Customer Solution Case Study
/ / Seychelles Unites ThreeMainIslands into Single IT Infrastructure in Just Four Years
Overview
Country or Region:Seychelles
Industry:Healthcare/Government
Customer Profile
The Ministry of Health and Social Services, Republic of Seychelles, provides primary, secondary, and tertiary healthcare services to 81,000 people living on islands in the Indian Ocean off the east coast of Africa.
Business Situation
The Ministry’s Health Department wanted to invest in an automated health information system for a diversified healthcare service responsible for 115 islands, but first needed to create an IT infrastructure from scratch.
Solution
The department chose Microsoft® Windows Server™ 2003 as the operating system, with the Microsoft Exchange Server 2003 communication and collaboration server.
Benefits
Automated infrastructure saves lives
Training support for the entire health service
Enhanced management of medical supplies
Foundation for electronic patient records system
Linking remote sites promotes social inclusion / “The Microsoft environment deployed at the Health Department has the potential to further increase our efficiency in administering healthcare processes.”
Benjamin Choppy, Permanent Secretary of IT, Republic of Seychelles
In 2001 the Republic of Seychellesfound that it needed an automated electronic patient records system for its 81,000 citizens who live on 115 islands. At that time, the Ministry of Health and Social Services lacked IT skills and equipment, and used mostly paper-based systems. First, the government gained funding from the World Health Organisation. It then worked with Microsoft to create an information and communications technology infrastructure based on Microsoft® Windows Server™ 2003 and Microsoft Exchange Server 2003. The Ministry is now ready to choose a partner to implement an electronic patient record system. The new system will save patients’ lives because doctors will be able to send medical data to remote locations in seconds rather than days. Also, all business decision making within the health department will be integrated in one IT infrastructure, resulting in reduced costs.
Situation
The Ministry of Health and Social Services in the Republic of Seychelles provides primary, secondary, and tertiary healthcare services to 81,000 people. They live in an Indian Ocean archipelago of 115 islands north-east of Madagascar off the east coast of Africa. The ministry’s Health Department is highly decentralised. It employs around 2000 people who provide high-quality healthcare in a geographically challenging environment. The main referral hospital is on the largest island of Mahé, with specialised surgical, diagnostic, and clinical care, while 16 health centre’s offer primary healthcare at the heart of the community on Mahé and three other islands.
Given the scale of the business challenge and the dispersed health centres, the Republic's Health Department sought to invest in an efficient automated health information system. Officials were convinced that doctors and nurses should electronically access timely and accurate information, including radiology services and laboratory test results between the various Health Department facilities.
Maurice Lousteau-Lalanne, former Chief Executive Officer at the Ministry of Health and Social Services, explains, “Imagine how difficult it was when under the old paper-based system, patient records could take three days to be referred back from the main hospital to a district clinic. Also, with patient mobility throughout the country, a patient could have 10 or more different sets of records.”
Starting in 2001, the Health Department’s IT team drew up a strategy to render communication between different services much more effective and efficient. The plan encompassed seven principal targets:
A secure network for the entire Ministry with an intranet, local area network (LAN) and wide area network (WAN).
An automated, centralised health information system.
Interactive Web site for the Department of Health.
Staff training on technology, since most doctors and nurses had few IT skills.
Development of an IT policy.
Use of telecommunications technology for medical diagnosis and patient care (referred to as "telemedicine") when the provider and client are separated by distance.
As a first step, the World Health Organisation (WHO) funded the creation of a centralised fiber-optic backbone network for the Health Department based at VictoriaHospital in Mahé, connecting seven principal buildings.
Dr Rui Gama Vaz, former WHO Liaison Officer, Republic of Seychelles, comments, “In the past five years, the WHO Liaison Office in Seychelles has played a crucial role in promoting and facilitating the acquisition of IT to improve healthcare in the country. WHO funded a computer network for the Ministry of Health headquarters. This grant has paid for the setting up of an intranet at the Health Department's central level.”
Solution
The department chose the Microsoft® Windows Server™ 2003 operating system, part of Microsoft Windows Server System™ integrated server software, with Active Directory® service. It runs on two Dell™PowerEdge 4600 series servers. The outlying health centres submit data by integrated services digital network (ISDN) links to a central data store.
Lanka Dorby, Director of Health Information, Ministry of Health, Republic of Seychelles, was the first person recruited to work on the project. The section now employs a secretary and four technical staff. She says, “The main factors influencing the choice of Windows Server 2003 for the operating system were security, which gives us peace of mind, plus system reliability and availability with no downtime. Windows Server 2003 also offers scalability to meet our future needs.”
For messaging requirements, the department picked the Microsoft Exchange Server 2003 communication and collaboration server and the Microsoft Office Outlook® 2003 messaging and collaboration client for the Health Department's workstations. Microsoft Services technical consultant Clarel Constance configured Exchange Server 2003 and also trained in-house staff to use Microsoft Internet Security and Acceleration (ISA) Server 2004 for the firewall. Microsoft helped support the project through its business investment fund and is now in talks with the Seychelles government about a Microsoft Enterprise Agreement.
For its workstations, the ministry is using the Microsoft Windows® XP operating system and Microsoft Office Professional Edition 2003. Constance advises, “The ministry’s IT team agreed with us that it was important to standardise the technology rather than roll out different versions of Microsoft Windows. The in-house IT team's expertise has grown, and they have adopted Windows Server 2003 Group Policy and managed the implementation of ISA Server 2004 itself.”
