The development of a novel local area network based EMR utilizing handheld devices to serve resource-limited clinics

: 1.015_TEC The development of a novel local area network based EMR utilizing handheld devices to serve resource-limited clinics Jared Sninsky, Elizabeth DeVos; University of Florida College Of Medicine, Gainesville, FL, USA, University of Florida College of MedicinedJacksonville, Jacksonville, FL, USA Program/Project purpose: Our project describes a practical electronic medical record (EMR) for global use in areas lacking Internet access or significant informational technology (IT) experience. We seek to provide better clinical communication, improved patient safety, and more coordinated and efficient patient care while maintaining patient privacy at resource-limited locations. We designed and beta-tested our new EMR at a remote clinic site with the above challenges. Our system provides an economical, practical, secure, and mobile EMR system useful for a myriad of global health settings. Structure/Method/Design: We pair a low-cost, commercially available wireless router/hard drive combo with unique software to create a dynamic system not requiring Internet access during encounters. Our portable EMR utilizes an Apple Airport Time Capsule that serves as a wireless hard drive and full-featured WiFi base station. The Time Capsule generates a secure local area network allowing multiple on-site providers to sync with the server and access the chart in real time. Dynamic portable document format (PDF) templates are organized within the iOS application “PDF Expert” providing an individual patient record. The patient PDF template outlines the encounter using free text, check boxes, and drop down selections that may be customized depending on clinic context. The resulting system allows health providers to share and analyze secure and confidential health information with local stakeholders including hospitals, governmental agencies, or patients themselves. Outcome & Evaluation: We beta-tested our EMR in the spring of 2015 at a remote health post in the Andes to better understand the individual challenges and aspects of the EMR. The system efficiently managed and securely stored tablet-generated simulated “patient encounters” on the Airport Time Capsule server. The EMR simulation demonstrated a promising model to enhance clinic flow, patient documentation, and medical record communication with local health officials. Going Forward: While no one template could meet every system’s needs in documentation, ours may be easily adapted for site nuances or research data collection applications. Limitations include tablet and phone connectivity only for iOs devices. Our system offers a technically viable EMR solution in resourcelimited settings with potential applications for global health service and research.