Rationale / Objectives
In Kenya, medical personnel spend approximately 40% of their time recording and reviewing patient activities. This is mainly due to missing and incomprehensible records. The reliability of data is a big concern in Kenyan health care systems. The number of patients with the same name and the lack of personal identity numbers create problems in retrieving records and identifying the correct patient 2. There has been a rapid increase in number of patients and visits along with increased complexity of clinical data.
Project/Program Description & Major Achievements
OpenMRS, which is an open source Electronic Medical Record, was implemented in several healthcare clinics in Africa to handle large amount of patient’s record in the area. The EMR program has significantly expanded in size and scope to include an additional 29 urban and rural primary care and HIV clinics in Kenya. By late 2007, the database contained more than 25 million observations from more than 800,000 visits made by more than 60,000 patients.
William Tierney, who was leading the transformation of African’s electronic medical reocrd notes: "Providing high-quality HIV/AIDS care requires high-quality, accessible data on individual patients and visits. AMRS has succeeded because it provides useful information to a wide variety of clinical and non-clinical personnel."
People / Organizations Involved
Healthcare clinics in Africa needed to modify the current to a more advanced system that could accommodate a large volume of patients and visits as well as handle complicated clinical date. In addition, they needed a customized medical record system that required no programming knowledge (although medical and systems analysis knowledge is required). This would allow a range of medical personnel to have accessibility to the information. In 2001, the Mosoriot Rural Health Centre, in Kenya modified the computer-based AMPATH Medical Record System (AMRS), originally programmed in MS-Access as a set of spreadsheets, into OpenMRS. OpenMRS is a comprehensive electronic medical records system (EMR) capable to collect, manage, and report clinical data in multifaceted HIV/AIDS care programs across Africa. It is a common framework upon which medical informatics efforts in developing countries can be built. The medical data stored in OpenMRS is available wherever and whenever needed 1, while providing encryption, confidentiality and safety for all data, at every level. Based on the principle that information should be stored in a way that makes it easy to summarize and analyze, OpenMRS uses minimal free text and maximum coded information.
|Expansion of the EMR program||Additional 29 urban and rural primary care and HIV clinics in Kenya Database contained more than 25 million observations from more than 800,000 visits made by more than 60,000 patients (2007). Between 1,500 and 2,500 new patients are being enrolled each month||African Health Clinics Use AHRQ Research on EMRs to Improve Care for HIV/AIDS Patients (2007)|
|Outreach program||Contacted more than 10,000 overdue patients|
|Psychosocial support program||Enrolled over 24,000 patients and family members|
|HIV testing program||Screened more than 180,000 individuals.|
|CD4 blood test||Increased 50% in reminding overdue tests||Journal of the American Medical Informatics Association 2|