Support For The Health Systems Strenthening For The Prevention And Care Management Of Non Communicable Diseases Programme
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 Setting. 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. 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 and improvements in resource allocation efficiency. 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.
Telemedicine and mobile health (mHealth) present possibilities to improve the effectiveness and efficiency of NCD management, which can occur principally in the outpatient setting. 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 . 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. 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). As mobile-cellular subscriptions are high in Jamaica (115 per 100 inhabitants). 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 Investment Programme has two (2) major components and an allocation to support programme administration and evaluation:
Component 1 – Organization and consolidation of integrated health services networks
This component will finance the purchase of medical equipment and the improvement of infrastructure for primary health care services in the catchment areas of three priority hospitals to increase their capacity in health promotion and disease prevention, especially regarding chronic, non-communicable diseases. The investments will focus on strengthening the diagnostic and screening capability as well as the clinical and resolutive capacity of health clinics. This Component will further finance the upgrading and or expansion of three (3) hospitals selected on criteria relating to strategic role in the national hospital network, supply-demand gap analyses, and physical needs assessment. The hospitals will benefit from infrastructure upgrading and or expansion as well as modernization.
Sub-Component 1.1 – Strengthening Primary Care
1.1 The purpose of this subcomponent is to increase the physical capacity for service provision at the primary care level in three (3) priority geographical areas. Approximately ten (10) health centres have been identified to receive investments in medical equipment and infrastructure refurbishment and expansion. The subcomponent will finance: (i) the preparation of building designs for the construction of new infrastructure on the sites of existing facilities (three centres), expansion of existing structures (four centres), and refurbishing (three centres); (ii) the physical works required for infrastructure improvement; (iii) the purchase of medical equipment including essential diagnostic and treatment items for NCDs, such as sphygmomanometers, electrocardiogram machines, pulse oximeters, defibrillators, computerized chemistry machines, etc.); (iv) engineering services for construction supervision; and (v) corrective and preventive maintenance of medical equipment
Sub-Component 1.2 – Increasing the Capacity and Efficiency of Hospital Services
This subcomponent will address urgent needs to enhance patient safety and services in three (3) hospitals whose catchment areas contain the health centres identified in subcomponent 1.1. Financing from this subcomponent will be allocated to:
(i) the building and engineering designs for the infrastructure improvement and expansion;
(ii) the construction in three hospitals according to contracted plans and designs;
(iii) the purchase of medical equipment to raise clinical capacity to partially account for existing demand;
(iv) the purchase of imaging equipment, including computerized tomography machines;
(v) purchase of industrial style laundry machines;
(vi) construction supervision services; and
(vii) the design and implementation of a corrective and preventive equipment maintenance programme.
Component 2 – Improvement of Management, Quality and Efficiency of Health Services
This component will provide technical assistance to design and implement the Chronic Care Model (CCM) in the participating health services networks; to review and develop care pathways and protocols; and to prepare change management, continuous quality improvement and social media marketing for behaviour change strategies. It will also finance the implementation of the fourth Jamaica Health and Lifestyle Survey. This component will further support:
- the creation of a strong foundation for a digital health ecosystem, including the adoption of standards for interoperability, system architecture, updated governance structure, and other key elements;
- the design and implementation of a sustainable Electronic Health Record (EHR) platform focusing on digitalization of key processes within the improved CCM;
- the strengthening of telehealth/telemedicine/telementoring capacity to include chronic care management, and the establishment of norms and processes for its institutionalization.
- the strengthening of telehealth/telemedicine capacity through the expansion of the ECHO model, the inclusion of chronic care in the platform, and the establishment of norms and processes for its institutionalization.
