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Cloud EHR lessons learned in Haiti

Brian Eastwood | July 30, 2013
Strip away preconceptions about why technology doesn't or shouldn't work and people are likely to embrace the change that tech brings. That's what electronic health record and practice management software vendor athenahealth learned when it helped a hospital in Haiti implement a cloud-based EHR system.

Healthcare providers in the United States have preconceived notions about electronic health records-namely, that EHR systems haven't lived up to their promise of transforming healthcare by improving efficiency and cutting costs.

The healthcare industry also has preconceived notions about cloud computing, too-namely, that the cloud isn't secure enough for patient data.

Go to Haiti, though, and the story's dramatically different. There are no preconceptions, no tales of IT implementations gone wrong and no government mandates to adopt technology. As one health worker told Pierre Valette, vice president of content communications for cloud EHR and practice management software vendor athenahealth, "They've got nothing to unlearn."

Treating Spinal Cord Injuries After Haiti Earthquake
The connection between Haiti and Watertown, Mass.-based athenahealth began several years ago, when CEO Jonathan Bush began donating to St. Boniface Hospital in rural southern Haiti, where running water and electricity are scarce.

After the Jan. 12, 2010 earthquake that destroyed much of Port-au-Prince, Haiti's capital, the hospital and the Massachusetts-based St. Boniface Haiti Foundation established the country's first spinal cord injury treatment center.

Spinal cord injuries in the developing world are much harder to treat at all stages of the care process, from transportation to the hospital to inadequate radiology equipment to poor rehabilitation services. While the life expectancy for spinal cord patients in the developed world can be measures in decades, in the Third World, it's mere years.

As of May 2013, though, only one patient in the spinal cord injury program at St. Boniface had died. To recognize this work, this spring athenahealth gave St. Boniface Haiti Foundation its 2013 Vision Award and athenaClinicals, its cloud-based EHR, to help improve clinical documentation and catalog the program's progress.

Cloud EHR Good Fit For Rural Setting
As Valette notes in a three-partblogseries about athenahealth's trip to Haiti, this was the hospital's first EHR system. This "purity" of sorts eased the adoption process, he says. It helped, too, that St. Boniface, while willing to think big, understood that successful EHR implementation requires a methodical approach.

Given the rural setting-it takes planes, buses and automobiles to get to St. Boniface, says Kevin Scheper, vice president of professional services for athenahealth-a cloud-based system made more sense than a client-server EHR deployment.

A single-instance cloud EHR helps connect St. Boniface with the Boston University Medical Campus, where doctors are donating their time to view X-rays and physician notes for patients in Haiti. This offers a marked contrast to the more traditional ASP-based delivery model, in which each practice has a customized version of an EHR system that's often compatible with other instances of the same system, Scheper notes.


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