Novel open-source electronic medical records system for palliative care in low-resource settings

Abstract

BackgroundThe need for palliative care in sub-Saharan Africa is staggering: this region shoulders over 67% of the global burden of HIV/AIDS and cancer. However, provisions for these essential services remain limited and poorly integrated with national health systems in most nations. Moreover, the evidence base for palliative care in the region remains scarce. This study chronicles the development and evaluation of DataPall, an open-source electronic medical records system that can be used to track patients, manage data, and generate reports for palliative care providers in these settings.DataPall was developed using design criteria encompassing both functional and technical objectives articulated by hospital leaders and palliative care staff at a leading palliative care center in Malawi. The database can be used with computers that run Windows XP SP 2 or newer, and does not require an internet connection for use. Subsequent to its development and implementation in two hospitals, DataPall was tested among both trained and untrained hospital staff populations on the basis of its usability with comparison to existing paper records systems as well as on the speed at which users could perform basic database functions. Additionally, all participants evaluated this program on a standard system usability scale.ResultsIn a study of health professionals in a Malawian hospital, DataPall enabled palliative care providers to find patients’ appointments, on average, in less than half the time required to locate the same record in current paper records. Moreover, participants generated customizable reports documenting patient records and comprehensive reports on providers’ activities with little training necessary. Participants affirmed this ease of use on the system usability scale.ConclusionsDataPall is a simple, effective electronic medical records system that can assist in developing an evidence base of clinical data for palliative care in low resource settings. The system is available at no cost, is specifically designed to chronicle care in the region, and is catered to meet the technical needs and user specifications of such facilities.

Integrated Disease Surveillance and Response (IDSR) in Malawi: Implementation gaps and challenges for timely alert

“…However, electronic syndromic surveillance systems remain a novel technology for most of developing countries to adopt and implement [48]. Several EMR systems had been developed in Malawi and MOH decided to move towards a national standardized EMR system to support all levels of HMIS [49][50][51]. This provides a unique opportunity to utilize existing information technology and infrastructures to strengthen the IDSR system with nationwide syndromic surveillance.…”

Integrated Disease Surveillance and Response (IDSR) in Malawi: Implementation Gaps and Challenges for Timely Alert

“…However, electronic syndromic surveillance systems remain a novel technology for most of developing countries to adopt and implement [45]. Several EMR systems had been developed in Malawi and MOH decided to move towards a national standardized EMR system to support all levels of HMIS [46][47][48]. This provides a unique opportunity to utilize existing information technology and infrastructures to strengthen the IDSR system with nationwide syndromic surveillance.…”

Maji: A New Tool to Prevent Overhydration of Children Receiving Intravenous Fluid Therapy in Low-Resource Settings

“…The 5-point Likert scale typically used in SUS was made more culturally appropriate by reducing the dependence on grammatical qualifiers such as "strongly agree" that are not present in the participants' native language of Chichewa. 13 All data were anonymized. A Wilcoxon signed-rank test was performed to determine whether the median system usability score was greater than 70, or "good," 14 which is a widely accepted usability criterion for an acceptable product.…”

“…A Wilcoxon signed-rank test was performed to determine whether the median system usability score was greater than 70, or "good," 14 which is a widely accepted usability criterion for an acceptable product. 13 Similarly, a Wilcoxon signed-rank test was performed to assess whether the median time to use the device was less than 2 minutes. Figure 4 shows the mean, median, first and third quartiles, and range of the residuals for each combination of initial volume and target volume tested in the laboratory.…”