The Loan also supports Programme Administration and Evaluation:
This allocation will support the MOH in terms of strengthening its institutional capacity for project implementation. It will finance, inter alia, the consultants of the Project Execution Unit (PEU), specialized technical services, independent auditing, as well as surveys and studies regarding the implementation of the programme and evaluation of its impact. The PEU is structured to provide additional capability in the areas of project management, procurement, financial management, infrastructure upgrading, medical equipment specification, and health information technology. Technical and fiduciary staff from the MOH will work closely with the PEU specialists so that the MOH benefits from knowledge transfer and capacity strengthening
The team: The team is led by the Project Execution Unit (PEU) from 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 role is to plan, coordinate, select, procure and implement the required components of a national ICT infrastructure that will enable the Ministry of Health’s vision for IS4H in Jamaica. This role is expected to be fulltime for a duration of 24 months (with a possible extension of up to 60 months) starting on April 1, 2019 and the key responsibilities include:
- Leading the design, planning and implementation of a national ICT infrastructure for Information Systems for Health under the direction of the Ministry of Health under recommendations from the National IS4H Steering Committee will enable the Ministry of Health’s vision for IS4H in Jamaica.
- Providing strategic advice and leadership to the Ministry of Health related to information systems for health strategic and technical enablers 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.
- Coordinating the design and implementation of a national IS4H technical and information architecture that will enable the Government of Jamaica’s vision of interoperable health information systems across both the public and private health sectors, in collaboration with MOH/GOJ and GOJ ICT leadership, and other national and international stakeholders;
- Managing the portfolio of IS4H ICT projects, including providing oversight of multiple ICT projects.
- Coordinating strategies, activities and project plans with other project managers and the Ministry of Health corporate ICT leadership.
- Developing performance measures for ICT projects, initiatives and information technology solutions, and preparing routine performance and progress report to MOH/GOJ leadership and the IS4H Governance Committee;
- Managing a team of contract and MOH/GOJ resources that will implement various ICT projects and initiatives in the IS4H Strategic Plan.
- Advising on the procurement of hardware, software and services based on identified requirements, including conducting research on vendors and markets, overseeing development of requests for proposals or tenders, preparing purchase orders, and reviewing contracts and service level agreements.
- Identifying and evaluating information systems, tools, strategies, standards and best practices from the international health community and beyond to deliver on the vision and priorities of the IS4H Strategic Plan.
- Product 1: Work plan – A work plan outlining the key activities and schedule that you will undertake as well as the inputs required from MOH/GOJ or other stakeholders
- Product 2: ICT Project Charter – Project charter outlining the scope of work for ICT work including objectives, goals, and deliverables/activities; constraints including schedule, cost, and required resources; governance model; and project delivery risks and considerations.
- Product 3: Progress Report – Biweekly progress report to the IS4H Project Director outlining status
- Product 4: Final Report – Final report on all of the activities carried out during the contract’s period as well as the conclusions
- Other products – Other deliverables to be defined on a semi-annual basis in consultation with and under the direction of the IS4H Project Lead
Qualifications and Requirements:
- Education: A Master’s degree or equivalent in computer science, business administration, or related field;
- Experience: Minimum of 5 years of professional experience working in a senior leadership role in the context of planning and implementing information systems and complex ICT infrastructures.
- Languages: Advanced writing, communication and presentation skills in English; Spanish a plus.
- Core and Technical Competencies: Experience implementing systems that transform business processes; Demonstrable knowledge current and emerging information technologies, information systems and technical architectures; Knowledge of health information systems architectures, technologies and standards is an asset; Excellent interpersonal skills with the ability to interact culturally, linguistically, and diplomatically with diverse internal and external individuals; Superior negotiation skills; demonstrated experience working in formal project management methodology; ability to manage concurrent projects that involve a broad range of stakeholders; Experience in procurement processes in public institutions; Experience working in an international context is highly desirable.
- Length of contract: Full-time for 24 months (with a possible extension of up to 60 months pending satisfactory performance)
- Starting date: August 2020
- Location: Jamaica and/or place of residency
- Responsible person /Reporting Relationship: IS4 H Project Lead. The Consultant shall also liase with the Director, SITU, and Michele Roofe, Senior Medical Officer – Health Informatics, MOH/GOJ
- Requirements: You must be a citizen of one of the IDB’s 48 member countries.