Overcoming health inequity: potential benefits of a patient-centered open-source public health infostructure

Abstract

The past 20 years have witnessed an astonishing increase in computational power and an incredible reduction in the cost of contemporary computer systems, but the public health infostructure in most countries has not changed significantly. This article discusses the potential benefits of applying patient-centered infostructure at the primary medical "points-of-care" services, based on networked integrated open-source technology and programming standards to develop tools to detect and reduce health inequalities. Such systems, which could be implemented from the local to the national level, would enable the expansion of evidence-based medicine, clearer identification of health inequalities, and more accurate cost-benefit analyses. In addition, the public health sector could link such databases to traditional Electronic Patient Record (EPR) systems at a greatly reduced cost by promoting the use of standards-based formats for data transfer and storage. Ultimately, the new health infostructure would help decrease health inequity. In fact, developing countries like Brazil, India, and South Africa are well-positioned to take advantage of the open-source movement and "leapfrog" countries burdened by legacy systems.

Complement factor H gene (CFH) polymorphisms C-257T, G257A and haplotypes are associated with protection against severe dengue phenotype, possible related with high CFH expression

“…After clinical and laboratorial evaluations, a subset of 121 well-characterized dengue cases was selected for genotyping the CFH promoter (Table 1). All personal information and clinical/laboratorial results were handled confidentially and integrated into a customized digital database that includes the research results, and the inventories of cryopreserved samples of Peripheral blood mononuclear cells (PBMCs), plasma and serum [32]. …”

MBL2 Gene polymorphisms protect against development of thrombocytopenia associated with severe dengue phenotype

“…After clinical and laboratory evaluations, a subset of 110 well-characterized dengue-positive patients were selected for MBL2 genotyping. All personal information and clinical/laboratorial results were handled confidentially and were integrated into a customized digital database that also includes research results including those for the cryopreserved samples of peripheral blood mononuclear cells (PBMCs), plasma, and serum [24]. Dengue virus was identified by immunofluorescence test, with serotype-specific, antidengue monoclonal antibodies (Bio-Manguinhos, Fundação Oswaldo Cruz, Brazil) according to the method of Cordeiro et al [22].…”

Access to medicines for acute illness in middle income countries in Central America

“…This study provides useful data about the magnitude of demand for acute illness care that could be helpful in organizing health care strategy. 13 The access framework proposed by Aday & Andersen 1 provided a useful theoretical underpinning to understand the predictors of access to medicines at the household level in this study. Considering health system characteristics that affect potential access to medicines, out-of-pocket payment for health services and medicines is an important burden, especially affecting the poor.…”