Center for Health Market Innovations (CHMI)

Programs

Overview

Implementation Partner(s): 
Indiana University School of Medicine and Moi University School of Medicine
Legal Status: 
Year Launched: 
2001
Stage: 
Existing/expansion stage
Income Level of Target Population: 
Bottom 20%, 20-60% (lower to lower-middle)

Funding

Primary Source of Funding: 
Donor

Technology

Technology Used: 
Computer › Apps/Software
Technology Purpose: 
Improving Data Management › Data Organization/Analysis

Scale

Personnel Employed: 
10-49
Number of Facilities Operated/Networked: 
2 sites, with the AMPATH site serving as a central repository for eight remote clinics
Other Measures of Scale: 
Number of patients entered: 60000 patients and over 150 000 visits in four years, For HIV care, 8000 patients, 3300 of whom are currently receiving anti-retroviral drugs (ARVs).
Summary: 

The Mosoriot & AMPATH Medical Record Systems (MMRS & AMRS) provide both patient registration and visit data collection functions. Data is collected on all patients seen in the medical clinic, including their laboratory results and medications.

Key program components: 

The growing MMRS and AMRS - AMRS is the updated, revamped MMRS - databases serve both clinical and research needs, generating clinical summary reports for providers and providing a centralised source of data for epidemiological research. This system allows physicians or nurses to request medications and investigations directly online, using rules to guide documentation and clinical decision making and assist in preventing some types of medical errors.

One of the benefits of using a networked EMR is that data is accessible and shared at multiple sites where users can enter data simultaneously. Information can be communicated between multiple locations such as from laboratory to physician with wide area networks linking up remote locations. Also web-based systems and some other client programs can often be debugged and upgraded over the internet without visiting remote sites.

MMRS
In the MMRS, patients are registered in the system upon arrival, travel through the clinic with a paper visit form, and present the visit form as they depart. Clerks perform the registration and transcribe visit data. MMRS provides both patient registration and visit data collection functions. Data is collected on all patients seen in the medical clinic, including their laboratory results and medications.

AMRS
AMRS data is collected on paper forms at each visit, delivered to a central location for data entry, and then returned to the patient’s paper chart. To date, the AMRS has collected more than 100 million discrete clinical observations from 2.8 million AMPATH visits made by 300,000 enrolled patients. Stored data includes discrete data such as test results; patient descriptors such as symptoms, vital signs, and physical exam findings; and diagnoses and treatments from clinical encounters. AMRS also supports comprehensive HIV care as well as mother-to-child transmission prevention,while serving as a database for quality improvement and answering research questions.

A key strategy that drives significant economies of scale for AMPATH is an emphasis on data reuse. The same data that supports direct patient care is used simultaneously to make cohort and community-based aggregate inferences, for monitoring and evaluation tasks, as well as to promote a rich series of basic science, clinical and health services research activities.

Program history: 

Indiana University School of Medicine and Moi University School of Medicine (Eldoret, Kenya) have been collaborating for over 15 years. In February 2001, this collaboration led to the Mosoriot Medical Record System (MMRS). The MMRS was installed in a primary care healthcare centre in rural Kenya. In November 2001, the MMRS software was adapted to support the AMPATH (Academic Model for the Prevention and Treatment of HIV/AIDS) project and renamed to AMRS.

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