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1.
Front Digit Health ; 4: 847002, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35360368

RESUMO

While electronic health records (EHRs) have been shown to be effective in improving patient care in low-resource settings, there are still barriers to implementing them, including adaptability, usability, and sustainability. Taking a user-centered design process we developed the Hikma Health EHR for low resourced clinics caring for displaced populations. This EHR was built using React Native and Typescript that sync to a Python backend repository which is deployed on Google Cloud SQL. To date the Hikma Health EHR has been deployed for 26,000 patients. The positive impacts of the system reported by clinician users are 3-fold: (1) improved continuity of care; (2) improved visualization of clinical data; and (3) improved efficiency, resulting in a higher volume of patients being treated. While further development is needed, our open-source model will allow any organization to modify this system to meet their clinical and administrative needs.

2.
J Rural Health ; 29(4): 339-48, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24088208

RESUMO

PURPOSE: To estimate travel distance and time for US hemodialysis patients and to compare travel of rural versus urban patients. METHODS: Dialysis patient residences were estimated from ZIP code-level patient counts as of February 2011 allocated within the ZIP code proportional to census tract-level population, obtained from the 2010 U.S. Census. Dialysis facility addresses were obtained from Medicare public-use files. Patients were assigned to an "original" and "replacement" facility, assuming patients used the facility closest to home and would select the next closest facility as a replacement, if a replacement facility was required. Driving distances and times were calculated between patient residences and facility locations using GIS software. FINDINGS: The mean one-way driving distance to the original facility was 7.9 miles; for rural patients average distances were 2.5 times farther than for urban patients (15.9 vs. 6.2 miles). Mean driving distance to a replacement facility was 10.6 miles, with rural patients traveling on average 4 times farther than urban patients to a replacement facility (28.8 vs. 6.8 miles). CONCLUSION: Rural patients travel much longer distances for dialysis than urban patients. Accessing alternative facilities, if required, would greatly increase rural patient travel, while having little impact on urban patients. Increased travel could have clinical implications as longer travel is associated with increased mortality and decreased quality of life.


Assuntos
Falência Renal Crônica/terapia , Diálise Renal , Viagem , Condução de Veículo , Feminino , Acesso aos Serviços de Saúde , Humanos , Falência Renal Crônica/epidemiologia , Masculino , Estudos Retrospectivos , Estados Unidos/epidemiologia
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