Keeping detailed patient records during the Ebola outbreak can be a nightmare.
Currently, health care workers use very basic methods, ranging from scanning files to writing on white boards to calling results across rooms to simple memorization. But the International Rescue Committee (IRC), a crisis organization, is about to change that by bringing in electronic health records to its new Ebola treatment unit opening the week of Dec. 15 in Monrovia, Liberia.
"There's a rule in medicine that if it's not written down, you didn't do it," says Dr. Wilson Wang, a senior clinical advisor for IRC's Ebola response. Wang says the new electronic health record system can be used for health care accountability and to record decisions made, as well as those decisions' outcome. IRC's new system can be accessed via waterproof Sony tablets that can be brought into high-risk zones. The devices will still destroyed when the unit is no longer needed, but the actual data will not be lost. The system was developed by IRC's own technology team with the help of health software company Vecna.
Some of the patient data will be handed over to the Liberian Ministry of Health to aid in contact tracing, but IRC says other data that doesn't identify patients will be shared publicly in some capacity. That data could consist of what specific Ebola treatments are being provided, how many patients are seen in the unit, what percentage of patients test positive or negative for the virus, how many people survived, and among those who didn't, where did they go? In the future, this may aid in other outbreaks, and help scientists and researchers understand what went right and wrong in the current outbreak.
"We want to share [the system]," says Wang. "We plan to essentially give it away, but we want to demonstrate that it works."
It will also enable physician support. Currently, doctors treating Ebola rely on their own experiences and what's reported to be successful in the past to determine how to treat a person, but Wang says there's not a single place doctors can go to get the most up to date data on what's working in the current outbreak. The new system could make it easier for doctors to get directions on how much medication they should provide, for instance, or what to do when someone has a seizure. "When providers are under stress, and even when they're not, they make mistakes. They're human," says Wang. It's his hope that this technology could help doctors avoid some of those mistakes by giving them a resource to turn to.
IRC has been in West Africa for over two decades often helping hospitals with infrastructure. When the current outbreak is contained, IRC says it plans to find a way to use the system to help rebuild the currently devastated health system in Liberia—even if it's just to aid in administrative tasks. "Hospitals need a system to manage this type of data and place orders [for resources and drugs]," says Wang. "[Right now] it's sort of like coming up with a grocery list for a party when you don't know what people are going to eat."
In the meantime, IRC plans to roll out the system in its own unit in mid-December, and plans to continue to refine the platform as they go.
"We think this has the potential to really change not only how quality and safety is addressed in an Ebola situation, but it can also be adapted to any health care situation," says Wang.