Photo left to right: Dr Lasith Ihalagamage and Dr Rangana Wadugedara, Postgraduate Institute of Medicine, University of Colombo; Dr Vindya Kumarapeli, Bloomberg Philanthropies Data For Health Initiative, University of Melbourne; Dr Aathirayan Sivanantharajah, Vital Strategies; Dr. Roshan Hewapathirana, Health Informatics Society of Sri Lanka
A new interactive mobile app that was created as part of Data for Health, won an award at the Commonwealth Digital Health Conference Awards in Colombo, Sri Lanka in October 2017.
The app addresses the high proportion of unusable and poorly specified causes of death in Sri Lanka, by educating doctors to accurately fill out the international standard death certificate form.
Why is MCCOD a problem in Sri Lanka?
In Sri Lanka, close to 55 per cent of all deaths take place in hospitals and are certified by doctors using the Death Declaration form. Doctors receive minimal training on the medical certification of cause of death (MCCOD) during undergraduate study, however the training does not continue and responsibility of filling out the form is generally given to young intern doctors.
The use of the Death Declaration form has recently been replaced by the international standard death certificate in Sri Lankan hospitals, but doctors were not provided training on how to fill in the new form.
Filling the MCCOD correctly requires the doctor to identify the disease that directly lead to death, the sequence of events leading to death as well as specifying which the underlying cause of death was.
While face-to-face training on the new form has been piloted in some areas, the number of practicing physicians - and their geographic spread throughout the country - makes face-to-face training difficult. The new app enables training to a wider group of doctors to make more sustainable and long-term improvements in cause of death certification. However, the application cannot completely substitute face-to-face training.
How the app fills the gap
The Medical Certification App shows young doctors how to correctly fill in the medical certificate and clarifies their legal obligations to accurate death certification, with an interactive 'COD tutor', which uses case scenarios.
The app is a handy tool that all doctors can resort to when in doubt and it can effectively contribute to better COD statistics. Once downloaded, internet connection is not necessary to use the app.