Halifax paediatricians honoured for developing health information system for Belize

Dr. Michael Graven and Dr. Noni MacDonald of Dalhousie University/IWK Health Centre were named Professional of Distinction by Nova Scotia’s Discovery Centre for developing a fully integrated health information system that has dramatically improved health care in Belize—all for the annual cost of just four dollars per citizen.

Dr. Graven was chief architect and Dr. MacDonald, editor-in-chief of Paediatrics & Child Health, was in charge of protocol development in establishing this tool, called the Belize Health Information System (BHIS).

Launched in 2007, the BHIS was adopted by 90% of the country’s health care facilities within nine months. Almost immediately, there was a marked decrease in the rate of hospital admissions. The BHIS also helped to reduce the maternal mortality rate to zero by 2011; not even Canada can boast of such a low rate.

The reason for its success is simple: The BHIS was developed by health care professionals, for health care professionals.

“When you do something that is complex like this, there are three things you can get out of it: glory, money or satisfaction that it works [properly],” said Dr. Graven.

In this case, he and Dr. MacDonald volunteered their time with the sole mission of improving health care. Health outcomes, not technology, were the focus of this tool.

For example, the system helps health professionals catch and treat illnesses early by prompting them to check patients for common or potentially serious health issues.

This early intervention approach keeps patients healthier, and in many cases, helps to reduce the need for hospital admission.

“Aggregate stimulus healthcare related expense in Belize has fallen three years in a row—one of only three countries in the world where that’s true,” said Dr. Graven.

Health care professionals nationwide can access the tool, which allows doctors and nurses to provide more personalized and appropriate care to each patient.

“It’s countrywide,” said Dr. MacDonald. “No matter how you come into the healthcare system, whether it’s a clinic or the public health nurse or a crash on the side of the road, and the ambulance guys are there for you, they have access to all of your patient information.”

Dr. Graven and Dr. MacDonald are thrilled to have received recognition for their work, but are even more excited about the positive results their information system has achieved.

“It has really helped change acute care in Belize because less people are now coming to the hospital with acute care problems; they’re being prevented upstream because of immunization, better pre-natal care. [People] are now being better managed so they don’t need to end up in hospital,” said Dr. MacDonald.

The biggest lesson, said Dr. MacDonald, is that a health care tool such as the BHIS can be extraordinarily powerful, especially when embraced so enthusiastically.

In fact, the BHIS is actually the number two lifesaver in Belize, beating out immunization and antibiotics combined.

“We knew that scientific evidence-based guidelines work, but we had no idea how well they would work when everybody used them,” said Dr. MacDonald. “Hypertension was the number one cause of death in 2003 in Belize, and it’s barely in the top ten now. Who knew these guidelines could be so powerful? They’re only that powerful because everybody’s doing it.”

Visit the Discovery Centre’s YouTube channel to watch the video about all 2013 Professionals of Distinction award recipients.

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