Saturday, December 17, 2011

Providing health care In The Wild! Technology on a shoestring budget.

Students in our medical school have since 2009 "adopted" a village in rural Peru.  They go there for a month at a time accompanied by faculty members to provide various health services.

While there are many challenges, technology is a big help.

One key challenge was to learn about the population and document this and pass it on to the next group of students using an Electronic Medical Records system.  This would help them plan on bringing appropriate supplies e.g. eye glasses, education material etc.

Solution:
OpenMRS:  This is an excellent, robust open source electronic medical records system that was developed out of a partnership (Regenstrief Institute @ Indiana University and Partners in Health).  This is available here.
It lets you create custom fields, forms and reports.  We wanted to capture the data at the point of care at the clinic where we would work.  This would save the time of entering data from paper forms to the database and hopefully decrease errors.
  One problem we have in rural Peru is a reliable power supply.  So we decided to create an ad-hoc wireless network using a laptop as a Server or host and tablet computers as the data entry devices.  The plan is to take some extra extended batteries for the laptop so it can run constantly for about 8-10 hours and the tablets should last for at least 6-8 hours if we don't use them for anything else.  We would charge everything overnight at the hotel be set for the next day at the clinic.

iPad (on right) connected to Laptop (Hosting ad-hoc network)

Another challenge is language - the folks there speak Spanish.

Solution:
The students and faculty are getting a crash course in Spanish from some of the students who are quite fluent in this.  Luckily there is a free medical Spanish app

Another challenge is checking the visual acuity so we can give the correct eye glasses.  We have an ophthalmologist in the group who is training all the students.  But getting them to learn refraction using retinoscopy may not be feasible.

Solution:
Just saw this amazing video of a $2 device that can be attached to a smartphone that lets you measure the refractive error in a few seconds.  Am hoping to get in touch with the genius inventor to see if we can get one or two of these devices to help the cause.



It is quite amazing how we are getting to a point where the portable devices are going to be able to change the world - a model where the health care provider goes to the patient rather than the other way around!  This may seem like something we need in rural and underserved areas in third world countries but why can't we use this right here in the US?  Is it because of our financial models or the legal system?