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Open Source Handheld-Based EMR for Paramedics Working in Rural Areas


This is a review of an article by Anantraman, Mikkelsen, Khilnani, Kumar, Pentland, and Ohno-Machado (2002), “Open source handheld-based EMR for paramedics working in rural areas”.

Research Question

The purpose of this study is to evaluate the impact of personal digital assistance (PDA) devices linked to an electronic medical records (EMR) on healthcare in remote rural areas. [1]


Abstract

A handheld-based EMR was implemented for paramedical health worker in remote areas of India. The study evaluates the challenges, as well as, the need for innovate PDA design, adaptation, and development.

Method

PDA linked to open-source system based in a Linux operating systems were given to 4 paramedical health workers covering a population of 28,000. All PDA were loaded with handheld-based EMR data including decision support and alerts. The decision support engine CLIPS was used to provide users with a rule-based engine. The greatest need in the rural Indian community for EMR access applies to prenatal and pediatric care.

Results

The handheld-based EMR was rate as satisfactory for usability, accuracy, and time needed for data entry. The workers were also satisfied with the replacement of paper-based records by the EMR system. Worker were even able to become entirely dependent on the electronic database. The decision support engine was reported to be very helpful by users. Challenges presented by this technology, can be dealt with by including users in the design process.

Discussion

The PDA provided paramedical health works with stable logistic support, eliminating the need for paper-based records. This study demonstrates that technology can be used at the point of care in remote rural communities to reducing clinical workflow and provide decision support. The adoption of these EMR based PDA’s will create a virtual database complete with alerts and rule-based guidelines; thereby, improving the availability and quality of care for pregnant women and children. Remote rural communities don’t have enough resources to adopt a system that requires signification cost for implementation and maintained. Because the system is open-source, the system is cost effective. Despite the system’s data security venerability, there are plan to expand the evaluation of handheld-based EMR’s to 10 paramedical health workers serving a population of 76,000.

Comments

Open-source EMR’s offer access to beneficial technologies in developing countries and remote communities. Without a low cost EMR option, these regions would be excluded from the evolution of healthcare. This study is a great example of how innovations, like handheld-based EMR’s, can be made available in remote areas that have limited resources.

Related Links

  1. Leveraging of Open EMR Architecture for Clinical Trial Accrual
  2. Open_source_EMR_software:_Profiling,_insights,_and_hands-on_analysis
  3. Evaluation and selection of open-source EMR software packages based on integrated AHP and TOPSIS
  4. The_OpenMRS_System:_Collaborating_Toward_an_Open_Source_EMR_for_Developing_Countries

References

  1. Anantraman, V., Mikkelsen, T., Khilnani, R., Kumar, V., Pentland, V., & Ohno-Machado, L. (2002). Open source handheld-based EMR for paramedics working in rural areas. AMIA Annual Symposium Proceedings, 12-16.