Experiencing the US health care system has been an awesome experience for me, as far as technology is concerned. My love for electronics drives me towards ideas of implementing Electronic Medical Records (EMR) in developing countries. A number of major obstacles exist before one even thinks about such endeavors, the biggest being the upfront cost of investing in the development of a good EMR system. Even in the US, despite the availability of technology, the cost has been a major deterring factor for smaller practices and hospitals.
Besides the cost however, implementation issues are equally difficult to tackle. Adoption of EMRs has been notoriously difficult in US, where people are supposedly more computer-literate than most developing countries. A variety of factors are involved here, ranging for workflow disruption to non-user-friendly interface.
There is one issue that is unique to developing countries however: The difficulty of tracking patients. From my own experience in Pakistan, rarely do people have any type of ID. Despite the efforts by tyhe government, the majority population in the rural areas does not have a national ID card. Even those who do have one, most do not use it or carry it. Having these people carry yet another card for healthcare purposes doesn't seem like a feasible option at this point in time. It is very common to see patients with chronic diseases who regularly do not bring their past records with them every time they come to see their physician.
In this context, multiple search methods are necessary to identify past records of patients if an EMR system is to be useful. One such method I have seen is the use of telephone/cellphone numbers for ID purposes. Most people in Pakistan do have access to a phone even if they don't carry any ID. Combining patient names with phone numbers will allow a good tracking method in the short term. Indeed there is a privacy concern here but as other forms of ID become common place, hopefully using EMRs will become much safer.
