Digitalising a health centre: the order that works

Digitalising a health centre rarely fails for technical reasons. It fails because a screen was added to the staff's work without removing anything from their load. Here is the order that works.

Step 1 — Start at reception, not with statistics

The temptation is to start with the monthly report, because that is what is owed up the line. That is the classic mistake: statistics are only worth what the upstream data entry is worth. Digitalise patient identification and the consultation first. The monthly report then builds itself from data already captured.

Step 2 — One identifier, one patient

Duplicates are the main enemy: the same patient registered three times makes follow-up impossible and distorts every indicator. Define the identification rule from the start — name, date of birth, village, phone number — and hold to it. A merge function must exist before go-live, not after.

Step 3 — The pharmacy, because it shows

This is the module that convinces teams: anticipated stock-outs, expiry alerts, month-on-month consumption. The benefit is immediate and visible, which buys the goodwill needed for the less rewarding modules.

Step 4 — Accept paper during the transition

For six to eight weeks, the register and the software coexist. It is uncomfortable, and it is the only way to lose nothing if the software reveals a problem. Set a date to stop the paper, announce it, and hold to it.

Step 5 — Train the stand-ins too

The project dies the day the trained clerk is transferred. Train at least two people per post, post a one-page memo by the workstation, and plan a refresher session three months after go-live.

Technical points to check

• Power. A UPS for each data entry station, sized for an ordinary outage.
• Network. The software must work offline and synchronise afterwards.
• Backup. Daily, encrypted, stored somewhere other than the machine being backed up. Test a restore after the first month.
• Confidentiality. Health data is sensitive under Law No. 2017-28: it requires prior HAPDP authorisation, named accounts and access logging.

Indicators to watch from month one

Average waiting time, share of complete records, duplicates created, stock-outs, and the gap between recorded and actual consultations. Those five figures say, better than any report, whether the project is holding or drifting.