Collecting Patient Info in Haiti using iPhones – How it Happened

As soon as Carlos Miranda Levy reached the field hospitals in Haiti, it became apparent that some sort of mobile medical apps would be needed to track patient records.

The process of identifying the need, brainstorming potential solutions and putting together a field trial happened through Facebook wall comments, Twitter, Email, Google Docs and a Gmail group, MedApps4Haiti.

The timeline is as follows:

Friday Jan 22, 2010

8:34 am @carlosmiranda We need someone to research the current iphone apps for managing and treating patients, so docs can use, don’t have internet to do myself

8:59 am @msquihuis 10-50 iphone donations needed to collect patient data in Haiti DM if you can help #haiti

11:35 am Carlos Miranda Levy posts a note on his Facebook wall:

We’re setting up a protocol for gathering patient data quickly in the field hospital and improvised tents. The iPhone came up in our discussion as a convenient mobile data entry device. Can you help us find donations for at least 50 iPhones, at least 10 to start? We can set it up so that they are formally received by one of the foundations (One Race Global Film Foundation, Yele, etc.) or universities we have contact with (Harvard, Stanford, UNIBE, UNAPEC, etc.) Do you know someone who knows someone who can be called? Can you help getting some? We can document in video, photos and text, development, deployment, usage, on a daily basis.

 

Margarita Quihuis

Margarita Quihuis

I’ve got two requests into Apple right now… Enoch, any insights on relevant iphone apps that can be used in the field? Carlos needs help researching the apps and he can’t do it effectively there due to low bandwidth net connection.
January 22 at 11:37am ·
Enoch Choi

Enoch Choi

you could just make notes. or use a database app. i’ll look into it. most iphone apps i know are for data review rather than entry. they display data that has been previously entered in a EMR with a traditional terminal with client server software.
January 22 at 11:38am
Hansel Johnson

Hansel Johnson

Not sure about what all you need in terms of core features. Take a look at: 

https://health.google.com/ health 

you can use one Google account and create many patient records under the same account (bottom left: caring for someone?) and track each record separately. But you’re going to need net access.

January 22 at 1:05pm
Enoch Choi

Enoch Choi

net access is $16/minute via satellite internet. not an economically feasible solution. wish google gears could do this offline with nexus one’s but it doesn’t. Instead, you have to use a database solution that works offline
January 22 at 2:59pm
Hansel Johnson

Hansel Johnson

I know time is of the essence so you may need to go with some off-line solution for now. I found this: 

http://groundcontrol.com/H aiti_Satellite_Internet.ht m?gclid=CLbb0tS1uZ8CFRKfnAodxjZw0g 

Looks like they’re already in Haiti and on board with the ability to deliver equipment to setup a connection. For about 20K you could set up unlimited access for 2 months (2Mb-down/1Mb-up).

January 22 at 6:17pm
Carlos Miranda Levy

Carlos Miranda Levy

We have wifi at the camp site we’re operating right now, this is supposed to grow to support a large number of patients (about 1000 at a time). 

Jon Katz is extending it. 

Although, the specs we are putting together include the ability to work offline and then transfer data or upload it to a server at a later time.

January 22 at 8:03pm
Alejandro Miranda

Alejandro Miranda

we are building a requeriments document, anybody thats interested in helpin, give me ur email to share the document with you
January 22 at 8:29pm
Carlos Miranda Levy

Carlos Miranda Levy

Alejandro, I suggest you make it a Google Doc, so it’s visible and available to everyone, even as a draft.These people and so many others can provide plenty of advise.
January 22 at 8:35pm
Margarita Quihuis

Margarita Quihuis

Carlos – I have a tech, Anthony Papillon (@cajuntechie) who leads the OpenEMR HQ and Advanced Data Concepts teams forhttp://www.openemrhq.com/. He has offered to help.
January 22 at 10:30pm ·
Margarita Quihuis

Margarita Quihuis

Carlos – I’ve submitted a friend recommendation on FB between you and Anthony. Also emailed him your posting.
January 22 at 10:38pm ·
Enoch Choi

Enoch Choi

Randy Roberson has an open source EMR he’s installed, but i think it’s PC based. not mobile phone
January 23 at 12:30am
Amandeep Singh Grewal

Amandeep Singh Grewal

Carlos: I have a solution that you can use on any phone (supporting java of course). You can collect data by using thie customized data gathering app. I used it for my forest project that you know of. It is a small client app resides on any low end nokia phone. all you have to do is specify the fields you want to have. It will send data using … See More
January 23 at 2:11am
Carlos Miranda Levy

Carlos Miranda Levy

Awsome, Aman. I will have Alejandro and Seth contact you.
January 23 at 5:46am
Enoch Choi

Enoch Choi

Aman, Carlos, can you email me with deets too? enochchoi1@yahoo.com i’ll be manning a shipping container clinic at the Four Square Church 2 minutes from the US Embassy
January 23 at 8:34am
Amandeep Singh Grewal

Amandeep Singh Grewal

@ Enoch: Yes sure
@ Carlos: Will wait for details. As soon as I have them the work will start here. Send details of what you want asap
January 23 at 8:39am
Carlos Miranda Levy

Carlos Miranda Levy

Aman, I sent e-mail with other contacts. will cc enoch
January 23 at 11:06am

10:23 pm @CajunTechie @carlosmiranda is the point person on the ground for the data collection need. #haiti #help #patientdata

10:31 pm @CajunTechie I’m taking you up on the offer & pinged on you Facebook- Carlos Miranda Levy (@carlosmiranda) has a thread on reqs for the app

Jan 23 2010

9 am: Alejandro Miranda jr starts working with Seth from Harvard on defining specs for patient registry data system.

