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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
Nareesa A Mohammed-Rajput, Dawn C Smith, Burke Mamlin, Paul Biondich, Brad N Doebbeling
OpenMRS is an open-source, robust electronic health record (EHR) platform that is supported by a large global network and used in over forty countries. We explored what factors lead to successful implementation of OpenMRS in resource constrained settings. Data sources included in-person and telephone key informant interviews, focus groups and responses to an electronic survey from 10 sites in 7 countries. Qualitative data was coded through independent coding, discussion and consensus. The most common perceived benefits of implementation were for providing clinical care, reporting to funders, managing operations and research...
2011: AMIA ... Annual Symposium Proceedings
Leo Anthony Celi, Luis Sarmenta, Jhonathan Rotberg, Alvin Marcelo, Gari Clifford
Moca is a cell phone-facilitated clinical information system to improve diagnostic, screening and therapeutic capabilities in remote resource-poor settings. The software allows transmission of any medical file, whether a photo, x-ray, audio or video file, through a cell phone to (1) a central server for archiving and incorporation into an electronic medical record (to facilitate longitudinal care, quality control, and data mining), and (2) a remote specialist for real-time decision support (to leverage expertise)...
January 1, 2009: Journal of Health Informatics in Developing Countries
John Dawson, Matthew Clark, Liz Peloso
The development of a paper based medical record system and the corresponding database at the Ola During Children's Hospital, Freetown, Sierra Leone are described. This project took place within an extremely resource constrained setting, through the partnership of local and international collaborators. The key factors which define the project are incremental progress, the intent to migrate the data to OpenMRS to ensure its sustainability and building local capacity for database management.
2011: Studies in Health Technology and Informatics
C J Seebregts, B W Mamlin, P G Biondich, H S F Fraser, B A Wolfe, D Jazayeri, J Miranda, J Blaya, C Sinha, C T Bailey, A S Kanter
OBJECTIVES: The overall objective of this project was to investigate ways to strengthen the OpenMRS community by (i) developing capacity and implementing a network focusing specifically on the needs of OpenMRS implementers, (ii) strengthening community-driven aspects of OpenMRS and providing a dedicated forum for implementation-specific issues, and; (iii) providing regional support for OpenMRS implementations as well as mentorship and training. METHODS: The methods used included (i) face-to-face networking using meetings and workshops; (ii) online collaboration tools, peer support and mentorship programmes; (iii) capacity and community development programmes, and; (iv) community outreach programmes...
2010: Yearbook of Medical Informatics
Seth Ohemeng-Dapaah, Paul Pronyk, Eric Akosa, Bennett Nemser, Andrew S Kanter
This paper describes the process of implementing a low-cost 'real-time' vital registration and verbal autopsy system integrated within an electronic medical record within the Millennium Village cluster in rural Ghana. Using MGV-Net, an open source health information architecture built around the OpenMRS platform, a total of 2378 births were registered between January 2007 and June 2009. The percentage of births registered in the health facility under supervision of a skilled attendant increased substantially over the course of the project from median of 35% in 2007 to 64% in 2008 and 85% midway through 2009...
2010: Studies in Health Technology and Informatics
Eric-Jan Manders, Eurico José, Manuel Solis, Janeen Burlison, José Leopoldo Nhampossa, Troy Moon
We have adopted the Open Medical Record System (OpenMRS) framework to implement an electronic patient monitoring system for an HIV care and treatment program in Mozambique. The program provides technical assistance to the Ministry of Health supporting the scale up of integrated HIV care and support services in health facilities in rural resource limited settings. The implementation is in use for adult and pediatric programs, with ongoing roll-out to cover all supported sites. We describe early experiences in adapting the system to the program needs, addressing infrastructure challenges, creating a regional support team, training data entry staff, migrating a legacy database, deployment, and current use...
2010: Studies in Health Technology and Informatics
William M Tierney, Marion Achieng, Elaine Baker, April Bell, Paul Biondich, Paula Braitstein, Daniel Kayiwa, Sylvester Kimaiyo, Burke Mamlin, Brian McKown, Nicholas Musinguzi, Winstone Nyandiko, Joseph Rotich, John Sidle, Abraham Siika, Martin Were, Ben Wolfe, Kara Wools-Kaloustian, Ada Yeung, Constantin Yiannoutsos
INTRODUCTION: Efficient use of health care resources in low-income countries by providers and local and national managers requires timely access to patient data. OBJECTIVE: To implement electronic health records (EHRs) in HIV clinics in Kenya, Tanzania, and Uganda. RESULTS: We initially developed and implemented an EHR in Kenya through a mature academic partnership. The EHR was then implemented in six HIV clinics in Tanzania and Uganda in collaboration with their National AIDS Control Programmes...
2010: Studies in Health Technology and Informatics
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