Bhutan description: (Thanks, Wikipedia) A landlocked country in South Asia located in the Eastern Himalayas. The country’s landscape ranges from lush subtropical plains in the south to the subalpine Himalayan mountains in the north, where there are peaks in excess of 7,000 metres. Bhutan is a developing nation and has a government based national health system with only a few hundred doctors. Patients can visit their doctor via traditional means or via helicopter for more serious situations.
Problem: After trying out Napier, a nonfree EHR that was expensive, slow, and couldn’t be customized, the doctors have moved back to a paper solution. The doctors do not like EHRs because of limited typing ability and scribes cannot be brought in due to a lack of resources, both in medical students to act as scribes and the sheer costs of such a role. Despite a lack of interest in EHRs, there is a healthy interest in setting up an electronic solution for patients to report their self measurements, based on provider orders. For instance, if a patient is hypertensive, the doctor wishes to see daily trends of the vitals rather than not being aware until a patient visit (with less information). The same use case exists for other conditions such as diabetes (glucose readings) and pregnancy (weight changes, first kick, etc) with the latter being a tad more nuanced.
Solution: The vibrant and volunteer OpenEMR community will develop an independent self measurements module with a generic interface for SMS (text message) services. With this solution, the provider can set up measurement rules and patients will be asked to input vitals on an interval basis. Providers will be able to trend data over time to provide better healthcare, without the need of an extensive patient trek to get to the practice. Users will be to use the module independently (cloud or self hosted) or within OpenEMR. Because SMS services are almost always nonfree, an interface will be provided and the wiki will document nonfree API interaction examples to comply with GNU. Dr. Pelgay Jamyang will work with us to test out the solution in his practice. If it’s a success, the feature will be rolled out to all Bhutan practices.
All Github issues (including mockups!) for the project can be found here: Remote Patient Vitals Module · GitHub - we need to put together a team ASAP!
Note that this has been promoted to an OpenEMR Core Roadmap project: http://open-emr.org/wiki/index.php/Roadmaps