A Short History of Health Informatics in Sri Lanka and the Health Informatics Society of Sri Lanka (HISSL)

In January 1997, a group of doctors met at the head quarters of the Sri Lanka Medical Association (SLMA) to discuss the formation of a committee on medical informatics. The meeting ended with the appointment of a committee with Dr. Shyam Fernando as the Chairperson and Dr. Vajira H. W. Dissanayake as the Secretary. The objective of the committee was to increase awareness about medical informatics among doctors. The main activity of the committee was the publication of an electronic newsletter called MediInfo that was emailed to members of the SLMA. The archive of this electronic newsletter, which can be accessed at http://www.infolanka.com/org/mediinfo/, provide interesting insights in to the medical informatics scene in Sri Lanka at that time.

Lighting the Oil Lamp at the inaugural meeting
Prof. Tissa Vitharana (Advisor to
The President, Chief Guest), Dr Shyam Fernando, Dr Vajira HW Dissanayake.

A section of the crowd at the inaugural meeting

HISSL was incorporated as a nonprofit company in Sri Lanka in the year 1999. HISSL became a member of the Asia Pacific Association of Medical Informatics (APAMI) in 1999 and a member of the International Medical Informatics Association (IMIA) in 2011. Dr. Vajira H. W. Dissanayake attended the APAMI meeting in Hong Kong in 2000 and read a paper, Dr. Kumara Mendis served in the steering committee of the APAMI meeting in 2003 in South Korea, and Dr. Roshan Hewapathirana represented HISSL when it was admitted as a member of IMIA at the IMIA General Assembly in Oslo on 28 August 2011.

The main activity of HISSL during its first decade of life was scientific meetings that it organized on its own and in collaboration with other professional medical colleges and associations. The inaugural scientific meeting of the HISSL was held on 4 April 1999, and thereafter meetings were held in March 2003 and in June 2004. In between many smaller meetings and symposia were held in collaboration with other professional medical colleges and associations. The Presidency of HISSL passed on to the Late Prof. M.T.M. Jiffry in 2003 and to Dr. Kumara Mendis in 2004. In these early years some of the prominent personalities who visited Sri Lanka and helped and encouraged us were Prof. Ian Purves from the UK, Prof. K. C. Lun from Singapore, Prof Yun Sik Kwak from South Korea, and Prof Yu-chuan Jack LI from Taiwan. Among them, Prof. Lun’s influence on HISSL was very prominent.

In January 2008, Prof. Rizvi Sheriff was elected President. He held this position until September 2009 when Dr. Vajira H. W. Dissanayake was elected President, a position that he continues to hold up to date. Under Dr. Vajira H. W. Dissanayake’s leadership, HISSL has grown from strength to strength. The foundation for this success came in the form of a chance introduction of Prof. Sundeep Sahay, Professor, Department of Informatics, University of Oslo, Norway to Dr. Dissanayake by Dr. Rohan Jayasuriya of the University of New South Wales, Australia in 2007.  Prof. Sahay who has been involved in developing health informatics in many countries offered his support for Sri Lanka to do so. In June 2007 Prof. Sahay visited the University of Colombo and at a meeting at the Postgraduate Institute of Medicine (PGIM) of the University of Colombo, facilitated by HISSL, at the office of Prof Rezvi Sheriff, who at that time, in addition to being the President Elect of HISSL, was also the Director of the PGIM, it was decided to start a Masters Course in Biomedical Informatics. After the meeting Dr. Dissanayake and Prof. Sahay worked on submitting a grant application to the Norwegian Center for International Co-operation in Higher Education (SIU) for funding to start the course. They were successful in securing a grant of over a million dollars that supported the course until 2014. Today the course has become self-financing and annually upto 30 students are taken into to follow the course. The grant, in fact, came from Norad under its Norwegian Masters (NOMA) programme that was managed by SIU. Dr. Dissanayake was requested to spearhead this project at the PGIM. By August 2008, curriculum development was completed, a specialty board in Biomedical Informatics was set up to administer the course with Dr. Dissanayake as Founder Chairperson and Dr. Roshan Hewapathirana as the Course Manager, and advertisements had been placed to recruit students for the course. The first batch of students started their training in May 2009. The commencement of the course laid the foundation to creating a generation of leaders in health informatics who would work with medical administrators hand in hand to spearhead the deployment of health informatics in Sri Lanka. The Ministry of Health granted two years paid leave for medical doctors and dental surgeons to follow the course. As a result, the course was very popular. So far there have been 89 Sri Lankan graduates from the course in 5 batches and 50 more are currently following the course. One of the graduates was a Vietnamese student who went back to Vietnam after graduation. The graduates have been appointed as Medical Officers/Dental Surgeons in Health Informatics in various institutions of the Ministry of Health and have been spearheading the development of health informatics in their institutions. This has resulted in rapid development of health informatics in Sri Lanka with exponential growth expected in the next few years. The success of the course and the impact it has had on the health sector in Sri Lanka resulted in Health Informatics being recognized as a board certifiable medical specialty in Sri Lanka in 2015. The graduates of the masters course can now follow a two-year Doctor of Medicine (MD) course in health informatics and after two more years of post MD training, of which one year is in an overseas country, they become eligible to be Board Certified in Health Informatics. The entire programme is funded by the Ministry of Health. MD students, like the MSc students, are granted paid leave to follow the course full time. The first batch of twenty-two MD students was selected in November 2016, and they will go on to become the first batch to be board certified in the year 2020.

