For 30 years, the St. Boniface Haiti Foundation, located in the rural town of Fond des Blancs, Haiti, has been improving the lives of underserved patients by providing high-quality and affordable healthcare and education. The Foundation’s commitment to the local community was tested following a massive January 2010 earthquake that rocked Haiti. More than 100,000 perished, and thousands of homes and commercial buildings were damaged or destroyed. St. Boniface lost almost all of its paper patient medical records.
In the wake of the disaster, as international relief organizations began to depart, St. Boniface stepped up to care for patients who had suffered spinal cord injuries. Without much knowledge or experience in long-term care, the foundation’s new commitment spurred the creation of St. Boniface’s Spinal Cord Injury Rehabilitation and Community Reintegration Program, which proved to save the lives of many affected by the earthquake.
As the program developed and its patient case load increased, the organization was in desperate need of an information system for clinical documentation that could provide a full picture of a patient’s condition and health history. It was imperative that the organization be able to track the program’s overall progress to effectively plan for the existing and future needs of its patients. With all of the documentation the organization needed, there was only one solution: a cloud-based EHR service.
|PHOTO COURTESY ST. BONIFACE – Dr. Roland Desiree, director of the Spinal Cord Injury Program at St. Boniface, consults with a patient while entering information on the athenahealth cloud-based EHR.|
So in April 2013, St. Boniface partnered with athenahealth to implement a cloud-based EHR at its rural location, finally giving patients an electronic documentation of their condition and health history. By the third day of implementation, phase one of the EHR go-live was successful. Because St. Boniface selected a cloud-based service, the EHR had a light footprint. No on-site infrastructure – such as traditional software servers and cables, or local IT staff – was needed. The connection from a nearby cell tower was able to deliver a strong signal, allowing the ability to connect to the Internet and to the EHR service.
The ease of adoption of a cloud-based service allowed St. Boniface to rapidly implement the new solution. For one thing, they were starting with a clean slate, so physicians had nothing to “unlearn” about other electronic systems. In training, the rehabilitation staff employed a creative way to learn the system by competing to see who could log in and enter test-patient data the fastest. Winners would give a big “fist pump” when the task was completed. Not only were they gaining cloud-based knowledge, but they were doing so in an engaging, efficient fashion. Participants today are very proud to be on the cutting edge of healthcare delivery in Haiti and remain eager to learn professional skills to deliver better care.
|PHOTO COURTESY ST. BONIFACE – Betsy Sherwood hugs a young patient from the St. Boniface Spinal Cord Injury Rehabilitation and Community Reintegration Program.|
Patient progress to recovery has proven the success of the EHR. In developing-world countries such as Haiti, life expectancy for spinal cord injury victims is about one year, at best. As for St. Boniface, all but one of the 62 patients in the Spinal Cord Injury Program has beaten those odds.
Take Mamaille, for example. She’s a 16-year-old female patient who was crushed by a falling building at a school in Port-Au-Prince during the earthquake. Her family thought she was dead. But Mamaille was brought to St. Boniface’s Spinal Cord Injury Program and now, three years after the injury, she’s thriving in a program that offers her psychological counseling, physical therapy, schooling, wound care and, most importantly, a supportive community.
St. Boniface’s ability to provide this level of care, sustain it and replicate it for other patients in a rural environment with little infrastructure is made possible with a cloud-based EHR service. As the popularity of cloud services grows, providers will continue to ask questions and, hopefully, will look to St. Boniface as a shining example of what can be accomplished under the most challenging circumstances.
About the author
Betsy Sherwood is program manager for the St. Boniface Rehabilitation and Community Reintegration Program; she served as coordinator of the program that implemented athenahealth’s cloud-based EHR at St. Boniface.
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