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From Haiti, Part I: Implementing an EHR at St. Boniface Hospital

by Pierre Valette, VP of Content Communications

On Monday, athenahealth announced the St. Boniface Haiti Foundation as our 2013 Vision Award winner. We honored St. Boniface for their 30-year effort to improve the lives of Haiti's underserved by providing high-quality, affordable health care and education in the rural region of Fond des Blancs.

In addition to recognizing St. Boniface with the award, athenahealth is partnering with the Foundation to implement our cloud-based electronic health records system—their first EHR—in rural Haiti. In fact, we currently have a team of athenistas in Haiti helping the Foundation get started. During their time there, our VP of Content and Communications, Pierre Valette, will share his experiences for you all. – Michelle, Social Media Manager.

It’s our third full day here.

We’ve had no running water since we arrived on Saturday at the St. Boniface Hospital in the rural region of Fond Des Blancs. The jugs of potable water in the kitchen ran dry last night (a few had gone missing over the weekend). Other than “splash showers” from buckets of cold well water, we haven’t bathed since we arrived. We’re all in good spirits, though. The electric generator is working, and the cell tower up the hill is delivering a strong Internet signal, ready to connect our friends to the cloud. So, athenahealth’s bold experiment to bring cloud-based electronic health records (EHRs) to the rural clinic where we are staying is—so far—working.

Over the past few days, athenahealth’s three person training team—Chris Vignare, Jamie Mercurio, and our very own Haitian translator, Jasmine Etienne—has been a giving crash course in athenaClinicals, our cloud-based EHR, to the Haitian and American teams who run the St. Boniface Hospital’s Spinal Cord Injury Program. The program, started three years ago after the worst earthquake in Haiti’s History, is the only one of its kind in the country of Haiti.

 Port au Prince, HaitiAs the hospital ambulance drove our team the four-and-a-half hours from the Port-Au-Prince airport, Jackie Mow, our cameraperson, wondered why the clinic was set up in such an inaccessible area. The question became more pointed as we covered the final 20-kilometer stretch along a rutted, dusty dirt road that let us into the mountains.

The answer is simple: no other health care organization, not even Partners in Health, volunteered to take on the care of the many post-earthquake spinal cord-injury patients who require intensive physical and psycho-social care for the rest of their lives. Sadly, though, in the case of most third-world spinal injury patients, post-trauma life expectancy is only 12-24 months, according to Dr. Inobert Pierre, the Director of the St. Boniface Hospital.

The hospital had no experience in treating spinal cord Injury patients. But they took on the challenge because it’s in the Foundations’ charter to care for the neediest of the needy in Haiti—no matter how difficult the task. Few could be considered more needy.

Mamaille, a patient at St. Boniface HospitalOn Sunday, we met Mamaille (pictured, left), a 16-year-old girl typical of many patients here. On January 12, 2010, she was crushed by a falling building at a school in Port-Au-Prince, considered dead by her family who lived in a rural province, and sent to a poorly equipped hospital in the Dominican Republic. There, the untrained workers shaved her head, eventually abandoning her on the Haitian border. Mamaille was then picked up by aid workers, her ankles eaten by rats, and eventually brought to St. Boniface’s ground-breaking Spinal Cord Injury Program.

Like all but one of the 60 patients in the program, she has beaten the odds. Three years after her injury, she’s thriving in the Program, which offers her psychological counseling, physical therapy, schooling, wound care and a supportive community.

athenaClinicals trainingBy all measures, the Program is a health care success story—with many caregivers throughout the country seeking to follow its model. One thing the program lacks, however, is an efficient way to track patients across all care providers and measure the success of the program. That’s where this athenahealth pilot comes in: The implementation team is down here in Haiti to install athenaClinicals, which requires only a laptop, electricity, and an Internet signal. We might not have running water this week, but the hospital has all the required resources to make athenaClinicals fully functional—including templates created in Creole by the athenahealth Professional Services team.

As I write this journal, I have been watching four social workers who have just learned to log onto athenaNet and register a patient for the first time. Two of these caregivers are in wheelchairs, graduates of the program and now members of the full-time staff. One of them, Maxsony, just gave me two thumbs up. “It’s easy,” he said. And we’re thrilled to hear that.

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