Haiti Trip, August 20-24

Two weeks ago, Evan, Neil, Emerson, and I kicked off this project with a launch trip to Haiti.  While Evan has traveled to our Haiti sites many times, it was the first visit for the rest of us.  Brittany Eddy, our Haiti Informatics Project Coordinator, did a wonderful job of accompanying us throughout the visit – arranging tours and interesting conversations with a variety of stakeholders, and ensuring we were fed, rested, and transported around when needed.  Below, I’ve outlined a few of our primary objectives for the trip, explained how we accomplished these objectives, and added in some photos to paint a picture of the experience.

Seeing our sites in action drove home a lot of what I’ve learned at PIH about the immense challenges our colleagues face daily providing high-quality care in rural Haiti.  Observing the determination of our providers and the vibrancy of the communities with which we work set the stage for our team to return to Boston eager to jump into the Project Inception week (photos here, and described by Darius in an earlier post), communicate what we learned with the rest of the group, and begin building our - dare I say it - audacious EMR.

Objectives

What: Gather context on current service delivery in Haiti

How:

• Visited two Zanmi Lasante sites - Lacolline Hospital and Cange.  Cange is PIH’s original site, and Lacolline is the site currently managing our patient registration module pilot (keep an eye out for future posts on this project).
• Engaged in conversations with physicians and nurses about how care currently happens and how patients access our existing hospitals and clinics.

In Action:

Patient registration at Lacolline

Paper archives at Lacolline

Pharmacy window at Cange

Queue for registration at Lacolline

What: Understand expected Mirebalais Hospital patient flows

How:

• Took an extensive hospital tour with Dr. David Walton.
• Shot numerous photos and videos of the buildings.
• Mapped standard patient visit processes to identify data collection points.

In Action: 

Mirebalais Hospital Tour

Mirebalais Ward

What: Gather clinical requirements

How:

• Met with physicians, nurses, laboratory technicians, pharmacists, security managers, and administrators about their daily tasks, biggest challenges, and hopes for how an electronic system could support their responsibilities.
• Considered important clinical indicators reported from our sites.
• Discussed common scenarios during routine and emergency care in rural Haiti.

In Action:

Pharmacy at Lacolline

Lab at Lacolline

What: Begin prioritization of requirements

How:

• Gathered feedback on our own synthesis of clinical requirements.
• Asked stakeholders to choose requirements for our Minimum Viable Product – termed “MVP”
• Encouraged collaboration and healthy debates over components of the MVP.

In Action:

Lauren Spahn, Naomie Marcelin, Pierre Paul, David Walton, Evan, Emerson, Neil