17 September 2012

Thinking "Out of the Box" for Care Continuity

In a moment of reflection, I began thinking about the many challenges of providing ongoing, meaningful health services and educational support to disadvantaged communities of the world.  One of the biggest health challenges is being able to track individuals with longstanding, chronic ailments so that patients are educated and guided in ways that will be most beneficial to them.

Single episodic treatment rendered by different, but well-meaning health providers during times of flare-ups or crises do not offer long-term solutions or support a preventative approach.  Health providers, whether, short-term volunteer team members, year-long individual volunteers or local healers need a continuous health history to use as a guide through the treatment maze.

How can this be accomplished?  Perhaps a combination of lap-top computer registration into a data base, when available, and simple index cards that community health workers could use in the field is one answer.  Elements on the index cards could be entered into the computer record during times when UMCOR health workers or UMVIM Health Volunteers are available to provide this service. Or depending on site resources, locals could use on-site computers to enter pertinent data.

In Panama, health workers have been given small coupon collector wallets with file tabs that can be used for storing index cards.  Health workers record health visit information on those cards.  Two card versions are available.  One for pre-natal visits and one for general health monitoring.

There is a recent article in the Journal of Nursing Scholarship, Vol. 44, Number 3.  That discusses a research project using cell phones among non-literate midwives in Liberia to collect pregnancy data and use sms texting to share the information with health providers.  Click here for the link.

Once a work flow plan across providers is in place for a site, a simple spread sheet specific to the population needs should be designed for this purpose.  The more uniform the process is across sites, the easier to educate health workers.

Please weigh in on this issue and offer your ideas on the subject.

Jane Dunn, RN, MS
Blog Manager


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