Health Informatics in Haiti: Improving Access to Data Improves Care

March 1, 2011

At the crossroads of information technology and health care lies the rapidly growing field of health informatics.

A lab worker at Hôspital de l'Université d'état d'Haiti, Haiti's largest hospital and the national teaching hospital in Port au Prince.

A lab worker at Hôspital de l'Université d'état d'Haiti, Haiti's largest hospital and the national teaching hospital in Port au Prince.

From electronic patient medical records to electronically processed and analyzed lab samples, health informatics focuses on the technology and resources required to make health data, such as patient records, more accessible and useful to health care workers and other stakeholders. Electronic medical record systems (EMRs) and laboratory information systems (LISes) are two important components of a network of systems that comprise a country’s health information architecture. When developed to capture and transfer data according to national standards, these information systems have the capacity to provide timely clinic and laboratory data. This information is critical for quality health service delivery; clinic, hospital, and laboratory management; and national-level health statistics and planning.

Informatics work can improve the care patients receive in any context–from primary care checkups to emergency procedures and critical illness. When health care workers have access to accurate and timely patient records and lab results, they can provide care more effectively and efficiently, a potentially life-saving benefit.

In Haiti, I-TECH has collaborated with the National Public Health Reference Laboratory (LNSP) to identify, adapt, and deploy an LIS that meets the unique needs of Haiti’s clinical and reference laboratories. This system, called OpenELIS (the Open Source Electronic Laboratory Information System),was originally developed by the University of Minnesota for US-based public health laboratories. It was selected for use in Haiti because it is flexible and can be developed to conform to existing laboratory work flow and to exchange data between laboratories and other information systems.

On 14 February, an updated clinical version of OpenELIS, Version 1.2, was released. Building upon lessons learned from the pilot implementation of Version 1.1, the current release supports standard electronic patient and specimen data collection and reporting, and introduces new functionality. This  includes selection of multiple test results for a single test, and reflex test algorithms for HIV testing. For reflex testing, the results of one test often indicate the need for more tests. With the Haiti clinical version 1.2 of OpenELIS, follow-up tests are automatically ordered as indicated by initial test results. Shortening the lag time between an initial test and required follow-up tests makes it possible for a patient to receive a diagnosis and care more quickly.

During the initial launch, OpenELIS will be rolled out to 15 clinical laboratory sites. Given unreliable power supply and internet connectivity throughout Haiti, I-TECH, LNSP and the US Centers for Disease Control and Prevention also developed and distributed a standardized paper logbook. This logbook can be used as a stand-alone paper-based LIS, and also as a backup system in case the electronic version is not accessible.

Additionally, the newly developed clinical version of OpenELIS interfaces with iSanté 9.0, the national electronic medical record system. The current interface enables sharing of patient demographic data, and thereby minimizes duplicate data entry for patients registered in both systems. Future development will enable electronic transfer of test requests and test results data between OpenELIS and iSanté, expediting the current paper- based process. I-TECH is preparing for a March release of an additional version of OpenELIS in Haiti, this one designed to meet the specific needs of the national public health reference laboratory. In addition to expanded clinical laboratory functionality, the LNSP version will enable quality control, confirmatory testing, and national level laboratory activity reporting. Clinical laboratories throughout the country will be able to transmit sample, test, and activity data directly to LNSP, a faster process that will be less time consuming for biologists, laboratory technicians, and managers.

To learn more about I-TECH Haiti click here.

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