Appendix H: Examples of Information Systems to Support HIV Treatment and Program Scale-up in Resource-Poor Settings
| Stand-alone databases |
|---|
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Mosoriot medical record, Kenyaa Microsoft Access® data are entered from a paper record. Used for general medical care in one hospital for more than two years and was extended to support HIV treatment at Moi University. This is now being superseded by a system built on the OpenMRS architecture.b |
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Children’s Hospital, Lilongwe, Malawi c Microsoft SQL Server® and Visual Basic® now converted to open source software (Linux and MySQL) and extended to collect information on HIV patients. Physicians, nurses, and other staff perform all data entry, including medication orders. Has made heavy use of a touch-screen medical record system for more than two years. |
|
Ministry of Health database, Cuba Includes extensive clinical data on the approximately 1,200 patients in the country who require ART. |
|
Department of Health and Human Services, United States Careware system (using Microsoft Access® provides comprehensive tools for tracking HIV patients and their treatment. Currently used in more than 300 health centers and hospitals in the U.S. Deployed in Uganda in October 2003. An Internet-accessible version has now been deployed in the US and several African countries. Careware is closed source but available free of charge at http://hab.hrsa.gov/careware. |
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FUCHIA (Follow-Up of Clinical HIV Infection and AIDS Guide for Users) Microsoft Access® and the Delphi programming language. Developed by Epicentre, the epidemiology group of Médecins Sans Frontières, to support their HIV treatment projects. It supports clinical care and long-term follow-up of patients, including scheduling of visits, and includes data on medications and certain investigations and generates some reports. Available free of charge at http://www.epicentre.msf.org. |
| Internet-based medical record systems |
|
PIH-EMR, Perud Supports clinical care, logistics such as assessment of drug requirements, and research studies on drug-resistant tuberculosis. In heavy use for over four years. Most data are entered from paper forms, with nurse order entry of medications now implemented. Extensions link TB laboratories to clinics and allow data collection with personal digital assistants. It uses the Linux operating system, Apache web server, Tomcat Java Servlet engine, and an Oracle® database. |
| Web-based collaboration and telemedicine systems (not specifically for HIV) |
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RAFTe Supports remote collaboration, case discussion, and data sharing over low bandwidth networks between Geneva University Hospitals and Bamako, Mali. The collaboration is being extended to other West African Francophone countries. Uses Linux and other open source software. |
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IPATHf A Web-based tool for image sharing in pathology and radiology. In use in South Africa, Switzerland, and the Pacific. Available free of charge at http://www.sourceforge.net. |
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TeleMedMailg Java and open source software. A secure e-mail and Web-based based telemedicine system under evaluation in South Africa and Peru. Available free of charge at http://www.sourceforge.net. |
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SatelLife Local healthcare workers collect data on PalmPilots® and download information onto cell phones that transfer the data to a central database. More information at http://pda.healthnet.org/. |
a Rotich JK, Hannan TJ, Smith FE, et al. Installing and implementing a computer-based patient record system in sub-Saharan Africa: the Mosoriot Medical Record System. J Am Med Inform Assoc 2003;10:295-303.
b Mamlin B, Biondich, PG , Wolfe B, et al. Cooking up an open source EMR for developing countries: OpenMRS - a recipe for successful collaboration. Proc AMIA Symp 2006; in press.
c Douglas G. The Lilongwe Central Hospital patient management information system: a success in computer-based order entry where one might least expect. Proc AMIA Symp 2003:833.
d Fraser H, Jazayeri D, Mitnick C, et al. Informatics tools to monitor progress and outcomes of patients with drug resistant tuberculosis in Peru. Proc AMIA Symp 2003:270-4.
e Geissbuhler A, Ly O, Lovis C, L’Haire J. Telemedicine in western Africa: lessons learned from a pilot project n Mali, perspectives and recommendations. Proc AMIA Symp 2003:249-53.
f Oberholzer M, Christen H, Haroske G, et al. Modern telepathology: a distributed system with open standards. Curr Probl Dermatol 2003;32:102-14.
g Fraser HS, Jazayeri D, Bannach L, et al. TeleMedMail: free software to facilitate telemedicine in developing countries. Proc MedInfo 2001;10:815-9.
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