11 am:Laura Diaz starts working on a patient registry, taking info manually and writing it a notebook.

12:30pm – Laura’s sister does rounds with the doctors, reviewing/completing patient registry.

Jan 24 2010

10am – start of e-mail exchange with international IT, social work and relief work experts to define, implement patient registry digital system.

Jan 25 2010

9am – Laura enters data collected by hand the day before by hand on a Google Docs spreadsheet and shares it with the international group working on drafting specs (Harvard, Stanford, India, United Nations, Dominican Republic Ministry of Health, UNIBE university, etc.).

4pm – Reviewed patient registry done by Laura and took some patient pictures to improve/update/test it.

Jan 25 2010

11:45 am MedApps4Haiti google group created

Jan 26 2010

1:58pm @carlosmiranda iPhone developers needed for patient registry application extensions in the DR, Haiti and/or USA

4pm Meeting at local World Health Organization / Panamerican Health Organization headquarters with UNIBE and Harvard and local UN Health cluster. Laura, Alejandro Miranda and myself attend. Darwin Muñoz from UNIBE, Dr. Elizabeth Cote from Harvard, and Dr. Alejandro Báez from UN Health Cluster and Dr. Román where present.

8:46 pm RT @CarlosMiranda: meeting World Health Organization, Harvard and Unibe to coordinate patient registry system to track earthquake survivors

Jan 27 2010

8:47 am RT @CarlosMiranda: iPhone developers needed for patient registry application extensions in the DR, Haiti and/or USA#haiti #help #iphone

Jan 28 2010

8:03 pm @carlosmiranda installing www.caretools.com iChart iPhone app to collect+manage patient data of earthquake survivors in #Haiti

11:30pm I meet by chance with UNICEF and UNCHR personnel and share with them our patient registry template and pilot data from the field and invite them to comment on it.

Jan 29 2010

3pm I meet with Harvard’s team to discuss the iphone application for patient data gathering.

 

Enoch Choi how’s iChart working for you?

January 29 at 11:21pm · Comment · Like · See Wall-to-Wall

Carlos Miranda Levy

Carlos Miranda Levy

field testing actually started last night. will report today
Sat at 1:16am
Carlos Miranda Levy

Carlos Miranda Levy

it is working like a charm. got caretools to customize it to include special field for data gathering in the field 🙂 including picture taking from within the app 🙂
Sun at 4:39am
Carlos Miranda Levy

Carlos Miranda Levy

in a cpl of hours we were able to collect more than 100 patient info.
Sun at 5:11am
Margarita Quihuis

Margarita Quihuis

Excellent! Enoch – Carlos and I are organizing a Relief 2.0 workshop/1 day conf @Stanford end of February. Will you be around? Can you present?
Sun at 11:13am ·
Enoch Choi

Enoch Choi

depends on the day, if i can make it(not in clinic), yes. i really want to talk to Carols
Sun at 2:20pm
Carlos Miranda Levy

Carlos Miranda Levy

Check out the Video: Collecting Patient Info in Haiti using iPhones.http://www.youtube.com/watch?v=05RUiCRRlTo
10 hours ago

Jan 31 2010

11:15 am @msquihuis iChart modified by Caretools- includes special field for data gathering in the field including picture taking from within the app #haiti

11:16 am @msquihuis iChart #iphone app successfully used to collect 100 patient records #haiti field hospital #medapps4haiti @carlosmiranda#help

Feb 1 2010

Dr. Elizabeth Cote, from Harvard Humane Initiative, collects patient data at Fond Parisien, Haiti using iPhone and iCharts from www.CareTools.com. The developers were kind enough to customize the form in less than a week to support fields and info required to comply with international disaster data collection standards.

Feb 2 2010

 

Enoch Choi thanks to Jonathan Manis Senior Vice President, CIO Sutter Health’s “Haiti Donation Committee” for 5 iPhones and iChart licenses (http://www.caretools.com/) to plug into the Haiti national EMR, and for Steven Lane for soliciting the donation and leading our Haiti EMR efforts!

Developed specifically for your iPhone and iPod Touch platforms as a digital medical assistant to manage patient records with:

3 Replies to “Collecting Patient Info in Haiti using iPhones – How it Happened”

  1. Very interesting. In the video it is nice to see how the patient interacts with the doctor while the information is collected. She addresses the doctor in Creole even though the doctor appears to only speak French. People should be aware that French will only get you so far in Haiti (especially if it is only basic French). So a Creole translation device is also needed if anything complicated is to be discussed. I know Google has a fairly good one going in Beta.Question: how is the data stored and transfered? These phones seem like they can easily be lost.

  2. Thanks to Apple & AT&T for 10 iPhone 3GS we’re using to electronically document medical records – we were asked by the United Nations to pilot iChart as Haiti’s new national EMR, we entered hundreds of records last trip, and plan to use it in the tents this trip leaving tonight! " – thanks to this MedApps4Haiti effort ( Carlos Miranda Levy and wife @laura )

  3. I’ve been trying to get as much information on openemr related content because of a paper I am writing. Reading this was both helpful and informative, thanks.

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