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Leveraging the Value of Human Relationships to Improve Health OutcomesLessons learned from the OpenMRS Electronic Health Record System
15 August 2016
Accepted: 30 February 2016
20 December 2017 (online)
Objectives: Despite significant awareness on the value of leveraging patient relationships across the healthcare continuum, there is no research on the potential of using Electronic Health Record (EHR) systems to store structured patient relationship data, or its impact on enabling better health-care. We sought to identify which EHR systems supported effective patient relationship data collection, and for systems that do, what types of relationship data is collected, how this data is used, and the perceived value of doing so.
Materials and methods: We performed a literature search to identify EHR systems that supported patient relationship data collection. Based on our results, we defined attributes of an effective patient relationship model. The Open Medical Record System (OpenMRS), an open source medical record platform for underserved settings met our eligibility criteria for effective patient relationship collection. We performed a survey to understand how the OpenMRS patient relationship model was used, and how it brought value to implementers.
Results: The OpenMRS patient relationship model has won widespread adoption across many implementations and is perceived to be valuable in enabling better health care delivery. Patient relationship information is widely used for community health programs and enabling chronic care. Additionally, many OpenMRS implementers were using this feature to collect custom relationship types for implementation specific needs.
Conclusions: We believe that flexible patient relationship data collection is critical for better healthcare, and can inform community care and chronic care initiatives across the world. Additionally, patient relationship data could also be leveraged for many other initiatives such as patient centric care and in the field of precision medicine.
KeywordsElectronic health records and systems - patient-centered care - family relations - parent-child relations - professional-family relations - chronic disease - care coordination
- 1 Cacioppo JT, Cacioppo S. Social relationships and health: The toxic effects of perceived social isolation. Social and personality psychology compass 2014; 8 (Suppl. 02) 58-72.
- 2 Mitchell P, Wynia M, Golden R, McNellis B, Okun S, Webb CE, Rohrbach V, Kohorn IV. Core principles & values of effective team-based health care. Washington, DC: Institute of Medicine; 2012
- 3 Lofgren R, Karpf M, Perman J, Higdon CM. The US health care system is in crisis: implications for academic medical centers and their missions. Academic Medicine 2006; 81 (Suppl. 08) 713-720.
- 4 Braveman P, Egerter S, Williams DR. The social determinants of health: coming of age. Annual review of public health 2011; 32: 381-398.
- 5 Petterson SM, Liaw WR, Phillips RL, Rabin DL, Meyers DS, Bazemore AW. Projecting US primary care physician workforce needs: 2010-2025. The Annals of Family Medicine 2012; 10 (Suppl. 06) 503-509.
- 6 Ruffin MT, Nease DE, Sen A, Pace WD, Wang C, Acheson LS, Rubinstein WS, O’Neill S, Gramling R. Effect of preventive messages tailored to family history on health behaviors: the Family Healthware Impact Trial. The Annals of Family Medicine 2011; 9 (Suppl. 01) 3-11.
- 7 World Bank.. New Country Classifications. 2015 Available from: http://data.worldbank.org/news/new-country-classifications-2015.
- 8 Decroo T, Rasschaert F, Telfer B, Remartinez D, Laga M, Ford N. Community-based antiretroviral therapy programs can overcome barriers to retention of patients and decongest health services in sub-Saharan Africa: a systematic review. International health 2013; 5 (Suppl. 03) 169-179.
- 9 Wouters E, Van Damme W, van Rensburg D, Masquillier C, Meulemans H. Impact of community-based support services on antiretroviral treatment programme delivery and outcomes in resource-limited countries: a synthetic review. BMC health services research 2012; 12 (Suppl. 01) 1.
- 10 Källander K, Tibenderana JK, Akpogheneta OJ, Strachan DL, Hill Z, ten Asbroek AH, Conteh L, Kirkwood BR, Meek SR. Mobile health (mHealth) approaches and lessons for increased performance and retention of community health workers in low-and middle-income countries: a review. Journal of medical Internet research 2013; 15 (Suppl. 01) e17.
- 11 Hulse NC, Ranade-Kharkar P, Post H, Wood GM, Williams MS, Haug PJ. editors. Development and early usage patterns of a consumer-facing family health history tool. AMIA Annu Symp Proc. 2011
- 12 Cambria E, White B. Jumping NLP curves: a review of natural language processing research [review article]. IEEE Computational Intelligence Magazine 2014; 9 (Suppl. 02) 48-57.
- 13 The OpenEHR Foundation.. OpenEHR: An open domain-driven platform for developing flexible e-health systems. Available from: http://www.openehr.org.
