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.