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Health Organization Case Study

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Introduction At the beginning of the nineties, the Soviet Union’s disintegration and its effect on Eastern European socialist countries produced a sudden shrinkage of Cuba’s economy. US sanctions were in that moment tightened, and a very significant economic crisis appeared in Cuba's socioeconomic infrastructure. All spheres of the society were affected, particularly those connected with energy supply. For instance, long daily hours of black out were common in the whole Cuban territory When the telemetric era was beginning its impressive development in most of the industrialized countries, those were the circumstances in a nation dealing with very limited material resources and a very low density of computers and telephone lines. Consequently, from the economical and material point of view, it was perhaps the less promising scenario to think in developing a complex technological project such as a nationwide knowledge network. However, Cuba had some remarkable features, especially: an efficient nationwide health system and a huge human potential. It became imperative to take advantage of them to deal with future demands of health information and solutions in collaborative environments. In this context, INFOMED, Cuba’s national online healthcare information network was founded in 1991. INFOMED leaders realized that the emergent communication technologies offered a golden opportunity to be in a roughly similar situation as a developed country concerning the information access. In a country with such a shortage of resources, it has a value difficult to be exaggerated. With a reduced staff of around 40 highly qualified specialists, who were learning while the project was growing up, INFOMED began to build what today is a national online healthcare information network that connects doctors, hospitals, research facilities, and rural clinics throughout the country providing health news and medical data. Since the project required an expensive physical infrastructure, along the first 5 years, the scope of the network was rather small. However, within only 18 months, an unsophisticated network was already up and running. Since its foundation it was decided to use Linux OS because it was more in line with Cuban philosophy of an open source approach; the fact that there were many Linux experts in Cuba was also considered. As a matter of fact, it was the first project on a national level anywhere in the world that ran exclusively on Linux. INFOMED’s growth inescapably involved to obtain US technologies which made the whole effort even more difficult because of the sanctions. It is possible to grasp the magnitude of the difficulties in this concern by visiting some American Web sites where it is found explicit prohibitions for a Cuban citizen to download anything from them, even universally free applications. Besides a modest amount of funds supplied by the Cuban ministry of health, INFOMED was the recipient of an extra-budgetary project from the United Nations Development Program (In association with the Pan American Health Organization). Subsequently, the scope of the network was significantly enlarged using finances acquired by consultancy projects and other services offered to several enterprises. It has also received regular help and hardware donations from the U.S. non- governmental agency “INFOMED USA”. At the present moment, INFOMED is a sustainable system which has an impact in the improvement of the community health through cost-effective use of information technologies in a nationwide and international information and knowledge network. It identifies and shares low-cost health and medical solutions and spreads that knowledge via family physicians to the communities they serve. A modular continuing-education strategy enables people to use information technologies for their own benefit and improve the continuing education of Cuban health workers. Cooperative agreements provide low-cost journal subscriptions and other information services. With points of access in all the provincial medical faculties, courses offered to health professionals, a Virtual Health University, "presence points" (places along the whole country where people lacking the means can go to access and disseminate resources and information), among many other activities and services, INFOMED presence in the National Health System has clearly increased the interaction of medical and health workers with the Cuban population and with the global health community. Particularly useful has been INFOMED Website where users can find the complete texts of all Cuban medical journals, electronic books, health databases, news, etc. The United Nations Development Programme has awarded Cuba's Informed Network special recognition for their contribution in applying information technology in the struggle for world social and economic development. We believe that, since project’s initial goal of linking Cuba’s major hospitals, primary health centers and health workers has been accomplished, INFOMED has created solid (structural and cultural) roots that enable its managers to think in higher developments. In our opinion this is an example of a successful experience consolidated after a critical situation that was faced with a vision of the future. At the same time, it can serve as a source of reflection even to developed countries, since it shows that not always it is necessary to have expensive technologies and to spend a lot of money to get relevant achievements concerning the administration and interchange of health information.

References
Fast Facts on US Hospitals. American Hospital Association Accessed September 2, 2007

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