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Judy W Gichoya, Marc Kohli, Larry Ivange, Teri S Schmidt, Saptarshi Purkayastha
Open-source development can provide a platform for innovation by seeking feedback from community members as well as providing tools and infrastructure to test new standards. Vendors of proprietary systems may delay adoption of new standards until there are sufficient incentives such as legal mandates or financial incentives to encourage/mandate adoption. Moreover, open-source systems in healthcare have been widely adopted in low- and middle-income countries and can be used to bridge gaps that exist in global health radiology...
May 10, 2018: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
V Muthee, A F Bochner, S Kang'a, G Owiso, W Akhwale, S Wanyee, N Puttkammer
INTRODUCTION: Electronic medical record (EMR) systems can yield many benefit; however, facilities need to meet certain requirements before they are able to successfully implement an EMR. We evaluated the feasibility and utility of conducting EMR readiness assessments (ERAs) to assess readiness of public facilities in Kenya for deployment of an EMR. METHOD: I-TECH supported the Ministry of Health to deploy KenyaEMR, an HIV/AIDS care and treatment EMR developed using the OpenMRS platform, at over 300 healthcare facilities in Kenya...
January 2018: International Journal of Medical Informatics
Neha A Goel, Amal A Alam, Emily M R Eggert, Soumyadipta Acharya
Telemedicine offers a method to bridge the healthcare access gap in low and middle income countries (LMICs) by connecting providers with patients using appropriate technology. Here we describe the design and development of a novel modular telemedicine platform, Intelehealth, that would enable health systems to connect remote doctors with patients in rural clinics using a customizable Android-based platform and a cloud-based electronic health record system at the backend (OpenMRS). This open source platform enables task shifting of medically relevant information gathering by a local health worker, transmission of this information to a remote doctor, and a telephonic conversation between the doctor and the patient that subsequently allows for delivery of an appropriate therapeutic plan...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Shefali Oza, Darius Jazayeri, Jonathan M Teich, Ellen Ball, Patricia Alexandra Nankubuge, Job Rwebembera, Kevin Wing, Alieu Amara Sesay, Andrew S Kanter, Glauber D Ramos, David Walton, Rachael Cummings, Francesco Checchi, Hamish S Fraser
BACKGROUND: Stringent infection control requirements at Ebola treatment centers (ETCs), which are specialized facilities for isolating and treating Ebola patients, create substantial challenges for recording and reviewing patient information. During the 2014-2016 West African Ebola epidemic, paper-based data collection systems at ETCs compromised the quality, quantity, and confidentiality of patient data. Electronic health record (EHR) systems have the potential to address such problems, with benefits for patient care, surveillance, and research...
August 21, 2017: Journal of Medical Internet Research
Saptarshi Purkayastha, Judy W Gichoya, Siva Abhishek Addepally
BACKGROUND: Multiple specialized electronic medical systems are utilized in the health enterprise. Each of these systems has their own user management, authentication and authorization process, which makes it a complex web for navigation and use without a coherent process workflow. Users often have to remember multiple passwords, login/logout between systems that disrupt their clinical workflow. Challenges exist in managing permissions for various cadres of health care providers. OBJECTIVES: This case report describes our experience of implementing a single sign-on system, used between an electronic medical records system and a learning management system at a large academic institution with an informatics department responsible for student education and a medical school affiliated with a hospital system caring for patients and conducting research...
March 29, 2017: Applied Clinical Informatics
Suranga N Kasthurirathne, Burke W Mamlin, Theresa Cullen
OBJECTIVES: Despite significant awareness on the value of leveraging patient relationships across the healthcare continuum, there is no research on the potential of using Electronic Health Record (EHR) systems to store structured patient relationship data, or its impact on enabling better healthcare. We sought to identify which EHR systems supported effective patient relationship data collection, and for systems that do, what types of relationship data is collected, how this data is used, and the perceived value of doing so...
February 1, 2017: Applied Clinical Informatics
Samuel Kang'a, Nancy Puttkammer, Steven Wanyee, Davies Kimanga, Jason Madrano, Veronica Muthee, Patrick Odawo, Anjali Sharma, Tom Oluoch, Katherine Robinson, James Kwach, William B Lober
BACKGROUND: Variations in the functionality, content and form of electronic medical record systems (EMRs) challenge national roll-out of these systems as part of a national strategy to monitor HIV response. To enforce the EMRs minimum requirements for delivery of quality HIV services, the Kenya Ministry of Health (MoH) developed EMRs standards and guidelines. The standards guided the recommendation of EMRs that met a preset threshold for national roll-out. METHODS: Using a standards-based checklist, six review teams formed by the MoH EMRs Technical Working Group rated a total of 17 unique EMRs in 28 heath facilities selected by individual owners for their optimal EMR implementation...
