Like a busy intersection, the West Bank’s health system is experiencing a lot of traffic. Bottlenecks and congestion have become commonplace—and expensive—for both the population and the Ministry of Health that works to serve it.

All this is due to an unsustainable increase in the flow of clients from primary care providers to specialists.

Because while medical professionals in West Bank are well-educated and dedicated, they serve a population that suffers from the diseases and conditions of poverty, old age, stress, and conflict.

Referrals for specialized treatment have increased from 8,000 annually to 62,000.

Clients need complex, specialized care for cancer, heart disease, and other noncommunicable diseases.

In thirteen years, the number of referrals for specialized treatment has increased from 8,000 cases annually to 62,000. And almost half of the referred clients are directed to service providers outside the West Bank, mostly in Israel.

This is extremely expensive—the cost of referrals to Israeli hospitals doubled in the last year for which we have data (and which represents services performed before the recent conflict between Israel and Gaza).

Referrals also raise significant hurdles for clients who live in a part of the world where passing through checkpoints requires approvals and permits.

Data and Information Can Clear the Jam

The Ministry of Health administers 13 hospitals and employs 7,000 health professionals, all of whom need access to timely, scientific health information that can inform their medical decision-making.

The benefits of easy access to information are long-lasting for the health system—over time, it allows health workers to learn more, gain experience, and develop skills in diagnosing and caring for more clients in the future.

And it will help more referrals remain within the West Bank.

That’s why IntraHealth International put its in-house knowledge management unit to work in the West Bank to help improve the referral process. Together with the Ministry of Health, we’ve invested in creating resource centers—or quick-access libraries of health information—in several West Bank hospitals and clinics.

Last month I (Stephanie) traveled to the West Bank to train facilitators who will provide information services to hospital staff, helping physicians and nurses find the latest research, best practices, and emerging trends to inform the way they deliver specialized care.

We led a training workshop for 19 Ministry of Health staff to help them develop the skills necessary to perform research services, engage with visitors, and promote and administer the resource centers.

Now they’re armed with a new wealth of online information.

The three-day workshop, “Advanced Searching Techniques & Hinari Use,” included interactive and participatory styles of instruction that called on the students to perform and demonstrate their understanding of the skills involved.

After all, the art of information retrieval and management is most effective when practiced.After the first workshop, the ministry asked me to present a condensed, one-day version to about 20 faculty members at Ibn Sina College of Health Sciences in Nablus, Palestine. So I provided instruction and demonstrated how to use Hinari (which offers access to one of the world’s largest collections of biomedical and health literature) and how to use free citation management software.

The participants of both workshops had never been trained to use Hinari. Now they’re armed with a new wealth of online information.

Now IntraHealth’s knowledge management unit is adapting the workshop materials into eLearning modules that can be shared with the facilitators and hospital staff who use the resource centers.

And thanks to an award from the British Medical Association, new books and learning materials will soon be available to users as well.

We hope this new power—to find timely information and to share it with others—will begin to clear the jam in West Bank’s referrals system. We hope that, eventually, citizens who need specialized care will be able to get it closer to home—without getting stuck in traffic, so to speak. But most of all, our hope is that this is only the beginning.

IntraHealth’s Palestinian Health Capacity Project is funded by the US Agency for International Development. Photo courtesy of Maureen Corbett and Barbara Stilwell.

Also read:

• West Bank Health Workers Use New Online Resource Centers to Prepare for Ebola and Other Health Care Challenges
• More about IntraHealth's work in the West Bank