Introduction

ICT's main role throughout the world is to increase the quality of life of people by use of Information and Communications Technologies. One of the most prominent ways to increase the quality of life is through advancing not just medical research, but by advancing the basic medical systems that people require to assure appropriate levels of medical care.

Medical records, and therefore financial information for private and public institutions, is of importance for maintaining a proper patient history and making processes which affect patient care more efficient. From ancillary department (Laboratory, X-Ray, Pharmacy, Central Supply, etc.) orders to the ancillary department results, the system is meant to streamline patient care and providing a complete medical history for each visit - as well as providing inventory control and tracking financial information at a departmental and organizational level. This system reaches a new level of complexity due to the outsourcing of some ancillary departments.

Medical records and health information within the Caribbean region are not usually maintained because of many factors.

• Cost of existing software packages, which includes customization for specific needs.
• A lack of standards for medical records within the region which are specific to the region.
• Training of medical personnel in the use of such a system.
• Inadequate hardware.
• A feeling by many of the 'old guard' in medical care that no such systems are required.

Existing Systems

Despite these issues, a few private doctors and healthcare facilities in the Caribbean region have created their own systems. From Microsoft Access databases to simple Microsoft Word documents, a variety of incompatible systems exist. Each system has it's limits, which range from the instability of Microsoft Access databases over a certain size as well as the human limits of tracking large Microsoft Word files and inserting information into patient records from various ancillary department results.

Internationally, the Health Standard 7 standards provides a baseline for international medical records which is not presently implemented by many private and public sector health care facilities in the region.

Copyright

Another issue that is being underplayed is the creation of software by insurance companies which require separate interfaces to integrate with health facilities within the region. By creating the software, it is possible for them to create a database of patient information which medical facilities - and therefore patients. In a world where copyright of databases is impossible, this is not problematic - but with TRIPs and GATT and copyright laws of each country varying, it is possible for insurance companies to charge health facilities (and therefore patients) for the use of the very generation which belongs to the patient.

Structure of a Medical Record

It is intuitive that a medical record is a chronological record of what happens to a patient during care - from presentation to the healthcare facility, preventive care, chronic illnesses, allergies, patient care (including ancillary departments), and aftercare. This means that software structured for recording chronologically what happens to a patient is ideal.

Premises

Thus, the following premises for the project are:

• Increase of quality of life for patients by expediting existing processes or replacing existing processes.
• Creation and maintenance of patient information outside of the systems of insurance companies such that patients who cannot afford insurance derive benefits, and also increasing quality of life and care while not increasing costs substantially.
• The use of Open Source software licensing to allow for local personnel to support and maintain the system, and perhaps contribute to later versions.
• The ability to use as much existing hardware as possible such that minimal hardware costs and needs are required.
• Intranet/Internet usability for use across a large medical facility, or a group of cooperative health care facilities.
• Require little or no training to use; little being defined as one month or less of active use for familiarity.
• Be Health Level 7 Standards Compliant.

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