EMR Consulting

HIV/AIDS Care and Electronic Medical Record Systems

Caring for HIV-positive patients, especially in this age of antiretroviral drugs (ARVs), is data-intensive. Treatment guidelines require that patients taking ARVs visit health care providers monthly, with less frequent visits (usually quarterly) for HIV-infected patients not yet requiring ARVs. Paper-based record systems are proving inadequate because the sizes of HIV clinics continue to grow, and patients are making numerous visits over the years as HIV is becoming a chronic disease with ARVs.

Electronic capturing of patient-level data provides a perfect solution for several reasons:
(a) it allows for information to be captured in a legible, well-organized, and standard format – ensuring that vital data is not missed;
(b) it enables information to be easily re-used without having to make copies or transfer information into paper-registries;
(c) it allows for easier, efficient, and accurate reporting to various stakeholders;
(d) it allows for higher level functions (e.g. clinical decision support to alert providers if they miss something) which are particularly important in resource-limited settings where most patients are seen by mid-level cadre of staff because the number of physicians is inadequate.

Open Medical Record System (OpenMRS)

One of the most successful EMRs currently implemented for HIV-care in developing countries is Open Medical Record system (OpenMRS®). OpenMRS is an open-source medical record system framework for developing countries. It is a multi-institution, nonprofit collaborative led by Regenstrief Institute, Inc., a world-renowned leader in medical informatics research, and Partners-In-Health, a Boston-based philanthropic organization with a focus on improving the lives of underprivileged people worldwide through health care service and advocacy.

These teams nurture a growing worldwide network of individuals and organizations all focused on creating medical record systems and a corresponding implementation network to allow system development self-reliance within resource-constrained environments. To date, OpenMRS has been implemented in several African countries, including South Africa, Kenya, Rwanda, Lesotho, Zimbabwe, Mozambique, Uganda, and Tanzania. It is also implemented in Haiti, Peru, India, and in Los Angeles California.

The work on OpenMRS has been supported in part by organizations such as the World Health Organization (WHO), the Centers for Disease Control (CDC), TheRockefeller Foundation, and the President's Emergency Plan for AIDS Relief (PEPFAR).