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Medical Documentation in Low- and Middle-income Countries: Lessons Learned from Implementing Specialized Charting
Andrew M Ferry1,2, Matthew J Davis1,2, Ewa Rumprecht3
1Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Tex.
Plastic and Reconstructive Surgery. Global Open
|June 25, 2021
Summary
Electronic health record (EHR) systems like Smile Train Express (STX) show potential in low- and middle-income countries (LMICs). However, adoption is limited by workflow and regulatory factors, impacting medical documentation practices.
Area of Science:
- Health Informatics
- Global Health
- Medical Documentation
Background:
- Electronic health record (EHR) implementation in low- and middle-income countries (LMICs) faces financial and technological barriers.
- Smile Train developed a specialized cleft treatment EHR system, Smile Train Express (STX), for partner institutions.
Purpose of the Study:
- To investigate medical documentation trends in Smile Train-partner institutions.
- To characterize the impact of specialized EHR software on healthcare facilities in LMICs.
Main Methods:
- Electronic surveys were sent to 843 Smile Train-partnered institutions across 68 LMICs.
- Inquiries focused on internet connectivity, documentation methods, and data storage practices.
- Institutions were analyzed based on economic and geographic subgroups.
Main Results:
- 162 institutions (19.2%) responded, with most using paper charting (64.2%) or institutional EHRs (25.9%).
- Smile Train Express (STX) was utilized by 11.1% of responding institutions during patient encounters.
- Workflow efficiency was the primary reason cited for documentation method selection (51.4%).
Conclusions:
- The distribution of STX influenced documentation practices, but full integration was likely hindered by regulations.
- Further research is necessary to understand medical documentation trends in LMICs at a detailed level.
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