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The Thomonde EMR started capturing patient registration and visit notes on October 14, 2016, after a training program of registration staff and clinicians. (As of November 8, 2016, 332 patients were registered in the EMR along with 167 vital signs encounters and 164 visit notes.)
Data entry
All data is entered into the EMR at point-of-care. Registration of all new patients is completed by data archivists (name, gender, birthdate, address, insurance info, mother’s name, contact information, etc). New and returning patients are “checked in” by cashiers who collect payment. The registration and check-in software is exactly the same as used at University Hospital in Mirebalais. At check-in, the reason for visit is recorded (ie. HIV, TB, etc) (Figure 1).
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For Thomonde and Lacolline, the system was expanded to collect the entire visit note so that data would be easily available for patient care and decision support. A clinical dashboard (Figure 2) was created for a simple summary of the most recent information (ie. vitals, diagnoses, visits, allergies).
After a patient visit is started, the clinician selects the appropriate action (vitals, intake or followup; adult or pediatric). There are many sections in the various forms (Figure 3) -- but there is a summary available for all the data captured in each section. A printout is available from this page that can be added to the patient file.
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All data is generated from the EMR. Data can be exported for various patient encounters (ie. registration, vitals, visit note, etc.) (Figure 54) The user customizes data output by date range. Some data is viewed directly by using the web browser and all data can be exported as csv/excel files.
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Team
There were many collaborators for this project: ZL Leadership and Information technology; Boston PIH Development, Finance, and Medical Informatics; and Thomonde leadership (Lazare), clinicians, and staff. Gratitude to MAC AIDS for funding.
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