The Health Department has gone live with a hosted Web site. Dorby says: “Starting next year, we plan to implement a feature called Online Doctor that will help patients to contact doctors through our Web site.”
The Health Department's main headquarters have been operating efficiently now for nearly three years. Since March 2003 all of the health centres are linked to the headquarters, with help from Cable and Wireless, a leading telecommunications operator in the Seychelles. This makes the Health Department one of the biggest wide area networks in the Seychelles.
Benefits
Fully Automated Health Systems Infrastructure Saves Lives
In 2001, the Seychelles had no IT infrastructure for its healthcare service. The geographical challenge was immense, with 16 health centres, three of which are on two outlying islands.
But with the new information and communications technology (ICT) infrastructure, Lousteau-Lalanne says medical practitioners have a much more powerful tool for life-saving early intervention in patient care. “Lives are already being saved because doctors can send medical and diagnostic data to remote locations in seconds rather than days.
“With hindsight, we should have done it 10 years ago,” he notes. “But the paradigm shift has now taken place, and with the help of Microsoft, we’re ready to move forward to the next phase.”
With the appropriate infrastructure design to match the complicated topography of the Seychelles, and thanks to its dedicated staff, the Health Department has won international recognition. In 2004, it won the African ICT Achievers Awards Top Government Department Award.
Dr Cornelia Atsyor, New WHO Liaison Officer, Republic of Seychelles says, “The Seychelles Health Department’s IT infrastructure is exemplary to the Whole of WHO member states.”
Dorby adds, “All our achievements happened in just four years, thanks to three principal partners working together: the Department of Health, which created and built an IT operation, WHO, for the funding, and Microsoft, for technical assistance and software.”
Foundation for Introducing Electronic Patient Records System
Thanks to Microsoft and the Department of Health IT unit, the ministry can now move to the implementation of an electronic patient records system. Benjamin Choppy, Permanent Secretary of IT, who reports to Seychelles Vice President Joseph Belmont, explains, “This will happen soon now, after the Ministry has settled on a software package for electronic storage of patient records. It will be used by healthcare practitioners and managers.
“All patient details will be incorporated and linked to other medically-relevant information. This integrated set of medical information, including lab test results, X-rays, and computed axial tomography (CAT) scans, must be made available throughout the health system. To promote social inclusion, this system will serve the main hospital and a health centre on one of the outer islands. Sub-sets of the information will no doubt be useful to agencies outside this immediate ministry.”
Choppy adds, “The capture and storage of medical information in electronic formats will also allow their transfer and exchange between medical institutions (local and overseas) to be more efficient, and therefore, make telemedicine possible for the Seychelles. The government hopes this will result in more patients being treated in the Seychelles and result in a reduced need to send patients overseas for specialised treatment.
“The central repository of medical information must be customised to be compatible with the rest of the e-government systems,” says Choppy. “We want to promote integration within the overall national system, which can permit the full electronic transaction of any government e-service process.”
Cost-Effective Technology Links Remote Sites
Microsoft technology helped the Health Department to link its remote sites and to offer universal health services to a dispersed population. The new IT infrastructure provides a sound environment for future projects, such as telemedicine and a centralised health information system.
Dr Vaz says: “The current network has helped different divisions, departments, and units within the ministry to share up-to-date information. It has increased the feedback of the weekly epidemiological data from the central to the primary healthcare levels, where data is generated. It has been proven as an effective clinical and management tool.”
Improving Stock Controls and Making Management More Agile
With around 320 users, all decision making within the health department is integrated in one IT infrastructure, down to middle management level.
Lousteau-Lalanne explains, "In addition to the clinical benefits, administration and basic housekeeping have been made more efficient and less time consuming. For example, in stock controls, we’ve updated our business processes. Managing medical consumables is a major challenge, but with automation, we can avoid holding too much or too little stock and thus improve our business agility.”
Choppy adds, "The Microsoft environment deployed at the Health Department has the potential to further increase efficiency in administering healthcare processes. More importantly, perhaps, is that a health information system for the whole population can be deployed using Microsoft technology.”
IT Training Support for Entire Health Service
Microsoft has been a major force in the Seychelles healthcare IT program by helping with the training of locally-based IT staff. “We started with the IT basics,” recalls Dorby. “Five years ago many of the around 2000 ministry staff members were not IT literate. Some of them were wedded to paper systems and a few could not immediately see the need for PCs in their everyday work.”
With help from Microsoft, Dorby’s team built up their own knowledge and then delivered IT training to some 300 users who are now making full use of online communications and collaboration technology.
Dorby says: “We have experienced a revolution in working practices and a major change in culture. Microsoft helped us in many ways: Our department is now seen as a model by the rest of the government for IT development.
“Furthermore, our doctors and nurses are now evangelists for the IT system. It saves them time on administration and record keeping. Most of the staff are now able to receive up-to-date statistics on a daily, weekly, and monthly basis, which is vital for all health professionals and decision makers.”
Windows Server 2003
The Microsoft Windows Server 2003 family helps organizations do more with less. Now you can: Run your IT infrastructure more efficiently; Build better applications faster; Deliver the best infrastructure for enhancing user productivity. And you can do all this faster, more securely, and at lower cost.
For more information about Windows Server 2003, please visit: