A computer-based medical record system and personal digital assistants to assess and follow pa tients with respiratory tract infections visiting a rural Kenyan health centre

Abstract

Background: Clinical research can be facilitated by the use of informatics tools. We used an existing electronic medica l record (EMR) system and personal data assistants (PDAs) to assess the characteristics and outcomes of patients with acut e 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 identi fy patients with ARIs who were prospectively followed up by a research assistant wh o rode a bicycle to patients' home s and entered data into a PDA. Results: A total of 2986 clinic visits for 2009 adul t 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 vill ages 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 complica tions. 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. Conclusion: EMRs and PDA are useful to ols for performing prospecti ve clinical research in resource constrained developing countries.