In this background HISSL has been showcasing its activities and the achievements of the graduates of the masters course at its annual conferences that have now taken an international dimension. The first in this series of conferences – eHealth Sri Lanka 2010 was held in October 2010; thereafter the conferences have been eHealth Sri Lanka 2013; eHealth Asia 2015 (ehealthasia.org); and Digital Health for Health and Wellbeing in collaboration with the Commonwealth Medical Association in 2016 (cma2016.org). These conferences have resulted in Sri Lanka becoming a hub for eHealth/mHealth and Digital Health activities. In recognition of this fact the Commonwealth Medical Association (CMA) invited Prof. Vajira H. W. Dissanayake to take on the Presidency of the CMA with the view to leading a Commonwealth wide Digital Health initiative. This resulted in the launch of the Commonwealth Digital Health Network and the Annual Commonwealth Digital Health Awards in October 2016 in Colombo. These initiatives are being driven with the technical assistance of HISSL.

In January 2010 HISSL joined up with PGIM to launch the Sri Lanka Journal of Biomedical Informatics as an outlet for showcasing Sri Lanka case studies in the field of Health Informatics. It was a peer reviewed open access journal published quarterly online (http://sljbmi.sljol.info). Dr. BJC Perera served as its founding editor in chief. The journal has had many challenges and ceased publication in 2013. It will be re-launched in 2017.

To day HISSL is the major technical partner of the Ministry of Health, Sri Lanka for ICT implementation in the country. The Sri Lankan government has recognized the role played by HISSL. HISSL is represented in the national eHealth Steering Committee of the Ministry of Health and the Country Coordinating Mechanism of the Global Fund. In fact in November 2013, when the World Health Organisation’s South East Asian Regional Office (SEARO) adopted a Regional eHealth Strategy at a High Level Ministerial Meeting in Bangkok, Thailand, President of HISSL, Prof. Vajira H. W. Dissanayake was requested by the government of Sri Lanka to represent the country and be the signatory for Sri Lanka. HISSL has also been working as partners with international development organisations such as such as the UNICEF and Bloomberg Philanthropies to implement major health informatics projects in Sri Lanka. The District Nutrition Monitoring System App developed by HISSL with funding from UNICEF, which is used by field level public health staff in Sri Lanka to monitor the nutrition status of children, won the prize for the best early stage app in the South Asian region at the mBillionth Awards Ceremony in New Delhi in July 2016. This has been one of the major milestones in the transformative process that the Health Informatics sector in Sri Lanka has been undergoing as a result of the work that HISSL has been doing since 1998. It is noteworthy that the driving force for this change has been the medical professionals themselves.

In November 2016 the government of Sri Lanka took a major step forward for Digital Health in the country when the Cabinet of Ministers accepted a proposal by Prof. Dissanayake to set up a Sri Lanka Institute of Digital Health. The institute will be established within the next two years. The opening of the institute in 2018 would be the culmination of a 20-year long journey by HISSL to promote and facilitate Medical Informatics, Health Informatics, eHealth, mHealth and now Digital Health in Sri Lanka.