This practice of self-referral appears to short-circuit the objective for which the GACO system was created, which was to centralize patients' requests on a shared list and to set access priorities based on the urgency and complexity of cases as assessed by health professionals.
On a national level, the aim was to centralize patient data.
For example, while there is evidence that an SMS based sentinel system has substantially improved disease surveillance in Madagascar [ 32], the highly sophisticated UK National Health System recently had to abandon a major national IT program to centralize patient records in midcourse [ 33, 34].
Centralized patient records were used to select monthly stratified random samples of patients discharged from the medical, surgical and four other major services at each facility to receive a mailed survey.
Most health clinics in sub-Saharan Africa use patient name, date of birth, government ID, or phone number to identify patients, and record numbers are not centralized, making patients virtually impossible to follow across services [ 9].
In addition, we should justly build a core stroke center in the district and centralize the patients.
IT service providers help doctors, hospitals, insurance companies and pharmaceutical companies digitize medical data, speed claims processing, centralize patient information, improve health care delivery and provide market research and sales support.
Such a model would be more centralized for individual patients, especially as primary care is becoming elevated in importance in the health care continuum, and would also retain the benefits of decentralization from a provider's point-of-view, as aggregated information would be often be more local rather than global in scope.
Consistent with others [ 30, 31, 34], our study findings points to the need to centralize accessing patient information across health-care organizations including the use of information technology.
In addition, this new position would create stronger integration between neurology and psychiatry in the hospital and medical school by centralizing a patient population in wards that could be used by both divisions.
