Introduction
The organization that I will look at is Ampath Center. Ampath Center is a partnership between two universities, Indiana University School of Medicine, which is in the US, and Moi Teaching and Referral hospital, which is in Eldoret, Kenya. Ampath center is concerned with taking care of the those affected with HIV/AIDS and has established over 30 comprehensive HIV care clinics in Africa. They care and provide antiretroviral to those who are economically unstable and live in the rural areas and urban areas. In Kenya alone, Ampath has 18 care clinics. The most overriding goal of Ampath is to provide a working model for those suffering from HIV/AIDS and thus provide services for these affected. Ampath resembles academic institutions in the way their structure is constructed. This is because it has care services and at the same time acting as the center for research and learning for researchers who are working on the virus. The Pilot Phase of Ampath began in November 2001.
Data Management
Ampath uses the Open Medical Records System (OpenMRS). They have tailored most of the modules to come up with AMRS (Ampath Medical Records System). OpenMRS is a system, which is used to manage medical records, especially HIV/AIDS records. With the escalating number of people who are either infected or affected by HIV/AIDS, prevention and management of the same requires efficient software and management systems. OpenMRS is a system that was developed at Regenstrief Institute in collaboration with Partners in Health[ CITATION Poi05 \l 1033 ].
Infrastructure
The system has three layers, which include data model layer, the API layer, and the web application layer.
Data model
The data model is made up of ten domains. The first domain is the concept domain. This domain is used to define and support data, which are strongly coded in the whole system. The second domain is the encounter domain, which has all the meta-data that deal with health care providers interventions with the patients. The providers will meet with the patients more than once and this requires that each meeting be recorded. It is important so that the provider will get the progress of their patients[ CITATION Ama05 \l 1033 ]. Then there is form, which is an interface description of all the components of the system. The form will contain the required component and will have the concepts in the system. New concepts are added by using the form domain. The observation is yet another domain, which is the actual repository for the health care data. It is here that holds the observations that were captured by the providers. There are many observations per encounter. Order entails the things that have been scheduled to occur[ CITATION Gar06 \l 1033 ]. Then there is the patient, which is the basic information about the patient recorded in the system. User is the domain that contains the information about the people who use the system. The users can be staff and the technical personnel. The person is the basic structure of the person in the system. These are the attributes for the person in the system. Business is the data that are non-medical. They are used for administrative purposes. The cohort and workflow of data is found in the Groups/Workflow domain (Gartee, 2006).
Evaluation of the data process
Assessment with MRI
There are principles that have been set by the Medical Records Institute (MRI) that will ensure quality data. The first principle as stated by MRI is that patients should be unique internally and externally. Basing the Ampath system, they can be said to have met this principle. This is because all the patients have an AMRS card assigned to them. The AMRS have bar codes, which help to uniquely identify the patients within Ampath and across other hospitals. The documentation must be accurate, complete and at the right time, compatible across systems, can be accessed, and can be audited[ CITATION Cat08 \l 1033 ].
Another principle that is required of this data is that of confidentiality and authentication. The OpenMRS is secure because of the fact that it I accessed behind SSL protocol. This way, the system is said to be secure. One issue with the system is that there is laxity in authentication. There are no strong mechanisms that have been put in place to ensure proper authentication. Users still use weak passwords. The stand of MRI is that when medical practitioners interact with data electronically, there are high chances that the requirements will be met[ CITATION Has06 \l 1033 ].
Evaluation using AHIMA
AHIMA stresses for the following attributes for data:
i. Accessibility
ii. Consistency
iii. Currency
iv. Granularity
v. Precision
vi. Accuracy
vii. Comprehensiveness
viii. Definition
ix. Relevancy
x. Timeliness
The OpenMRS system meets all of these requirements as the data from the system are taken using the most recent encounters. In addition, they are relevant as the information that is captured in the OpenMRS system is current. All encounters and observations are relevant.
OpenMRS system can therefore be said to meet most of the requirements of both the MRI and AHIMA.
References
Amatayakul, M., & Lazarus, S. (2005). Electronic health systems: Transformating your medical practice. Chicago: Medical Group Management.
Cater, J. (2008). Electronic health systems: A guide for clinicians and administrators. New York: ACP Press.
Gartee, R. (2006). Electronic health systems: Understanding and using computerised medical ystems. Michigan: The University of Michigan Press.
Hasset, M. M. (2006). Case study: Factors in defining the nurse informatics specialist role. Journal of the Health Information Systems Society , 20 (2), 30.
Poissant, L., Tamblyn, T., & Kawasumi, Y. (2005). The impact of electronic health records on time efficiency of physicians and nurses: A systematic review . Journal of American Medical Informatics Association , 54-57.
