August 9, 2005
A Web-based electronic medical record system (EMRS) has helped Partners in Health treat thousands of multi-drug resistant TB (MDRTB) cases at its chronic care center in Lima, Peru, said Hamish Fraser, PIH's director of informatics and telemedicine. By July, some 3,479 patients had enrolled in the system, many from neighboring slums. In addition to lowering second-line TB drug prices through bulk ordering, staff members monitor patient records, monthly lab tests, and side effects. PIH reported a 70 percent cure rate.
With the system, prescription errors have declined from 17 percent to 3.3 percent, said Fraser, since everyone accesses the same centralized EMRS data. Doctors can also predict drug quantities they will need by one year in advance, with less than a 10 percent error, he said.
PIH has taken its EMRS to parts of Russia, where MDRTB numbers are high, and used it as the foundation for systems in Haiti, where six sites are operating and a seventh is being built. PIH saw more than 800,000 patients in Haiti last year, and each patient's name, gender, location, and diagnosis were recorded, allowing workers to spot medical trends and improve diagnoses and organizations to efficiently allocate resources.
The system allows researchers to weigh the importance of different variables. For instance, given different health outcomes but the same medications and patient populations, researchers might discover that the critical difference that makes one program more successful than another is the addition of a food program.
EMRS is also being used to track the efficacy of combination HIV drugs. The Baobab Health Partnership's touch-screen system in Malawi relies on barcodes to help keep track of patients, many of whom are illiterate, through a health passport. Thirty touch screens have been installed at three HIV counseling and testing facilities.