Peru

Mobilizing Medical Records in Resource Poor Settings

Challenges:

USAID Development 2.0 (2009)

Submitted by danielbachhuber on March 17, 2010 - 6:20pm

10 comments

Mobilizing Medical Records in Resource Poor Settings

Short Project Overview:

We will develop software that enables health workers to utilize electronic medical records [EMR] remotely via SMS. We will use SIM-based mobile phones, and implement the project at clinics that serve more than 65,000 people in Peru and Burundi.

Detailed Project Overview:

Mobilizing the medical record is a high impact opportunity, EMR adoption has direct and well documented health impact. However, EMRs are rarely implemented successfully in poor areas because of hardware that is expensive, unfamiliar, or unavailable locally, lack of internet and hassles associated with data re-entry. These issues can be address by SIM based phones.

EMR will be used more broadly and effectively if more health workers (not just physicians) gather and make use of medical data. Health workers are often out in the field where they do not directly contribute data to EMR.
Data collected off-site is often recorded on paper; it must be entered into a database by a different (more trained with computers) person, in a different place, at a different time. Unnecessary steps increase confusion, reduce efficiency and accuracy.
Patients currently do not remotely report health issues (I'm out of insulin needles, where can I get condoms?). This impeeds data collection in poor areas where transportation to a clinic may be a serious investment and many patients walk. Remote reporting would facilitate preventative medicine.

Our goal is to produce software that can:

Use SIM-based mobile phones. They are cheap, durable, prevalent, require less training and are less likely to make workers a target for theft/mugging (relative to smart phones).
Use OpenMRS, an open source EMR. OpenMRS manages hundreds of thousands of patients records; existing installations will be able to plug and play with our software, increasing our project's potential to scale.
Health workers or patients send data via SMS, it will be added to patient's medical record. Physicians will be notified of urgent situations (a hemorrhaging home-based childbirth), and worker/patient may receive SMS advice from clinician or an automated SMS based on electronic records.
Builds on, smooths interoperability with existing OSS like OpenRosa and Mesh4x.

Data transfer optimized for low-signal environments.

What else have you done in this area?:

The greatest barrier to implementing distributed medical records is adapting organizational practices, not building software. Our development efforts will be put into action because our project was initiated and is being carried out by organizations that provide health care for the poor.

Health Bridges International has helped to develop and operate a clinic and community health care delivery program in the impoverished peri-urban communities of Alto Cayma, Peru.Â The clinic consists of full time medical, dental, nursing, pharmacy and health education staffing.Â In addition, the clinic has outreach workers who act as advocates in the communities (35k people total) to help identify the most marginalized populations and connect them to services.

Village Health Works is dedicated to the principle that all people, including the most oppressed and impoverished, are entitled to the highest standards of health care in their pursuit of happy and productive lives. VHWâ€™s first project is to design, build, and operate a model community health clinic in Kigutu, Burundi. VHW serves about 30k people, regardless of ability to pay.

The primary directors of the project are two students, Isaac Holeman, a co-founder of Squarepeg, a N2Y3 featured project to help people find service and action opportunities on the Internet, and Daniel Bachhuber, the founder of Oregon Direct Action, an organization at the University of Oregon that is developing an open source organizational model for student groups.

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Organization supporting your Project, if any:

Village Health Works

Supporting Organization URL:

http://villagehealthworks.org/

City:

Kigutu

Country:

Burundi

Does your Project have financial support?:

Is the impact area of your Project global?:

Yes

If no, what country(s) does it impact?:

Burundi

Peru

Type of expertise needed:

Technical Expertise

Description:

Additional tech development help would be quite nice!

Sustainability (financial) Model:

This project requires only minimal seed funding to get off the ground. Once it is functional, it will be supported by the organizations that use it. These include health care organizations like Village Health Works and Health Bridges International, and open source communities like OpenMRS and OpenROSA.

Additional Project Idea Representative NetSquared User Name:

iholeman

Submitted by danielbachhuber on December 5, 2008 - 3:12am

10 comments

Against Seniors Discrimination

Project URL:

http://www.seniorsperu.com

What will change in the world because this Project happens?:

People over fifties who are actually a marginal population will have theÂ opportuntityÂ live with dignity.

We cannot change the world with this project butÂ we can make a better world.Â

What information will people interact with to make this change?:

We need to create a new way ofÂ business opportunities to provide a source of employment for people that cannot access the local employment market due Â¿age discrimination.Â Ww will need to retrain this people to live according the times in this way people will be still productive for our nation. Peruvian elderly population is going to increase in the next three years to be over 12% of the total population that it is actually over 28 Millions.

