Exploring the potential of Open Source solutions to deliver Clean, Clear Information for Health Service Improvement

探索开源解决方案的潜力，为改善卫生服务提供干净、清晰的信息

• 批准号: MR/N005600/1
• 负责人: Christopher Paton
• 金额: $ 12.37万
• 依托单位: University of Oxford
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2015
• 资助国家: 英国
• 起止时间: 2015 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FN005600%2F1
• 关键词: Exploring; potential; Open; Source; solutions

Electronic Health Records (EHR) systems are computer systems used by hospitals and clinics to record medical information about patients. They include information about patients' symptoms, medical diagnoses, treatment, operations, blood tests, x-ray results and how they are progressing. Although EHR systems have been used in hospitals in high-income countries for many years now, in low-resource countries such as Kenya, they are just beginning to be used at scale. This proposal is the result of the the research team in Kenya being asked by the Kenyan Ministry of Health (MoH) and the World Health Organisation (WHO, Kenya office) to explore how EHR systems could be used, not just to help doctors and hospital workers in managing their patients, but to also re-use the information that is collected for improving health services more widely. The information needed to improve care locally and across the health system needs to be clean and clear if it is to be used effectively to make the right decisions in the same way that drinking water needs to be clean and clear to be safe to drink. The aim of this proposal is to allow us to develop the partnerships (both academic and institutional) and knowledge necessary to create a new large programme of research around the development and use of clean, clear information contained in EHR systems for improving health. To achieve this aim, the first part of this proposal will find out which EHR systems are currently in use in Kenya, why they have been implemented, whether they are meeting expectations of users, whether they contain the kind of information that would be useful to improve care and whether they adhere to best practice international standards for safe and effective use. We will then investigate how a particular open-source EHR system called OpenMRS is being used in Machakos County in Kenya. This system is used in lots of HIV clinics across Africa (and the rest of the world) but is not usually used in more general forms of care or in hospitals. A recent project supported by the Kenyan MoH and WHO is attempting to implement OpenMRS widely in Machakos County but early experience suggests challenges and we aim to find out what lessons can be learned to support the further introduction of EHR systems in Kenya and how best to gain advantage from the open source (voluntary) community that can help develop and improve these not-for-profit systems. Finally, we will look at what kind of information from EHR systems could be useful enough to incentivise hospital and county administrators to invest in implementing and sustaining EHR systems that include the ability to collect medical information as well as the kind of financial information that is commonly the first priority for these kinds of system. Once we know what kind of EHR systems are in use and the type of data they are collecting, how EHR systems are currently being implemented, and what kind of data is of use to policy-makers, administrators and health workers, we can identify the specific objectives of our planned larger programme of research. This new programme will aim to ensure that EHRs in developing countries such as Kenya are implemented efficiently and effectively with minimal disruption to healthcare workers but that will also enable the re-use of clean, clear information throughout the health care system to foster improvements in health.

电子健康记录（EHR）系统是医院和诊所用于记录患者医疗信息的计算机系统。它们包括有关患者症状、医疗诊断、治疗、手术、血液测试、X光结果以及病情进展的信息。 虽然电子健康记录系统已经在高收入国家的医院中使用多年，但在肯尼亚等低资源国家，它们才刚刚开始大规模使用。肯尼亚卫生部（MoH）和世界卫生组织（WHO，肯尼亚办事处）要求肯尼亚的研究小组探索如何使用EHR系统，不仅帮助医生和医院工作人员管理他们的病人，而且还重新使用收集的信息，以更广泛地改善卫生服务。改善当地和整个卫生系统的护理所需的信息必须是干净和清晰的，如果要有效地利用这些信息来做出正确的决定，就像饮用水需要干净和清晰才能安全饮用一样。 该提案的目的是使我们能够发展必要的伙伴关系（学术和机构）和知识，以围绕开发和使用EHR系统中包含的清洁，清晰的信息来改善健康创建一个新的大型研究计划。 为了实现这一目标，本提案的第一部分将查明肯尼亚目前正在使用哪些电子健康记录系统，为什么要实施这些系统，它们是否满足用户的期望，它们是否包含有助于改善护理的信息，以及它们是否符合安全有效使用的最佳实践国际标准。 然后，我们将调查如何在肯尼亚Machakos县使用一个特定的开源EHR系统，称为OpenMRS。该系统在非洲（和世界其他地区）的许多艾滋病诊所使用，但通常不用于更一般的护理形式或医院。肯尼亚卫生部和世卫组织最近支持的一个项目正试图在马查科斯县广泛实施OpenMRS，但早期的经验表明存在挑战，我们的目标是找出可以吸取的经验教训，以支持在肯尼亚进一步引入EHR系统，以及如何最好地从开源（自愿）社区中获得优势，帮助开发和改进这些非营利系统。 最后，我们将研究来自EHR系统的什么样的信息可能足够有用，以激励医院和县管理者投资于实施和维护EHR系统，包括收集医疗信息的能力以及通常是这些系统的第一优先级的财务信息。 一旦我们知道正在使用什么类型的EHR系统以及它们正在收集的数据类型、EHR系统目前如何实施以及什么类型的数据对政策制定者、管理人员和卫生工作者有用，我们就可以确定我们计划的更大研究计划的具体目标。这项新计划旨在确保肯尼亚等发展中国家的EHR得到高效和有效的实施，对医疗工作者的干扰最小，但也将使整个医疗保健系统能够重新使用干净，清晰的信息，以促进健康的改善。

项目成果

The Privacy and Security Implications of Open Data in Healthcare.

• DOI: 10.1055/s-0038-1641201
• 发表时间: 2018-08
• 期刊: Yearbook of medical informatics
• 作者: Kobayashi S;Kane TB;Paton C
• 通讯作者: Paton C

Implementing an Open Source Electronic Health Record System in Kenyan Health Care Facilities: Case Study.

• DOI: 10.2196/medinform.8403
• 发表时间: 2018-04-18
• 期刊: JMIR medical informatics
• 影响因子: 3.2
• 作者: Muinga N;Magare S;Monda J;Kamau O;Houston S;Fraser H;Powell J;English M;Paton C
• 通讯作者: Paton C

I've got 99 problems but a phone ain't one: Electronic and mobile health in low and middle income countries.

• DOI: 10.1136/archdischild-2015-308556
• 发表时间: 2016-10
• 期刊: Archives of disease in childhood
• 影响因子: 5.2
• 作者: Kumar P;Paton C;Kirigia D
• 通讯作者: Kirigia D

Building Learning Health Systems to Accelerate Research and Improve Outcomes of Clinical Care in Low- and Middle-Income Countries.

• DOI: 10.1371/journal.pmed.1001991
• 发表时间: 2016-04
• 期刊: PLoS medicine
• 影响因子: 15.8
• 作者: English M;Irimu G;Agweyu A;Gathara D;Oliwa J;Ayieko P;Were F;Paton C;Tunis S;Forrest CB
• 通讯作者: Forrest CB