Recently, thanks to the efforts of volunteers from around the world, donors, and our dedicated staff, several substantial technological improvements have been made at Bayalpata Hospital.
In the past, we’ve struggled with the lack of consistent electricity, and consequently, have had to carefully ration our energy utilization. This has, of course, further limited our options for implementing new technologies within our daily work. Recently though, with the help of the Nepali Government, SunEdison, and Gham Power, we were able to install the first phase of a solar energy project. This has proved to be an extraordinary addition to our patient care, allowing our staff to provide energy-dependent clinical services (everything from simple CFL bulbs to operating our laboratory equipment) 24 hours a day, regardless of the status of the public electric grid (which is frequently shut off or running at very low voltages).
As our energy situation has improved, we have been able to start thinking more creatively about integrating more energy-dependent technology into our daily clinical and administrative operations. Databases for our store manager and pharmacist have been implemented, documenting all consumable stocks, projecting needs for coming months, and (very importantly) helping our pharmacist to be aware of pharmaceuticals that will expire soon. Thanks to a recent donation of laptops from our supporters at the University of Pennsylvania and the Brigham and Women’s Hospital in Boston, MA, we are now able to have a laptop in each clinical department to ensure that any point-of-care pharmaceutical administration can be appropriately logged into the pharmacy database. In the past, these kinds of drug administrations were frequently not logged, causing substantial inaccuracy in the database’s stock versus the stock on the shelves.
In tandem with distributing computers throughout our clinical and administrative departments, we are extremely excited to welcome the introduction of ADSL internet to our hospital, now available on wifi in all buildings on campus. This initiative, which dates back over two years, is a massive credit to the Nepali government, which has worked for years to slowly expand infrastructure into the Far West, recently reaching Achham. Phone landlines were first installed in early 2011, followed by the introduction of ADSL capability in late 2011. We now have 4 phone lines at Bayalpata Hospital, and have wireless internet in all of our clinical, administrative, and staff quarters buildings. The degree to which this has changed our pace of work and our ability to connect to the outer world—both professionally and personally—cannot be understated.
One other major step forward has been the decision to move to an all-digital general patient registration process. Starting in December 2011, all patients coming for outpatient visits at Bayalpata Hospital are registered directly into our patient database, rather than into the former paper-registration system (which then had to be back-entered into our patient database). The decision to take this step was based on the huge burden of work that dual paper and digital registration caused, while also taking into account the profound importance of maintaining proper patient records. To date, we are not yet at a point where our clinicians are using a full electronic medical record, nor will we be for quite some time, but we aspire to take small steps in that direction over the next year. Eventually, we envision a digitally-run hospital, with online (protected) storage of patient records, obviating concerns of termite or water damage, or of the patient losing the records that we currently ask them to keep and bring back when they return.
Slowly but surely, along with our partners in the Nepali government and other local organizations, we are working to improve not only the health standards of the people of Achham, but the actual manner of healthcare (and other service) delivery. We have made enormous strides for the people of Achham over the past three years since first opening the Sanfe Bagar Medical Clinic, but there is still an immense amount of work in front of us. These small improvements in technology and service delivery do not solve the problems of the Achhami people, but they do help us along our way in that journey.
Dan Schwarz is the member of the Board of Directors and a medical student at Brown University School of Medicine. He completed his MPH at the Harvard School of Public Health.