Electronic multimedia data management for remote population in Ecuador

Abstract

Purpose: A large part of medicine is the management of patient related information inclusive of demographic data, historical data, data-rich multimedia diagnostic studies and longitudinal disease management. Managing the volume of information generated from patient examination and disease management into an accurate and seamless record challenges traditional record systems. This array of patient relevant data is currently recorded with handwritten notes and reviewed by the physician only after accessing the patient's medical record in the office. By integrating an electronic medical record (EMR) into patient management, the physician can access and manage patient data efficiently and accurately. Many successful EMR applications are available for advanced health systems. This study applied a Spanish language EMR developed with the clinical practitioners at remote clinics in Ecuador to support patient management. The data files were shared electronically with their regional collaborating clinics and internationally for clinical consultations. Methods: A relational database format was established with user-friendly interface to contain the necessary fields for data acquisition inclusive of manual data field entry as well as drop down fields for rapid data entry. Still and video format images were integrated to accommodate results from radiographs, sonograms, microscopic and colposcopy examinations. Application of the software at the general medicine clinics in a remote area of Ecuador provided an interface on a desktop computer to capture and share data for general medicine cases, general surgery, pediatrics, as well as obstetrics. The patient files were archived in a secure format within the computer at the clinic with restricted entry by password. Results: Staff and clinicians in the clinics easily recorded demographic, and specific patient care information. Clinicians were able to query electronic files for easy update and for follow-up in patient care practices. The software design allowed file compression in order to include various data file formats from multiple freestanding diagnostic devices to a consolidated EMR. The EMR was utilized locally at its source and shared with consultants at Virginia Commonwealth University (VCU) in a teleconsultation format. Conclusion: The EMR described here can support integration of diverse data formats from multiple diagnostic devices and provides a uniform interface in compliance with federal regulations. Additionally, the EMR data can be extracted in XML format for secure export independent of operating systems. Such a comprehensive database serves the needs with minimal lines of code, minimal need for technical support, simplicity of usage and responsive to local medical and linguistic realities.