health records and other e-health-related plans. “We cannot leave ICT implementation [in health] in the hands of a few enthusiastic individuals anymore,” Vajira Dissanayake, the president of the Health Informatics Society of Sri Lanka (HISSL), wrote in a local news publication in late 2015. “We have to move forward with a national digital health initiative with the political commitment at the highest level. Can we do this? I believe we can.”

Recent Developments

Technology has been an important component of Sri Lanka’s health sector since 1998, when the HISSL was launched with the “idea of promoting the use of computers and IT in teaching, learning, research and delivery of care in the field of health care”, according to the society’s website. HISSL has played a major role in the sector ever since. In 2008 the organisation was a driving force behind the establishment of an Master of Science programme in biomedical informatics – the first in the region – at the Sri Lanka Postgraduate Institute of Medicine (PGIM). In addition, a medical degree course in health informatics is also expected to launch in 2016 at PGIM, at which point Sri Lanka will become the second country in the world, after the US, to offer such a programme.

As an initial step towards formulating a national e-health policy, in 2009 the MoHNIM, in conjunction with the World Health Organisation (WHO), carried out a national health information system survey. The results offered feedback on Sri Lanka’s e-health policy planning mechanisms, institutional capacity, human resource development, financing and infrastructure. Based on these survey results, the MoHNIM set out to improve these systems, with the objective of integrating digital IT into the everyday practice of medical care in Sri Lanka.

According to an October 2015 presentation given at the Indonesia Health Informatics Forum by Achala Upendra Jayatilleke, a senior lecturer at PGIM, Sri Lanka’s new e-health policy is expected to cover a five-year period in its initial stages and will be organised into five significant policy areas, namely health information-related resources; indicators and data elements; data and information management; data security, client privacy, confidentiality and ethics; and e-health and innovations.

Powerful Data

In an effort to streamline patient data management and facilitate data sharing among hospitals, clinics and other public health entities, the state launched a pilot project in 2015 to test the viability of assigning a personal health number (PHN) to all individuals that make use of the public health system. The programme involved issuing PHN cards to patients in five hospitals in the south-western city of Galle. The PHN is linked to digitised patient records, which are stored in a central encrypted online database. If the project is deemed a success, the database could ultimately house all of Sri Lanka’s medical data, to be made accessible to all public health authorities and eventually private health care providers as well.