Patient-number-based computerized medical records in Crete. A tool for planning and assessment of primary health care

Abstract

Primary Health Care (PHC) in Crete is in a state of rapid development. The strategy for introducing PHC involves an orientation towards the population and the creation of possibilities for evaluation. A case records system, "Egino", was installed in the University of Heraklion and at the Health Centre in Spili in 1988, and was further developed according to local needs during 1989, when also a Greek version of the statistical system, "DoIt", was installed. The main reasons for establishing a computerized medical information system were (i) to assess the health needs in Crete, (ii) to monitor activities of the primary health care organizations, and (iii) to introduce epidemiological research into primary health care in Greece. The information system was based on specially assigned patient numbers containing several pieces of information about the individual; the system was developed at the Dalby Health Sciences Centre in Sweden. Each month, data were extracted in Spili Health Centre, and these data were regularly used to present incidence and prevalence indices. Some of the data extracted were reported to the health authorities in Greece. "EginO" and "DoIt" gave possibilities to evaluate health services by following the morbidity, while also making it possible to describe and analyse health needs in the population of Spili and other primary health care catchment areas in Greece.

PIP: The Lund University Health Sciences Centre in Dalby, Sweden and the Department of Family and Social Medicine at the Crete University in Heraklion entered a collaborative agreement in December 1987 which involved the development of a computerized patient information system for primary health care (PHC) in Crete. In 1988, computer programmers installed the case record system "Egin0" on a personal computer at the University of Heraklion and at the health center in Spili, Crete. Based on local needs, this system was improved upon in 1989 which included installation of the Greek statistical System "DoIt". Purposes of the system included assessment of the health needs of the island, monitoring activities of PHC organizations, and introduction of epidemiologic research into PHC in Greece. The Crete and Swedish team successfully established a computer based information system in Spili in only 1 year and was able to analyze data on health care use and cardiovascular risk. The Greek version was more inclusive than the Swedish version because it included dental and preventive. The installed patient information system should allow comparison of date to evaluate new PHC settings in Greece in the future. Further, it should permit analyses of the effect of sociocultural factors on the use of PHC and attitudes and behavior of patients. Health center workers in Spili have continuously assessed the system. Immediate feedback has resulted in identifying needs for training and modifications of procedures. The "Egin0" and "DoIt" systems have also allowed researchers to analyze aggregate data. The success of these systems have resulted in their implementation in other health centers in Crete and other parts of Greece.