Terms of Reference – Electronic Health Record (EHR)/Telehealth Lead

Operation #: JA-T1141 or ATN/OC-16573-JA

Background:

Ministry of Health, Government of Jamaica (MOH/GOJ) is planning and executing an investment loan from Inter-American Development Bank (IDB; JA-L1049). The programme objective is to improve the health of Jamaica’s population by strengthening comprehensive policies for the prevention of NCDs risk factors and for the implementation of a chronic care model with an improved access to strengthened and integrated primary and hospital services networks, that provide more efficient and higher quality care. The policy-based operation of this Hybrid Programme is the first operation of a PBP series which will be made up of two contractually independent and technically linked loans. The policies in the Programmatic Series will consolidate regulatory measures to address the preventable causes of NCDs and to reorient health systems to address prevention and control of NCDs through a people-centred primary health chronic care model. The investment component, in turn, will finance activities to consolidate integrated health networks and improve the management, quality and efficiency of health services. While the PBP will benefit the Jamaican population at-large, the Investment Loan will have approximately 800,000 potential direct beneficiaries who reside in the catchment areas of the health services networks that will receive investments.

Information systems for health are critical to primary health care and the CCM, as well as complex care. The WHO recognizes the need for information systems for health as part of the Package of Essential Noncommunicable (PEN) Disease Interventions for Primary Health Care in Low-Resource Settings [25]. Additionally, research shows that digital tools can make important contributions to the provision of chronic care when patients and providers are connected to share information, compare this information to knowledge found in evidence-based standards, and monitor results through regular feedback and interaction [26]. Adoption of health information technology has produced mortality rate reductions for complex patients whose diagnoses require cross‐specialty care coordination and extensive clinical information management in hospital settings [28] and improvements in resource allocation efficiency [29]. Health information systems, along with information sharing, have the potential to improve clinical practice by reducing staff errors, improving automated harm detection, monitoring infections more effectively, and enhancing the continuity of care during physician handoffs. A significant number of opportunities exist for the Hospital Information Management System (HIMS) to contribute to savings for both the health system and the Jamaican economy.[1]

Telemedicine[2] and mobile health (mHealth) present possibilities to improve the effectiveness and efficiency of NCD management, which can occur principally in the outpatient setting [31]. For example, blood pressure control consultations by way of 10-15 emails and/or phone calls can occur across weeks and the cost is approximately 29% of the cost of in-person acute care [32]. mHealth tools, such as text messages, medication reminders, symptom monitoring, educational resources, and facilitated patient-provider communication to increase adherence targeting low-income, elderly, and minority groups were found to lessen the burden of travel to a care provider. They have also facilitated better management and improved patient confidence to monitor chronic diseases [33]. Telehealth, or the remote diagnosis and treatment of patients by means of telecommunications technology, has been especially effective in the management of chronic diseases, and has demonstrated improvement in outcomes (diabetes), empowerment and self-management (diabetes and high-risk dialysis patients) [33]. As mobile-cellular subscriptions are high in Jamaica (115 per 100 inhabitants) [34] mHealth and telemedicine may provide an opening to improve patient adherence and aid in follow-up. Given Jamaica’s experience using ECHO’s tele‑mentoring portal for HIV, this platform could be expanded to support chronic illness, and use-cases could be developed to pilot the use of mHealth and telemedicine for chronic care.

PAHO has also been supporting MOH/GOJ to strengthen information systems for health (IS4H) in Jamaica. IS4H is a key strategy in the efforts of the MOH/GOJ improve planning, decision-making, policy formulation, and health equality in Jamaica. MOH/GOJ has embarked on a renewed effort to strengthen and expand its use of information technology to improve the efficiency, efficacy and safety of both clinical and business processes, and to improve the availability of quality information to support clinical, program and policy decision-making.

 

The team: The team is led by the Project Execution Unit (PEU) of the MOH/GOJ and comprises experts from Jamaica and the international community.  The successful individual will form part of this team on a contract basis and report to the IS4H Project Lead.  The successful individual will also work collaboratively with other leaders from across the Ministry of Health, Regional Health Authorities, and the private health sector, as well as with other ministries and international partners.

