Since AMPATH's inception, Health Information Technology (HIT) has been identified as a key innovation that drives and directly supports the healthcare mission. As AMPATH moves into the second decade of this millennium, our program scope will expand to provide more comprehensive health care including primary healthcare, chronic disease, oncology and cardiology care. Innovation in all areas of AMPATH will continue to be a key driver in this growth. As AMPATH evolves into a broader health systems strengthening initiative, the AMPATH Informatics team sees a unique opportunity to not only directly support this broader mandate, but also serve as an international "proof of concept" for resource-constrained environments throughout the world. The mission of the AMPATH Informatics department is to provide effective and innovative information technology to support and drive the ongoing mission of AMPATH in Western Kenya.
The AMPATH medical record system (AMRS), originally conceived by the AMPATH Informatics team, is a centerpiece of AMPATH Informatics and is a cornerstone of the AMPATH initiative. Currently deployed at the AMPATH center in Eldoret, Kenya and at eight other AMPATH sites in Western Kenya, the AMRS is one of the first and largest examples of an electronic medical record system in sub-Saharan Africa. To date, the AMRS has collected more than 100 million discrete clinical observations from 2.8 million AMPATH visits made by 300,000 enrolled patients. Stored data includes discrete data such as test results; patient descriptors such as symptoms, vital signs, and physical exam findings; and diagnoses and treatments from clinical encounters. This robust backbone is at the heart of AMPATH's strategy to create unique, globally accessible patient health records for each individual served by the initiative. A key strategy that drives significant economies of scale for AMPATH is an emphasis on data reuse. The same data that supports direct patient care is used simultaneously to make cohort and community-based aggregate inferences, for monitoring and evaluation tasks, as well as to promote a rich series of basic science, clinical and health services research activities.
Mobile health (mHealth) offers an enormous range of possibilities in expanding access to health care to underserved and remote locations. In 2007, AMPATH implemented an mHealth solution to support the Home-based Counseling and Testing (HCT) program. This early project used PDAs to capture data collected by community health workers in remote locations. In little time, the promise of using smart phones running Google's Android operating system has made it possible for clinicians and community health workers to access patient information in real time while in remote locations. Work is underway to provide this technology to support work in reproductive health, chronic disease management and to support primary health care. Once deployed, AMPATH will push health care closer to the villages and homes of our clients.
Please click here for a video demonstration of how mobile technology is being used by health care providers, and click here for the PDF of a paper written on Android technology in Home-based Counseling and Testing. To hear Dr. Martin Were talk about AMPATH clinical decision support systems, click here for a short video.
Evolution into Health Information Exchange
Given that AMPATH currently supports the health records for over 300,000 individuals, and has ambitions of supporting the comprehensive health services of a 2 million patient catchment area, we must rapidly evolve our current, centrally managed health information infrastructure into a series of distributed clinical applications which together support comprehensive health services in the region. We intend for the product of this work to rival many resource rich environments through a deep focus on customizing these technologies to real, not perceived needs.
Connecting sites via a fast and low-cost wireless wide area network offers the promise of pushing access to health information across a good portion of our catchment area. When completed in late-2011, we will be able to provide clinicians and other members of the AMPATH team access to patient information in real time across all rural clinics.