“If it can’t be measured, it can’t be improved.”
– Mark Schelbert, F.D. Board Member
In 2012, our volunteers established that the most recent existing health data for our region was more than six years old, and some areas appear never to have been surveyed. Throughout a dynamic health landscape, many local variations among the communities and in the environment create enormous differences in health across very small areas—the Bahia Azul area in Panama’s Ngabe Indigenous reserve is less than 100 square miles, but has over 150 small, dispersed villages with a very wide spectrum of health conditions. In addition, health conditions within a community can change drastically over very short time periods—one month there may not be a single case of Dengue, but a month of spring showers may bring mini-epidemics from mosquitos.
Surveying these areas by traditional methods is costly and logistically challenging, and many indigenous people have extreme distrust of strangers coming around asking personal questions. The unique access and acceptance we have earned in the communities we serve allows us an unprecedented opportunity to develop good information on these areas.
The clinical data we gather during deployments is compiled and analyzed through a database built by our volunteers and allows us to monitor conditions in the community, targeting our interventions based on current need and evaluating the effects. Additionally, our volunteers have conducted targeted needs assessments in HIV, Family Planning, and other regional health issues for which effective interventions are a priority.
Additionally, we have been working to develop a tablet-based EMR suitable for use in remote field settings. We look forward to implementing it, but we will not do so until it can out-perform the paper system we have now. For us, outperforming does not mean better defensive practice protection or clearer billing—it means the EMR gathers the maximum amount of data useful for the acute and future management of individual patient and for our regional public health knowledge, promotes continuity of care through prompts and menu selects of appropriate treatments for local conditions, and maximizes the time a clinician can spend actually looking at and talking to the patient instead of entering data as fast as possible.
We provide reports to the Ministry of Health and other groups to facilitate their planning, and are able to assess the effects of our own programs. Our database (currently passing 30,000 patients over more than 4 years) additionally provides an invaluable baseline for researchers interested in targeted studies in the population we serve, and we are very happy to help facilitate other groups’ public health research that can benefit our patients. If you have a research project you would like to discuss, please contact us for more information.
In general, the requirements we have for any research projects are:
- The structure of the data gathering itself must directly benefit the patients
- The project should have a practical application for addressing health needs of our region
- The project must adhere to international standards of ethical public health research standards