Prehospital Eletronic Record with use of Mobile Devices in the SAMU´s

Prehospital Eletronic Record with use of Mobile Devices in the SAMU´s Ambulances in Ribeirão Preto-Brazil

Alexandre Freitas Duarte, Hilton Vicente César

Ribeirão Preto Medical School (FRMP)

University of São Paulo

Ribeirão Preto, Brazil

[e-mail], [e-mail]

Paulo Mazzoncini de Azevedo Marques

Internal Medicine Department - FMRP

University of São Paulo

Ribeirão Preto, Brazil

[e-mail]

André Luis Mendes Marques

Ribeirão Preto Health Services

SAMU

Ribeirão Preto, Brazil

[e-mail]

Gerson Alves Pereira Júnior

Surgery and Anatomy Department - FRMP

University of São Paulo

Ribeirão Preto - Brazil

[e-mail]

Abstract—Mobile devices are emerging as an important technology to be incorporated into computerized health systems in order to enhance and support the health services provided to the patient. With the popularization of mobile and wireless technologies, the motivation and encouragement for the use of these technologies increases in support of the reliability and quality of data. An usability evaluation was conducted to identify problems and deficiencies presented in the mobile application. The combination of these two contexts creates a new term called mobile health, which has motivated much discussion of how greater access to mobile phone technology can be leveraged to mitigate the numerous pressures faced in the medical care of health systems. This paper presents the development of an electronic record system for tablets with a focus on pre-hospital patient care.

Medical informatics, electronic health records, mobile tech-nology, emergency medicine.

 Introduction

Due to the complexity of knowledge, the large amount of information and clinical data and their inter-relations in healthcare, the use of computer systems is necessary and useful in order to assist healthcare professionals in their activities. Computer systems can be used in conjunction with the electronic record in pre-hospital and hospital service, clinical course, outpatient care and general management. With advances in technology and the continuing development of mobile technologies and wireless, there is a growing need for mobility in regard to people, companies, objects and information [1].  

In the medical field, the trend is towards the increasing use of mobile technologies, a new concept called mobile-health (mHealth). Although there is no consensus on its definition, this term is commonly used to refer to the use of mobile communication devices, such as smartphones, tablets and personal digital assistants (PDAs) in health services [2].

Prehospital care is provided by a specialized team in emergency situations for events occurring outside the hospital. The process of care is intended for victims of trauma or nontraumatic cases and performed at the location of occurrence for clinical stabilization and removal to a close and appropriate health service based upon to the complexity of features that the patient needs. This service plays an important role in public health, since some situations are critical, and it helps to determine the need for emergency and immediate care [3].

Given this context, in order to address the lack of related systems and mobility required by the prehospital service, this paper presents the development of an electronic record system of the patient for prehospital emergency care by ambulance in the Mobile Emergency Care Service (SAMU), enabling the collection of patient data. The data will be synchronized with a remote server where it will be stored in a database for the purpose of analysis and studies.

With the awareness that centralizing information generated in different places can help health professionals, prehospital clinical data can be made available, integrated into triage at the Emergency Regulation Center (determines the health service to which the patient will be taken) and into the hospitals designated to receive the patient. Quality information is a key factor for decision making by healthcare teams in any scenario.

The goal of the developed systems is to provide an electronic record system to support prehospital care using mobile and distributed computing between different systems (interoperability), to assist in the registration and search into the full patient care system. From the validation of the solution, the system features will be available and integrated with an existing solution already deployed in the SAMU.

OverView

This project developed an electronic record system for prehospital emergency care, using mobile technologies (tablets) to collect data and provide the mobility needed in SAMU’s ambulances. The aim of the system is to allow a health professional to collect/registering patient data in the prehospital field, and later search and send on this information for continuity in hospital care. The development process consisted of four steps:

Design and definition scope: this definition came from the lack of healthcare information systems related to  prehospital care.

Definition of the medical records: in order to define the structure and the fields to be included in the prehospital record system, surveys have been made of content and information relevant to the subject through specific medical literature and weekly meetings with medical professionals.

Development: a mobile solution was performed on the Android platform, this offers a software development platform adhering to the proposed project with free distribution. The languages used were Java and XML (Extensible Markup Language). For storage of data on the device itself , SQLite database was used with native support Android and without configuration or installation.