Testing ‘digital pens’ in hospitals in Tanzania

Technical hospital advisor at Israel Pascal testing a digital pen

In many hospitals throughout the world, it is still standard practice for doctors and nurses to keep handwritten patient files; this is also the case in Africa. However, these files can easily get lost, and if patient data have to be transferred from one medical institution to another, the files can take a long time to arrive. Digital documents that can be shared and stored easily could go a long way to combating such problems. To help remedy this situation, at the beginning of January 2010, the IT managers of several hospitals in Tanzania began gearing themselves up to test a new ‘digital pen’; one that can convert doctor’s handwriting into a compact, easy-to-archive digital file.

So why a digital pen and not a computer? “Using a computer and a keyboard to enter data could be a solution”, confirms Israel Pascal, technical project officer in Arusha. “Doctors are currently using normal keyboards for data input. But in many cases, doctors are reluctant to use a keyboard because they lack required skills: they type slowly and make frequent errors. It would be much more convenient if their handwriting could just be converted automatically into a digital file. The pen that we will experiment with can do that.”

First results: end of January 2010

The digital pens are currently being tested at a number of hospitals in Arusha and Mwanza that are owned and managed by the Evangelical Lutheran Church Tanzania (ELCT), a body that manages around fifteen per cent of Tanzania’s national health services. After the first results have arrived from Arusha at the end of January 2010, the pen will be tested at various medical facilities in and around Mwanza. If successful, the hospitals will order more pens.

The Health Management Information System (HMIS) project

Hospital nurses in a knowledge sharing workshop on HMIS

The ‘digital pen test’ is only one aspect of a much wider health initiative in Tanzania called the Hospital Management Information System (HMIS) project, which is run by ELCT and supported by the International Institute for Communication and Development (IICD). In fact, the ELCT hospitals and those in Mwanza that are taking part in the digital pen test are also part of the HMIS project.

Under this project, an automated HMIS has now been installed in four hospitals. Part of the project also involves developing a generic Tanzanian version of Care2X, an open source HMIS. ELCT programmers are, therefore, cooperating with the University Computer Centre (UCC) in Dar es Salaam, Tanzania’s capital, to adapt the software to Mfumo wa Taarifa za Uendeshaji wa Huduma za Afya (the Swahili name for HMIS) – the government health registration system. Through the HMIS project, hospitals can quickly and easily collect, store and analyse data on patient registration, billing, laboratory tests, pharmaceutical issues, stock-taking, x-rays, and ward management by using digital tools. In addition, the effort also focuses on a wide range of other ICT issues, such as telemedicine.

The benefits of a well-functioning HMIS

Laboratory Technician from Selian Lutheran Hospital, Arusha, Tanzania

Health facility management often suffers from inefficient management practices due to chronic staff shortages, high staff turnover rates and a sub-optimal use of health data. The quality of information from many health facilities, particularly in Tanzania’s rural areas, does not meet the required standards and takes a lot of time for the staff to collect. Fortunately, the country’s ICT structure has now developed to a level where it is realistic to computerise some of the routine processes in hospital management. Through the HMIS project, there has been a marked benefit during the last four years for both hospital staff and patients as a result of digitising hospital data. First of all, the new system provides timely and accurate information, which in turn leads to better healthcare planning and improved hospital diagnoses. Furthermore, an increasing number of patients gain access to better healthcare services. It also boosts hospital finances through better revenue collection, better patient flows and a more efficient use of capacity.

For more information about the IICD-supported eHealth programme in Tanzania, which consists of seven eHealth projects and reaches over 6,000 health workers and hospital managers, contact: Nic Moens, Country Programme Manager for Tanzania at: or visit

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