A computer-based medical record system and personal digital assistants to assess and follow patients with respiratory tract infections visiting a rural Kenyan health centre.
BACKGROUND
Clinical research can be facilitated by the use of informatics tools. We used an existing electronic medical record (EMR) system and personal data assistants (PDAs) to assess the characteristics and outcomes of patients with acute respiratory illnesses (ARIs) visiting a Kenyan rural health center.


METHODS
We modified the existing EMR to include details on patients with ARIs. The EMR database was then used to identify patients with ARIs who were prospectively followed up by a research assistant who rode a bicycle to patients' homes and entered data into a PDA.


RESULTS
A total of 2986 clinic visits for 2009 adult patients with respiratory infections were registered in the database between August 2002 and January 2005; 433 patients were selected for outcome assessments. These patients were followed up in the villages and assessed at 7 and 30 days later. Complete follow-up data were obtained on 381 patients (88%) and merged with data from the enrollment visit's electronic medical records and subsequent health center visits to assess duration of illness and complications. Symptoms improved at 7 and 30 days, but a substantial minority of patients had persistent symptoms. Eleven percent of patients sought additional care for their respiratory infection.


CONCLUSIONS
EMRs and PDA are useful tools for performing prospective clinical research in resource constrained developing countries.
Diero
Lameck
L
Moi University Faculty of Health Sciences, Eldoret, Kenya. ldiero@africaonline.co.ke
Rotich
Joseph K
JK
Bii
John
J
Mamlin
Burke W
BW
Einterz
Robert M
RM
Kalamai
Irene Z
IZ
Tierney
William M
WM
D000208:Acute Disease; D000328:Adult; D000359:Aftercare; D000555:Ambulatory Care Information Systems / Q000706:statistics & numerical data*; D003151:Community Health Centers / Q000592:standards*; D034201:Computers, Handheld / Q000706:statistics & numerical data*; D003906:Developing Countries; D005500:Follow-Up Studies; D006801:Humans; D007630:Kenya; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011785:Quality Assurance, Health Care / Q000379:methods; D012141:Respiratory Tract Infections / Q000175:diagnosis / Q000628:therapy*; D019035:Rural Health Services / Q000592:standards*; D011795:Surveys and Questionnaires; D013997:Time Factors