What else have you done in this Cause Area?:

I m preparing a pre-factibility project, capturing all information available about the population over 5o years old.

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Does your Project have financial support?:

What kind of help or resources do you need to turn your project idea into a completed mashup?:

The project require a financial support of around $18,000Â to complete the study and three months to provide the final report.

Additional Project Idea Representative:

Juan E. Rubin

Project Designer:

Juan E. Rubin

Project Engineer:

Juan E. Rubin

Submitted by jerubin on May 12, 2008 - 9:00pm

The Disappeared

Project URL:

http://thedisappeared.org

What will change in the world because this Project happens?:

In the 1980s and 1990s, over 69,000 people were killed in a brutal conflict between the Peru government and Maoist rebels. Of those killed, there are still many unresolved disappearances â€“ and the figures have been put at 8,558 by the Peruvian Truth Commission. The Peruvian Forensic Anthropology Team (EPAF) puts this figure as closer to 14,000 and to date has been able to collect information on 13,721 people who are still missing.

EPAF is seeking a way to develop an interactive map that would mesh the GIS capabilities of GoogleMaps with data on missing persons from their databases and spreadsheets with a feedback form where external audience would supply information to EPAF for verification and later inclusion on the map.

This map/data tool as described above would used as:-

1. GIS Investigative Tool: This would help in establishing any spatial relationships and trends in the people who went missing. Currently, EPAF has information on where people went missing from, place(s) where they are thought to have been taken to and where they were last seen. The use of maps and GIS as an investigative tool has been well established, and we have no doubt that this would be just as useful in this case.

2. National Record of the missing: Currently, there is no national record of those that went missing. While various records with data about the missing can be found â€“ usually this is combined with other information (e.g Peru's Unified Registry of Victims has data on all victim typologies e.g. sexual assaults, torture). This this would be the beginnings of a central database of information for this purpose.

3. Outreach/ Educational Tool: This would also be used on behalf of and for families whose family members still remain unaccounted for. Ultimately, this would evolve to a focal point with information related to the disappeared (e.g. links to support facilities on the ground, news stories related to disappearances etc).

4. Preventative Tool: It is hoped that the success of this tool encourages its use in countries with similar disappearances (e.g. the Philippines). This tool could be used to track enforced disappearances, analyze trends as they occur, solicit information from the public, and rally a public behind an unfolding situation.

What information will people interact with to make this change?:

1. Google Maps/ Earth
*Incidences of disappearances

2. EPAF Information Sources:
* EPAF's database of ante-mortem data for missing persons. This has documented and verifiable information on people who went missing
* EPAF's spreadsheet of information on the missing.
* Records (hardcopy files) on government activities during the time frame specified. There is a need for EPAF staff members to still comb through mountains of files to get data that is then used to collaborate information on the missing people.
* Information from accredited sources (e.g. the Peru Registry of Victims etc.) with information on locations of places of alleged atrocities and where specific people are thought to have been disappeared.

3. Visitors to the Website:
*Information on places/ locations providing support to the families of people who were disappeared.
*An interactive forum where people could provide information and stories of the missing (if possible).

What else have you done in this Cause Area?:

EPAF applies forensic anthropology to the search for forcibly disappeared persons during the period of internal political conflict from 1982-2000. EPAF was founded in 1997, when a group of Peruvian professionals working for the International Criminal Tribunal for the former Yugoslavia decided to apply their expertise in their own country. It is their final goal to restore the identity of the thousands of missing Peruvians that rest in hidden burial sites across the country.

EPAF has created software that captures data on the people who went missing during the period of the insurgency.

The group has carried out interviews and gone through files and files of information to get as comprehensive a picture of the disappearances as possible â€“ a still ongoing task.

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Organization Supporting your project, if any:

The Advocacy Project

Supporting Organization URL:

www.advocacynet.org

Does your Project have financial support?:

What kind of help or resources do you need to turn your project idea into a completed mashup?:

Technical Assistance:
* Help us consolidate the various types of information that we have into a visual record of enforced disappearances.
* Use text ante-mortem data (from the EPAF database) to create dynamic records of the victims.
* Map these visual records onto a map (GoogleMaps) that shows the locations of where the people were disappeared.
* A feedback form where people would enter data on disappearances and missing persons.
Financial Assistance:
* Support to pay for data entry from the physical hard copies (files, newspaper clippings, handwritten notes etc) into usable forms.
* Support for data management (cleaning up the data, standardization into the format needed for the map/database tool).
* Small assistance in the development of the campaign on behalf of and for families of the disappeared.

Submitted by mnjonjo on March 14, 2008 - 12:23pm