Development and Evaluation of a Web-based Electronic Medical Record System Without Borders

Abstract

Despite implementation of electronic medical record (EMR) systems in the United States and other countries, EMRs often lack global access, standardization, an efficient interface, and effective knowledge-based tools at the point of care. Consequently, the information needs of patients, practitioners, administrators, researchers, and policymakers often go unmet, leaving providers especially dissatisfied. To address this multifaceted problem, a novel EMR design referred to as "Electronic Medical Records Without Borders" (EMR WB) was created to ensure that the most vital pieces of patient clinical records are available to make health care decisions. A web-based, standardized, family medicine, clinical history model was developed and evaluated as an EMR clinical core that integrates state-of-the-art terminology, peer-reviewed, evidence-based protocols with real-time access to diagnostic decision support systems and the biomedical literature, using a unified, navigable, intuitive computer interface. This project aimed to facilitate structured clinical documentation, usability, global access, and decision-making processes to better address not only local, clinical, and psychosocial primary care problems in targeted underserved communities in the state of Guanajuato, Mexico, but also to mitigate transnational migration health issues based on information exchange among primary care settings. A survey of post-exposure EMR WB use indicated a measurable, positive effect was made on provider satisfaction compared with a previously used, paper-based record system. Data were analyzed using descriptive statistics.