title: Three years experience with the implementation of a networked electronic medical record in Haiti.
abstract: Since 2005 we have been developing and implementing an electronic medical record (EMR) that supports both individual and population health care of HIV-infected patients in Haiti. Unreliable electrical power and network infrastructure, cultural differences, variable levels of experience and computer literacy, and the geographic dispersion of the team remain challenges, but the system is now implemented in about 40 sites nationwide providing antiretroviral therapy, and includes records for about 18,600 patients. The need to support country-wide monitoring and evaluation drove early architectural decisions to support linking systems under conditions of network uncertainty. We have found surprising end user acceptance of the system, with the adoption of interactive EMR usage exceeding our expectations and timeline.
authors.affiliation: University of Washington/I-TECH, Seattle, USA.
authors.forename: William B
authors.initials: WB
authors.lastname: Lober
authors.forename: Christina
authors.initials: C
authors.lastname: Quiles
authors.forename: Steve
authors.initials: S
authors.lastname: Wagner
authors.forename: Rachelle
authors.initials: R
authors.lastname: Cassagnol
authors.forename: Roges
authors.initials: R
authors.lastname: Lamothes
authors.forename: Don Rock Pierre
authors.initials: DR
authors.lastname: Alexis
authors.forename: Patrice
authors.initials: P
authors.lastname: Joseph
authors.forename: Perri
authors.initials: P
authors.lastname: Sutton
authors.forename: Nancy
authors.initials: N
authors.lastname: Puttkammer
authors.forename: Mari M
authors.initials: MM
authors.lastname: Kitahata
mesh_terms: D020000:Decision Support Systems, Clinical / Q000458:organization & administration*; D057286:Electronic Health Records / Q000458:organization & administration*; D015658:HIV Infections / Q000175:diagnosis* / Q000628:therapy*; D006254:Hawaii; D020407:Internet / Q000458:organization & administration*; D008498:Medical Record Linkage / Q000379:methods*; D013673:Technology Assessment, Biomedical; D017216:Telemedicine / Q000458:organization & administration*