January 2017: International Journal of Medical Informatics
Terry J Hannan
The management of health care delivery requires the availability of effective 'information management' tools based on e-technologies [eHealth]. In developed economies many of these 'tools' are readily available whereas in Low and Middle Income Countries (LMIC) there is limited access to eHealth technologies and this has been defined as the "digital divide". This paper provides a short introduction to the fundamental understanding of what is meant by information management in health care and how it applies to all social economies...
2015: World Hospitals and Health Services: the Official Journal of the International Hospital Federation
S Marceglia, P Fontelo, E Rossi, M J Ackerman
BACKGROUND: Mobile health Applications (mHealth Apps) are opening the way to patients' responsible and active involvement with their own healthcare management. However, apart from Apps allowing patient's access to their electronic health records (EHRs), mHealth Apps are currently developed as dedicated "island systems". OBJECTIVE: Although much work has been done on patient's access to EHRs, transfer of information from mHealth Apps to EHR systems is still low. This study proposes a standards-based architecture that can be adopted by mHealth Apps to exchange information with EHRs to support better quality of care...
2015: Applied Clinical Informatics
Suranga N Kasthurirathne, Burke Mamlin, Harsha Kumara, Grahame Grieve, Paul Biondich
We sought to enable better interoperability and easy adoption of healthcare applications by developing a standardized domain independent Application Programming Interface (API) for an Electronic Medical Record (EMR) system. We leveraged the modular architecture of the Open Medical Record System (OpenMRS) to build a Fast Healthcare Interoperability Resources (FHIR) based add-on module that could consume FHIR resources and requests made on OpenMRS. The OpenMRS FHIR module supports a subset of FHIR resources that could be used to interact with clinical data persisted in OpenMRS...
November 2015: Journal of Medical Systems
Suranga N Kasthurirathne, Burke Mamlin, Grahame Grieve, Paul Biondich
Interoperability is essential to address limitations caused by the ad hoc implementation of clinical information systems and the distributed nature of modern medical care. The HL7 V2 and V3 standards have played a significant role in ensuring interoperability for healthcare. FHIR is a next generation standard created to address fundamental limitations in HL7 V2 and V3. FHIR is particularly relevant to OpenMRS, an Open Source Medical Record System widely used across emerging economies. FHIR has the potential to allow OpenMRS to move away from a bespoke, application specific API to a standards based API...
2015: Studies in Health Technology and Informatics
Darius Jazayeri, Shefali Oza, Glauber Ramos, Hamish Fraser, Jonathan M Teich, Andrew S Kanter, Ellen Ball
Ebola treatment presents unique challenges for medical records because strict infection control requirements rule out most conventional record-keeping systems. We used the OpenMRS platform to rapidly develop an EMR system for the recently opened Kerry Town, Sierra Leone Ebola Treatment Centre. This system addresses the need for recording patient data and communicating it between the infectious and non-infectious zones, and is specifically designed for maximum usability by staff wearing cumbersome protective equipment...
2015: Studies in Health Technology and Informatics
Tom Oluoch, Nicolette de Keizer, Patrick Langat, Irene Alaska, Kenneth Ochieng, Nicky Okeyo, Daniel Kwaro, Ronald Cornet
INTRODUCTION: Several studies conducted in sub-Saharan Africa (SSA) have shown that routine clinical data in HIV clinics often have errors. Lack of structured and coded documentation of diagnosis of AIDS defining illnesses (ADIs) can compromise data quality and decisions made on clinical care. METHODS: We used a structured framework to derive a reference set of concepts and terms used to describe ADIs. The four sources used were: (i) CDC/Accenture list of opportunistic infections, (ii) SNOMED Clinical Terms (SNOMED CT), (iii) Focus Group Discussion (FGD) among clinicians and nurses attending to patients at a referral provincial hospital in western Kenya, and (iv) chart abstraction from the Maternal Child Health (MCH) and HIV clinics at the same hospital...
