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WiRED International Launches Electronic Medical Record System in Peruvian Amazon

BY ALLISON KOZICHAROW AND BERNICE BORN

n an isolated area of the Peruvian Amazon, WiRED International just inaugurated what it believes to be the first electronic medical record (EMR) system that is completely portable and can be operated in out-of-the-way clinical settings.

WiRED Director Gary Selnow, Ph.D., said, “Clinicians who travel to remote areas of the Amazon can see hundreds of patients a day. Now instead of using paper records — vulnerable to tropical humidity and loss — these health professionals can generate EMRs in underserved, inaccessible locations and operate entirely off the grid.”

Since 2012 WiRED has partnered with Project Amazonas, a non-profit organization that works with medical volunteers to provide clinical services on an isolated portion of the Amazon River. WiRED supplies Project Amazonas with computers, projectors and electronic health libraries for use on the organization’s clinical boat, in villages and in a new clinic, soon to begin operation.

Last year Project Amazonas Director Devon Graham, Ph.D., asked if WiRED could design a system that would allow data gathering and recording in electronic form. In other words, could WiRED create a portable, jungle-ready, EMR system where patient data could be recorded during clinics held in secluded villages?

WiRED’s EMR System

 

To enable the EMR system, WiRED provided waterproof cases with laptop computers, WiFi gear, batteries and operating instructions. The equipment can be charged with portable solar panels and requires no Internet or phone connection. The system can remain in the field indefinitely.

 

The system allows clinicians to create permanent portable patient records, analyze data, track work activities, upload to the cloud for storage and monitor health trends in the communities they serve.

WiRED’s mission for the past 19 years has been to develop and distribute medical and health education programs. Creating a portable EMR would be a new assignment, but WiRED staff accepted the challenge.

Within several months, the development team — headed by Brian Colombe writing the software program and Sameer Verma, Ph.D., configuring the hardware system — arrived at a solution.

In July WiRED’s staff assembled the computers, WiFi and power system into a sturdy shell case and tested it at San Francisco State University. The rigorous field test came in early August when Dr. Selnow took the equipment to Iquitos, which lies in the rainforest of northeastern Peru and can be reached only by air or boat.

From Iquitos WiRED and the Project Amazonas team traveled on the Amazon River and set up the new system in a small school in Mishana, the town where the first clinic was held. Several additional clinics were held throughout the week in four other villages. Intake workers recorded patient data and vital signs on one laptop, the clinical staff then accessed that new patient record from a second laptop and recorded the patient’s signs and symptoms, diagnoses and treatment details. And so, one patient record at a time, the database was built throughout the day. Although the clinical teams used only two laptops in this test, the system can accommodate a number of additional laptops, all accessing the same database stored on a server.

In the evening the team returned to the boat, the Esperanza, to access patient data available for immediate examination and analysis of the day’s outcome. Everyone agreed: The system had operated successfully, exactly as designed.

Dr. Selnow said, “It was wonderful to see clinical staff entering patient data, passing it along via the WiFi system and building patient records for people in remote villages. The equipment and software could not have worked better.”

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