 

What you’ll do: The primary function of this contract is to oversee development and implementation of Jamaica’s EHR and telemedicine programs. The successful candidate will be an experienced project leader in the health sector who will be responsible for overseeing the design, development, procurement and deployment of Jamaica’s national electronic health record system, an eConsult program, a chronic care mhealth app, and a Tele-ECHO (tele-mentoring) program. This role is expected to be fulltime for a duration of 24 months (with a possible extension of two additional contract renewals of 24 and 12 months) starting in April 2019 and the key responsibilities include:

General responsibilities

  • Prepare and maintain project plans for the duration of the contract
  • Develop and implement stakeholder engagement and consultation plans with MOH representatives, clinicians, and other health system stakeholders
  • Provide routine status reports to IS4H Project Lead

 

EHR and eConsult Programs

  • Consult with MOH representatives and other health system stakeholders to establish the scope, budget, and schedule for the EHR and eConsult programs
  • Oversee development of Jamaica’s electronic health record and eConsult programs (e.g., governance mechanisms, policy and procedure development, solution evaluation and procurement) based on input from internal staff and external consultants
  • Oversee implementation and adoption activities including creation of change management strategy and approach to incorporate the EHR and eConsult into clinical practice
  • Champion the EHR and eConsult programs in Jamaica and promote clinician and patient engagement
  • Oversee development of the clinical guidelines and standards, and a corresponding change management approach to incorporate the EHR and eConsult into clinical practice

 

mHealth

  • Consult with MOH representatives and other health system stakeholders to establish the scope, budget, and schedule for an mhealth app supporting chronic care
  • Document the project charter for the mhealth program
  • Lead development of the business / clinical and stakeholder requirements for the mhealth app
  • Lead procurement of an mhealth app or development company to provide the app
  • Oversee development as required and implementation of the mhealth app
  • Ensure the development of guidelines and protocols for using the mhealth app
  • Develop a clinical change management approach and supporting materials to incorporate use of the app into clinical practice

 

Tele-mentoring

  • Liaise with the Tele-mentoring Lead and Facilitator to ensure coordination among the programs
  • Support project oversight of the tele-mentoring initiative as required

 

Deliverables (to be completed within the first 6 months)

  • Product 1: Workplan – A workplan outlining the key activities and schedule that you will undertake as well as the inputs required from MOH or other stakeholders
  • Product 2: eConsult Project Charter – Project charter outlining the scope of work for the eConsult initiative including objectives, goals, and deliverables/activities; constraints including schedule, cost, and required resources; governance model; and project delivery risks and considerations.
  • Product 2: EHR Project Charter – Project charter outlining the scope of work for the eConsult initiative including objectives, goals, and deliverables/activities; constraints including schedule, cost, and required resources; governance model; and project delivery risks and considerations.
  • Product 3: mHealth Project Charter – Project charter outlining the scope of work for the econsult initiative including objectives, goals, and deliverables/activities; constraints including schedule, cost, and required resources; governance model; and project delivery risks and considerations.
  • Product 4: Progress Reports – Biweekly progress reports to the IS4H Project Director outlining status
  • Other products – Other deliverables to be defined on a semi-annual basis in consultation with and under the direction of the IS4H Project Lead

 

Requirements:

  • Education: A Master’s degree or equivalent experience business administration, health informatics, health/hospital administration, public health, or a related field
  • Experience: Minimum of 10 years of experience managing or leading development of clinical, public health, or ehealth programs
  • Languages: Advanced writing, communication, and presentation skills in English
  • Core and technical competencies: Demonstrated experience in program development or delivery of eHealth and its components; Project management expertise; Knowledge of ehealth solutions and applications; Experience reporting to executive-level stakeholders; Experience working in an international context is highly desirable; Strong organizational skills; Ability to work independently without direct supervision

 

Opportunity Summary: 

  • Length of contract: 24 months with the possibility of two additional contract renewals of 24 and 12 months each pending satisfactory performance
  • Starting date: April 2019
  • Location: Kingston, Jamaica
  • Reporting to: IS4H Project Lead, MOH/GOV
  • Requirements: You must be a citizen of one of the IDB’s 48-member countries and have no family members currently working at the IDB Group. The successful individual is required to obtain a Tax Compliance Certificate (TCC) from Tax Administration Jamaica, Government of Jamaica upon contract award.

 

Our culture: Working with us you will be surrounded by a diverse group of people who have years of experience in all types of development fields, including transportation, health, gender and diversity, communications and much more.

Consanguinity: Pursuant to applicable Bank policy, candidates with relatives (including the fourth degree of consanguinity and the second degree of affinity, including spouse) working for the IDB, IDB Invest, or MIF as staff members or Complementary Workforce contractuals, will not be eligible to provide services for the Bank.

Diversity: The Bank is committed to diversity and inclusion and to providing equal opportunities to all candidates. We embrace diversity on the basis of gender, age, education, national origin, ethnic origin, race, disability, sexual orientation, and religion. We encourage women, Afro-descendants and persons of indigenous origins to apply.

[1]     Conservative estimates suggest if the United States healthcare system were interoperable, at least US$77 billion would be saved annually [37].

[2]     Telemedicine allows patients, providers and other health care system players to overcome geographical barriers by connecting users who are not in the same physical location [30].