HEROS: A Patient-centered Goal-directed Electronic Medical Record System For The Homeless

Abstract

Homelessness is a growing problem in the United States. Numerous barriers keep the street homeless from obtaining healthcare. Medical Street Outreach (MSO) programs are designed to reach out to the homeless. Gathering relevant clinical information on the streets is difficult, and carrying paper records in MSO is cumbersome and inefficient. Several complex healthcare record systems have been developed for hospitals, but no such system exists for collecting health data on the streets. In this thesis, we describe a light weight Electronic Medical Record (EMR), called HEROS (Homeless Electronic RecOrd System) that we have built to address the process of healthcare on the streets. The HEROS system has been designed for use on a Tablet Personal Computer (TPC) to collect, organize, and share clinical data between clinicians and provide quality healthcare to the homeless. The workflow is based on a novel model of healthcare known as Goal Negotiated Care (GNC), which stresses the needs of a patient on the street, and stresses on small success and the self-efficacy theory. Some major features of HEROS include: (1) Advanced usability features like handwriting recognition, collapsible user interface modules; (2) Communication features like email client and Internet Telephony; (3) Health Level 7 (HL7) compliant Message Passing mechanism for communication with other HL7 compliant EMRs; and (4) Security measures that comply with Health Insurance Portability and Accountability Act (HIPAA) regulations. We will report a field test that has been conducted to evaluate the effectiveness of this system. The design and workflow of HEROS can be easily expanded as a disaster relief EMR or an EMR for emergency situation.