image: A community health worker uses a hand-held device to collect in-home information on drug treatment in rural Kenya. view more
Credit: World Health Organization
INDIANAPOLIS – A $1.3 million grant to Indiana University from the National Institutes of Health's Fogarty International Center will establish the East African Center of Excellence in Health Informatics.
The new center will connect the expertise of one of the world's foremost informatics programs at IU and the Regenstrief Institute with one of the leading academic medical centers in East Africa at Moi University and Moi Teaching and Referral Hospital to increase the capacity for electronic health records in one of the worlds' poorest regions. By helping East African countries use electronic health records to increase the efficiency and quality of care, this Center of Excellence grant will help East Africans cross what has been termed "the digital divide."
"To be most efficient and effective, health care delivery and public health needs require timely access to high-quality data," said William Tierney, M.D., of the IU School of Medicine and the Regenstrief Institute, co-director of the new center. "Developing countries have been on the far side of the digital divide. Without computerized care management, tracking and analysis, these nations have obtained less than optimal outcomes from what they spend on health care." Dr. Tierney, an internationally respected leader in medical informatics, is an Indiana University-Purdue University Indianapolis Chancellor's Professor of Medicine and executive director of the Regenstrief Center for Healthcare Improvement and Research.
"Importantly, this Center of Excellence will train East Africans to use electronic tools to solve healthcare problems in their own countries," he said. "My American and Kenyan colleagues have shown in Kenya that in spite of problems such as scarce resources, lack of trained personnel, ethnic tension and even lack of dependable electricity, we can capture data electronically that have been used to enhance health-care outcomes and public health. We believe this is an outstanding model for the millions of men, women and children throughout the developing world."
The new East African Center builds upon nearly two decades of IU School of Medicine and Regenstrief collaboration with Moi University in Eldoret, Kenya. This collaboration is responsible for the Academic Model Providing Access to Healthcare (AMPATH), one of sub-Saharan Africa's largest health care programs. It is served by the AMPATH Medical Record System (AMRS), the first and most successful outpatient electronic medical record system in sub-Saharan Africa.
Today the AMRS serves 46 urban and rural health centers in western Kenya and contains more than two million visit records for more than 100,000 Kenyans. AMRS has spawned OpenMRS, a free open-source electronic medical record system that is now the most widely adopted electronic medical record system in the developing world. OpenMRS is used in Kenya, Rwanda, South Africa, Uganda, Tanzania, Zimbabwe, Lesotho, Malawi, as well as Peru and Haiti. It also has been implemented in several health centers in the United States.
OpenMRS pioneer Paul Biondich, M.D., a Regenstrief Institute investigator who is an associate professor of pediatrics at the IU School of Medicine and director of informatics for AMPATH, co-directs the East African Center of Excellence in Medical Informatics. Abraham Siika, M.D., of Moi University and a former Regenstrief–Moi biomedical informatics fellow, is also a co-director of this regional Center of Excellence.
The new five-year grant supports the reinstatement of the Regenstrief-Moi biomedical informatics fellowship program which will increase health informatics capacity throughout East Africa using a variety of approaches. This funding will allow prospective fellows to spend one to two years in Indianapolis pursuing a master's degree in clinical research or health informatics. The following fellowship year will be spent in Eldoret developing, implementing and studying the effects of informatics tools. Other approaches will focus around more pragmatic vocational training short courses related to the implementation and support of health information systems.
"Electronic medical records have allowed our Kenyan clinics to care for two to four times more patients than similar clinics using paper records. But for such benefits to be sustainable, these systems must be maintained and improved by trained local technicians and developers. This grant will help that happen," Dr. Tierney said.
Dr. Tierney is a member of the Institute of Medicine. In recognition of his work to improve health in Kenya, he was named an elder of the Nandi tribe of Mosoriot, Kenya in 2002.
This award to Indiana University is one of eight global health informatics awards from NIH totaling $9.23 million.