The MOSORIOT Medical Record System (MMRS) Phase I to Phase II Implementation: An Outpatient Computer-based Medical Record System in Rural Kenya

Abstract

The authors of this paper describe the second phase of the implementation of the Mosoriot Medical Record System (MMRS) in a remote health care facility on the outskirts of Eldoret, Kenya, located in sub-Saharan Africa. Eldoret, Kenya in sub-Saharan Africa has characteristics of many third world countries. There exists widespread poverty, poor technology infrastructure, and rudimentary essential services such as those that supply electricity, telephone linkages and tap water. We describe of the collaboration between Indiana University (IU) and the Moi University (MU), and the process that led to the development of the computer-based Mosoriot Medical Record System (MMRS) is provided. We then provide the conceptualization and initial implementation of this basic electronic medical record system. Kenya, in common with many other African countries, is also experiencing an epidemic of HIV infection. This epidemic is occurring in association with the illnesses characteristic of third world countries such as tuberculosis, malaria, polio and rheumatic fever. (1) We also describe the different processes for assessing the MMRS' effects on health care, including time-motion studies and a strict implementation plan that is necessary for the successful implementation of the system. A collaborative project between Indiana University and the Moi University Faculty of Health Sciences (IUMUFS) initiated in 1989 implemented a project with the purpose of enhancing medical education and public health research and this would hopefully influence the development of health care leadership in Kenya and the US. (2,3) All programs introduced through this collaboration must become self- sustaining by the Kenyan community if they are to achieve the expected benefits. The MMRS project has many features that make it significant in the domain of CBPR systems. It may serve as a model for establishing similar, basic electronic record systems in the developed and developing world. In developing countries there are few (if any) projects that have attempted to implement such a system. This paper describes the planning, end-user education to new technologies, and time-motion studies necessary for the successful implementation of the MMRS. The system will be used to improve the quality of health data collection and subsequently patient care. It will also be used to link data from ongoing public health surveys and this can be used in public health research programs of the Moi University.