Deployment of a Web-Based LIS on a National Scale in Peru

Driven by a need to provide a national LIS, a web-based system was deployed in the Peruvian national TB laboratory, two regionals labs, and twelve health centers at a very low cost (see: A web-based laboratory information system to improve quality of care of tuberculosis patients in Peru: functional requirements, implementation and usage statistics). The core functionality of the system, called e-Chasqui, has been implemented using the open source medical record system OpenMRS. Below are excerpts from the article describing the new system by the open access publisher BioMed Central (boldface emphasis mine):

• A web-based laboratory information system “e-Chasqui” has been designed and implemented in Peru to improve the timeliness and quality of laboratory data. It was deployed in the national TB laboratory, two regional laboratories and twelve pilot health centres. Using needs assessment and workflow analysis tools, e-Chasqui was designed to provide for improved patient care, increased quality control, and more efficient laboratory monitoring and reporting.
• In total, e-Chasqui will serve a network of institutions providing medical care for over 3.1 million people. The cost to maintain this system is approximately US $0.53 per sample or 1% of the National Peruvian TB program’s 2006 budget.
• e-Chasqui has the potential to provide a national TB laboratory network in Peru. Furthermore, the core functionality of e-Chasqui as been implemented in the open source medical record system OpenMRS for other countries to use.
• There are potentially greater benefits of using clinical information systems in locations with limited infrastructure where other methods of communications are more costly. However, though they can provide many benefits, these systems are difficult to implement.....Among the many challenges that need to be surpassed are over-burdened laboratory and clinical personnel, frequent staff rotation, limited computer and internet access, and frequent changes in administrations and policies.

What a fantastic idea! I hope that various U.S. and international public health agencies will pick up on this same idea and help deploy a similar system in other less developed countries. Obviously, the Internet is now relatively evolved, even in poorer countries. Using the infrastructure to deploy a web-based LIS make perfect sense as does infectious disease reporting as a major driver of the project. I have no idea how the stated cost of US$ 0.53 per sample stacks up against the cost of LISs in the U.S. but, of course, these latter systems would probably be managing a much larger volume of test specimens. Perhaps some entrepreneurs will emulate this Peruvian example and develop a similar open source system for the U.S. market, particularly for smaller rural labs with limited resources.

Comments

[Anonymous]

Bruce,

Was wondering whether you have checked out Medziva http://www.medziva.com