August 2015: Journal of Biomedical Informatics
Maxwell O Akanbi, Amaka N Ocheke, Patricia A Agaba, Comfort A Daniyam, Emmanuel I Agaba, Edith N Okeke, Christiana O Ukoli
BACKGROUND: The Electronic Health Record (EHR) is a key component of medical informatics that is increasingly being utilized in industrialized nations to improve healthcare. There is limited information on the use of EHR in sub-Saharan Africa. This paper reviews availability of EHRs in sub-Saharan Africa. METHODS: Searches were performed on PubMed and Google Scholar databases using the terms 'Electronic Health Records OR Electronic Medical Records OR e-Health and Africa'...
2012: Journal of Medicine in the Tropics
Rabea Krexner, Georg Duftschmid
In this paper we present our experiences with extending an existing approach for an archetype-compliant collection and export of data according to the openEHR specifications within the open source EHR system OpenMRS. It allows an automatic generation of forms from templates, which were introduced by openEHR as an extension of the dual-model approach. Data entered in these forms can be exported in form of standardized EHR extracts. The use of templates allowed us to solve problems reported for the original archetype-based version of the approach, which were caused by the high optionality within archetypes...
2014: Studies in Health Technology and Informatics
Jeffrey W Pennington, Byron Ruth, Michael J Italia, Jeffrey Miller, Stacey Wrazien, Jennifer G Loutrel, E Bryan Crenshaw, Peter S White
Biomedical researchers share a common challenge of making complex data understandable and accessible as they seek inherent relationships between attributes in disparate data types. Data discovery in this context is limited by a lack of query systems that efficiently show relationships between individual variables, but without the need to navigate underlying data models. We have addressed this need by developing Harvest, an open-source framework of modular components, and using it for the rapid development and deployment of custom data discovery software applications...
March 2014: Journal of the American Medical Informatics Association: JAMIA
Louis E Fazen, Benjamin T Chemwolo, Julia J Songok, Laura J Ruhl, Carolyne Kipkoech, James M Green, Justus E Ikemeri, Astrid Christoffersen-Deb
We present a new open-source Android application, AccessMRS, for interfacing with an electronic medical record system (OpenMRS) and loading 'Smart Forms' on a mobile device. AccessMRS functions as a patient-centered interface for viewing OpenMRS data; managing patient information in reminders, task lists, and previous encounters; and launching patient-specific 'Smart Forms' for electronic data collection and dissemination of health information. We present AccessMRS in the context of related software applications we developed to serve Community Health Workers, including AccessInfo, AccessAdmin, AccessMaps, and AccessForms...
2013: Studies in Health Technology and Informatics
Hamish S F Fraser, Ali Habib, Mark Goodrich, David Thomas, Joaquin A Blaya, Joseph Reginald Fils-Aime, Darius Jazayeri, Michael Seaton, Aamir J Khan, Sharon S Choi, Foster Kerrison, Dennis Falzon, Mercedes C Becerra
INTRODUCTION: Multi-drug resistant TB (MDR-TB) is a complex infectious disease that is a growing threat to global health. It requires lengthy treatment with multiple drugs and specialized laboratory testing. To effectively scale up treatment to thousands of patients requires good information systems to support clinical care, reporting, drug forecasting, supply chain management and monitoring. METHODS: Over the last decade we have developed the PIH-EMR electronic medical record system, and subsequently OpenMRS-TB, to support the treatment of MDR-TB in Peru, Haiti, Pakistan, and other resource-poor environments...
2013: Studies in Health Technology and Informatics
David K Vawdrey, Karthik Natarajan, Andrew S Kanter, George Hripcsak, Gilad J Kuperman, Melissa S Stockwell
In the 1990s, NewYork-Presbyterian Hospital began developing a comprehensive, standards-based immunization information system. The system, known as EzVac, has been operational since 1998 and now includes information on 2 million immunizations administered to more than 260,000 individuals. The system exchanges data with multiple electronic health records, a public health immunization registry, and a standalone personal health record. EzVac modules have recently been incorporated into the OpenMRS application and are being used to enhance immunization efforts in developing nations...
2013: Studies in Health Technology and Informatics
Hamish S F Fraser, David Thomas, Juan Tomaylla, Nadia Garcia, Leonid Lecca, Megan Murray, Mercedes C Becerra
BACKGROUND: In 2006, we were funded by the US National Institutes of Health to implement a study of tuberculosis epidemiology in Peru. The study required a secure information system to manage data from a target goal of 16,000 subjects who needed to be followed for at least one year. With previous experience in the development and deployment of web-based medical record systems for TB treatment in Peru, we chose to use the OpenMRS open source electronic medical record system platform to develop the study information system...
2012: BMC Medical Informatics and Decision Making
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