TITLE:
Mobile EMR Use for Epidemiological Surveillance on a Medical Service Trip in Honduras: A Pilot Study
AUTHORS:
Christopher J. Dainton, Charlene H. Chu
KEYWORDS:
Electronic Medical Records, Epidemiology, Global Health Experience, Medical Missions, Medical Service Trip, Primary Care
JOURNAL NAME:
E-Health Telecommunication Systems and Networks,
Vol.5 No.1,
March
4,
2016
ABSTRACT: Rationale: Medical treatment on short-term primary care
medical service trips (MSTs) is generally symptom-based and supplemented by point-of-care
testing. This pilot study contributes to the effective planning for such austere
settings based on predicted symptomology. Objective:
We aimed to prospectively document the epidemiology of patients seen during two
low-resource clinics on a MST in Honduras and apply predefined case definitions
adapted from guidelines used by international healthcare organizations (e.g. World
Health Organization). Methods: An observational
design was used to track the epidemiology during two clinics on an MST in Limon,
Honduras in March 2015. The QuickChart mobile electronic medical record (EMR) application
was piloted to document diagnoses according to predefined case definitions. Results: The most commonly diagnosed syndromes
were upper respiratory complaints (20.19%), nonspecific abdominal complaints (20.19%),
general pain (15.38%), hypertension (9.62%), pruritus (6.73%), and asthma/ COPD
(4.81%). The case definitions accounted for 94% of all complaints and diagnoses
on the brigade. Discussion: The distribution
of common patient diagnoses on this MST was similar to that which had been reported
elsewhere. The use of broader symptom-based case definitions for epidemiologic surveillance
could also facilitate the syndromic management of patients seen on MSTs, and improve
the consistency of treatment offered. Conclusion:
Case definitions for common syndromes on primary care MSTs may be a feasible method
of standardizing patient management. Preliminary use of the QuickChart EMR was acceptable
for documentation of epidemiology in the field. Further study is necessary to investigate
the reliability of syndromic diagnostic criteria between different clinicians and
in a variety of MST settings.