The Front Line in Early Diagnosis and Intervention
HAS helped to develop a model in global health that seeks to match appropriate levels of care with the needs of the patient. Such a model is crucial in in HAS’s 600-plus square mile service area, where patients may need to walk many hours over rough and mountainous terrain to get to the main hospital, and where the majority of mothers still give birth at home.
Community Health Workers (CHWs) and local dispensary (clinic) nurses are trained to identify emerging high-risk and emergency situations, so patients can be referred to the main hospital if and when needed. HAS employees in the many communities served by HAS therefore truly act as the front line in early diagnosis and intervention, before patients’ health problems become serious and even life-threatening. CHWs and the dispensaries are a core part of HAS, even though they may be located many miles from the main hospital campus.
Hôpital Albert Schweitzer Haiti believes that directly connecting these frontline health care providers to clinicians and specialists in the main hospital will allow HAS to deliver important, often life-saving care to patients in remote areas in a much more timely, effective, and efficient way. But cost constraints, the remoteness of the locations, and other logistical challenges have until now hindered connecting community clinics and care providers to the resources of the main hospital. This meant that clinicians working in HAS dispensaries did not have access to past patient data created at the main hospital, nor could they send new patient data to the hospital in preparation for referring a high-risk patient to the main hospital. Dispensary nurses and staff were having difficulty communicating with hospital staff when advice or input regarding a more complicated case was needed—sometimes leading to delayed diagnoses or less effective care plans. Since many referrals from dispensaries occur because of life-threatening and emergency health conditions, delays can have devastating consequences for patients and their families.
Working Toward Solutions with Wireless Connectivity
Hôpital Albert Schweitzer Haiti will soon be able to harness the power of wireless technology to improve patient care in remote mountain communities—and beyond.
A generous grant from the Hummingbird Foundation is allowing HAS to develop an ambitious and ground-breaking project: to give HAS community clinics reliable access to the main hospital’s Electronic Medical Records (EMR) system. Until now, the four community clinics at HAS—two of which are located in remote, mountainous areas—have lacked access to important patient data contained in the EMR system, which is maintained at the main hospital. Unlike the main hospital, which was an early adopter of an EMR in Haiti, the community clinics have had to rely on paper records and handwritten data to record patient care and outcomes.
Thanks to the support of the Hummingbird Foundation, a new wireless tower located at one hilltop clinic will create an intranet system among the four community clinics and main hospital. Energy-efficient solar panels will power the computers and equipment. Clinic staff will begin to be trainedthis year, and the EMR system is expected to go live at the clinics in early 2015. Rubens Paul, Director of IT, is supervising training and implementation so the unique technology needs of these remote community clinics will be addressed.
Once live, clinic staff will gain access to crucial information in patient medical records, and be able to add clinical notes and data in real time. The continuum of care from the community to the hospital will be improved with this new capability. In cases when patients must be referred to the main hospital, clinical decision-making will become more efficient and effective, informed with data from community primary care staff.. Emerging public health trends among the large patient population served by HAS also will be more easily identifiable.