- 14 Buck J, Garde S, Kohl CD, Knaup-Gregori P. Towards a comprehensive electronic patient record to support an innovative individual care concept for premature infants using the openEHR approach. International journal of medical informatics 2009; 78 (Suppl. 08) 521-531.
- 15 Kashfi H, Torgersson O. editors. A migration to an openEHR-based clinical application. MIE 2009
- 16 Atalag K, Yang HY, Tempero E, Warren J. Model driven development of clinical information systems using openEHR. 2011
- 17 Bernstein K, Tvede I, Petersen J, Bredegaard K. editors. Can openEHR archetypes be used in a national context? The Danish archetype proof-of-concept project. MIE 2009
- 18 Noll J, Beecham S, Seichter D. editors. A Qualitative Study of Open Source Software Development: The Open EMR Project. 2011 International Symposium on Empirical Software Engineering and Measurement; 2011 IEEE.
- 19 OpenEMR.. Development 4.2.2 Demo. 2016 Available from: http://www.open-emr.org/wiki/index.php/Development_4.2.0_Demo.
- 20 Afrin LB, Oates JC, Boyd CK, Daniels MS. editors. Leveraging of open EMR architecture for clinical trial accrual. AMIA Annual Symposium Proceedings; 2003: American Medical Informatics Association.
- 21 Jayasekara I. Management Information System for Medical Centre at University of Sri Jayewardenepura. 2013
- 22 Neokleous KC, Schiza EC, Pattichis CS, Schizas C. A patient centered electronic health system: an example for cyprus. ICIMTH 2014
- 23 Keyani S, Mumtaz A, Mushtaq H, Hussain A. Affordable and accessible tele-healthcare to rural areas of Pakistan through web and mobile based technologies. 2009 6th International Symposium on High Capacity Optical Networks and Enabling Technologies (HONET); 2009 IEEE.
- 24 Wolfe BA, Mamlin BW, Biondich PG, Fraser HS, Jazayeri D, Allen C, Miranda J, Tierney WM. The OpenMRS system: collaborating toward an open source EMR for developing countries. AMIA Annual Symposium Proceedings; 2006: American Medical Informatics Association.
- 25 OpenMRS Inc.. About OpenMRS. 2016 Available from: http://openmrs.org/about.
- 26 Thompson A, Castle E, Lubeck P, Makarfi PS. Experience implementing OpenMRS to support maternal and reproductive health in Northern Nigeria. Stud Health Technol Inform 2010; 160 Part 1 332-336.
- 27 Manders E-J, José E, Solis M, Burlison J, Nhampossa JL, Moon T. Implementing OpenMRS for patient monitoring in an HIV/AIDS care and treatment program in rural Mozambique. Studies in health technology and informatics 2009; 160 Pt 1 411-415.
- 28 Tierney WM, Achieng M, Baker E, Bell A, Biondich P, Braitstein P, Kayiwa D, Kimaiyo S, Mamlin B, McKown B, Musinguzi N, Nyandiko W, Rotich J, Sidle J, Siika A, Were M, Wolfe B, Wools-Kaloustian K, Yeung A, Yiannoutsos C. Experience implementing electronic health records in three East African countries. Stud Health Technol Inform 2010; 160 Pt 1 371-375.
- 29 Epic Systems Corporation.. In a nutshell 2016. Available from: http://www.epic.com/About.
- 30 Cerner Corporation.. Hospitals & Health Systems. 2016 Available from: http://www.cerner.com/solutions/hospitals_and_health_systems/.
- 31 eClinicalWorks.. About us 2016. Available from: https://www.eclinicalworks.com/about-us.
- 32 Liu A, Sullivan S, Khan M, Sachs S, Singh P. Community health workers in global health: scale and scalability. Mount Sinai Journal of Medicine: A Journal of Translational and Personalized Medicine 2011; 78 (Suppl. 03) 419-435.
- 33 Kasthurirathne SN. Help us understand how the OpenMRS relationship feature is used!. 2016 Available from: https://talk.openmrs.org/t/help-us-understand-how-the-openmrs-relationship-feature-is-used/5387.
- 34 Thoughtworks Inc.. Hospital System for Low Resource Settings. 2016 Available from: http://www.bahmni.org/.
- 35 Balcazar H, Lee Rosenthal E, Nell Brownstein J, Rush CH, Matos S, Hernandez L. Community health workers can be a public health force for change in the United States: three actions for a new paradigm. American journal of public health 2011; 101 (Suppl. 12) 2199-2203.
- 36 National Institutes of Health.. Precision Medicine Initiative Cohort Program. 2016 Available from: https://www.nih.gov/precision-medicine-initiative-cohort-program.