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Health + Tech | Population health management

Published:Friday | December 28, 2018 | 12:00 AMDoug Halsall
Doug Halsall

Jamaica has long been engaged in strategies to manage population health. From the establishment of the Extended Programme on Immunisation in 1977 to the 1978 Alma Ata declaration which focused on the need to shore up the primary healthcare system.

Efforts have consistently continued along these lines and, admittedly, we have made much progress over the last few decades.

Although we have seen an improvement in general life expectancy, which was 76 years as at 2016, we seem to be going backwards with the increasing incidence of non-communicable diseases.

Recently, the Minister of Health Dr Christopher Tufton indicated that he will be taking proposals on the matter of a National Health Insurance Scheme (NHIS) to the Cabinet. This is an initiative that has been more than 50 years in the making, with the intention of improving population health. Unlike 50 years ago, I believe we are now in the best position, with the available technology, to make this a reality.

For us to determine the nature, structure and ongoing requirements of an NHIS, we need to ensure that we have the right data to support our efforts. The current health technology can achieve this.

This data analysis can help us to identify our current position at any given time, as well as requirements for each cohort of the population. This is essential to general population health management. Data analysis can allow us to be able to identify trends across various groups in specific communities so that we can formulate timely and effective policies and interventions.

Health technology comprises several data sources that can together achieve this goal.




Electronic Medical Records (EMR) is currently a part of the Health Information Management System at the University Hospital of the West Indies, as well as several medical office management systems. This is where you can find a complete medical history of the patient and, in some cases, the patient's family. This could include inheritable illnesses that may affect the patient and need to be a part of the care protocol. EMR is very rich in clinical data and trusted by physicians. Also, most technology comes with reporting and analysis, so it would be easy to extract data from this source as opposed to using paper records.

- Insurance claims information: Our major insurance companies have been using online real-time claims administration for years now. Insurance claims information can give non-personal details such as the type of care most accessed, illnesses circulating at any given time, the location of any cluster of cases for certain illnesses, the cohort of persons accessing care, and a host of other information. Information can also be accessed on the prevalence of certain illnesses, including non-communicable diseases.

- Pharmacy data: this can be used a surveillance tool as it can alert the Government of emerging illnesses based on medication prescribed and over the counter drugs accessed. In addition, pharmacy data can give an account of medication coming into the country, where from, how consumed, diseases that are currently being treated, and where.

- Administrative data: this provides non-clinical data, including the characteristics of the population, the level of use of service by various groups, ability to pay, access to health services via geographic location, gender, age, and so on.

- Remote care management tools: these have become very popular over the past few years because they allow individuals to constantly track their health indices and provide information on issues like fitness, heart rate, blood pressure, as well as several others. The good thing about these devices is that they can allow for this information to pass from patient to doctor in real time, facilitating quick interventions if necessary. There is important health data that can be obtained from these devices to gauge the general health and well-being of the population, as well as determine health and fitness practices.

A combination of data sources will give a holistic picture of the health status of the country. There is the ability to extract grouped and individual information for specific and streamlined interventions. This is necessary if we hope to have a successful NHIS.

- Doug Halsall is chairman and CEO of Advanced Integrated Systems. Feedback: