As far as I can tell from news reports, what little healthcare infrastructure Haiti had before last week's earthquake is all but gone now. Yet, some advanced health information technology soon will be on its way to the devastated, impoverished Caribbean nation.
Disaster-response specialist Randy Roberson should know later today whether a mobile medical clinic filled with state-of-the-art telemedicine gear and a satellite audio/video link will accompany him on a flight to Haiti, or whether the 20-foot shipping container known as the "Doc-in-a-Box" will have to make the journey by sea. Roberson will personally be carrying the "Bring 'Em Back Pack," a 25-pound, solar-powered, medical backpack with a telemedicine connection.
In either case, at least a few of the medical professionals working to help Haitians survive this unthinkable tragedy will have live, remote access to specialists stateside. The clinic also will provide doctors with digital stethoscopes, a pulse oximeter, basic ultrasound equipment, Internet access and, yes, an electronic medical record to document the cases they see. The IT is all open-source and rather rudimentary by EMR standards. "They don't have time to learn anything," Roberson says. "They just want to be able to point and click."
Indeed, a humanitarian crisis of such proportions is not the ideal time to be teaching doctors how to use an EMR. Plus, Roberson won't know exactly where the clinic will set down, which doctors will use the facility or even what types of cases it will handle until he actually arrives in Haiti. (In fact, he many not even get into that country. When we spoke over the weekend, Roberson noted that some relief has been coming in via Santo Domingo, Dominican Republic, and that the better-equipped Dominican side of the island may be where a lot of Haitians get treated.) "I don't make any final decisions until I've actually been there," Roberson says.
At this point, Roberson and his two Payson, Ariz.-based organizations, Disaster Logistics and Humanitarian Emergency Logistics & Preparedness (HELP) are working to line up clinicians to use the clinic and the backpack. In past disaster-response scenarios, including the 2004 Asian tsunami and earthquakes in Turkey and El Salvador, he's worked with several Christian missionary aid organizations, one of which Roberson says has indirect ties to the Clinton Foundation. Roberson says he has some funding from various churches, foundations and corporations--the latter mostly in the form of donated medical supplies, but like so many other aid groups, HELP is always looking for more resources.
One other group that's more widely known, Médicins Sans Frontières (Doctors Without Borders) had been using an open-source EMR called OpenMRS to track surgical patients at a hospital in Port-au-Prince, but that hospital was destroyed in the quake. Dr. Hamish Fraser, director of informatics and telemedicine for Partners In Health, a Boston-based organization that supports OpenMRS and has a presence in Haiti, says his group is looking for a quick way to automate patient registration and track cases under this expected surge in demand for care. "This will include handhelds," Fraser says in an email.
Even in such an acute disaster area, health IT will have a visible presence. - Neil