A free, open-source, offline digital health system for refugee care (Preprint)

2021 ◽  
Author(s):  
Henry Ashworth ◽  
Senan Ebrahim ◽  
Hassaan Ebrahim ◽  
Zahra Bhaiwala ◽  
Michael Chilazi
Keyword(s):  
Health Systems ◽  
Digital Health ◽  
Healthcare Providers ◽  
Lessons Learned ◽  
Extreme Weather Events ◽  
Mobile Clinic ◽  
Low Resource ◽  
Displaced Populations ◽  
Weather Events ◽  
Displaced People

BACKGROUND Rise of conflict, extreme weather events, and pandemics have led to larger displaced populations worldwide. Displaced populations have unique acute and chronic health needs that need to be met by low resource health systems. Electronic Health Records (EHRs) have been shown to improve health outcomes in displaced populations but need to be adapted to meet the constraints of these health systems. OBJECTIVE To describe the development and deployment of a EHR designed to care for displaced populations in low resource settings. METHODS Using a human-centered design approach we conducted in-depth interviews and focus groups with patients, healthcare providers, and administrators in Lebanon and Jordan to identify the essential EHR features. These features including modular workflows, multilingual interfaces, and offline-first capabilities led to the development of the Hikma Health EHR which has been deployed in Lebanon and Nicaragua. RESULTS We report the successes and challenges from 12 months of Hikma Health EHR deployment in a mobile clinic providing care to Syrian Refugees in the Bekaa Valley, Lebanon. Successes include the EHR’s ability to (1) increase clinical efficacy by providing detailed patient records, (2) prove adaptable to the threats of COVID-19, and (3) improve organizational planning. Lessons learned include technical fixes to methods of identifying patients through name or their medical record ID. CONCLUSIONS As the number of displaced people continues to rise globally, it is imperative that solutions are created to help maximize the healthcare they receive. Free, open-sourced and adaptable EHRs can enable organizations to better provide for displaced populations.

Leveraging Volunteered Geographic Information to Improve Disaster Resilience

2019 ◽  
pp. 1636-1662
Author(s):  
João Porto de Albuquerque ◽  
Flávio Eduardo Aoki Horita ◽  
Livia Castro Degrossi ◽  
Roberto dos Santos Rocha ◽  
Sidgley Camargo de Andrade ◽  
...  
Keyword(s):  
Interdisciplinary Research ◽  
Research Agenda ◽  
Volunteered Geographic Information ◽  
Geographic Information ◽  
Lessons Learned ◽  
Extreme Weather Events ◽  
Disaster Resilience ◽  
Weather Events ◽  
The Face ◽  
Source Of Information

Volunteered Geographic Information (VGI) has emerged as an important additional source of information for improving the resilience of cities and communities in the face of natural hazards and extreme weather events. This chapter summarizes the existing research in this area and offers an interdisciplinary perspective of the challenges to be overcome, by presenting AGORA: A Geospatial Open collaboRative Architecture for building resilience against disasters and extreme events. AGORA structures the challenges of using VGI for disaster management into three layers: acquisition, integration and application. The chapter describes the research challenges involved in each of these layers, as well as reporting on the results achieved so far and the lessons learned in the context of flood risk management in Brazil. Furthermore, the chapter concludes by setting out an interdisciplinary research agenda for leveraging VGI to improve disaster resilience.

Leveraging Volunteered Geographic Information to Improve Disaster Resilience

2017 ◽  
pp. 158-184 ◽  
Author(s):  
João Porto de Albuquerque ◽  
Flávio Eduardo Aoki Horita ◽  
Livia Castro Degrossi ◽  
Roberto dos Santos Rocha ◽  
Sidgley Camargo de Andrade ◽  
...  
Keyword(s):  
Interdisciplinary Research ◽  
Research Agenda ◽  
Volunteered Geographic Information ◽  
Geographic Information ◽  
Lessons Learned ◽  
Extreme Weather Events ◽  
Disaster Resilience ◽  
Weather Events ◽  
The Face ◽  
Source Of Information

Volunteered Geographic Information (VGI) has emerged as an important additional source of information for improving the resilience of cities and communities in the face of natural hazards and extreme weather events. This chapter summarizes the existing research in this area and offers an interdisciplinary perspective of the challenges to be overcome, by presenting AGORA: A Geospatial Open collaboRative Architecture for building resilience against disasters and extreme events. AGORA structures the challenges of using VGI for disaster management into three layers: acquisition, integration and application. The chapter describes the research challenges involved in each of these layers, as well as reporting on the results achieved so far and the lessons learned in the context of flood risk management in Brazil. Furthermore, the chapter concludes by setting out an interdisciplinary research agenda for leveraging VGI to improve disaster resilience.

Surveying After a Disaster: Capturing Elements of Vulnerability, Risk and Lessons Learned from a Household Survey in the Case Study of Hurricane Irma in Sint Maarten

2019 ◽  
Vol 06 (02) ◽  
pp. 1950001 ◽  
Author(s):  
Neiler Medina ◽  
Yared Abayneh Abebe ◽  
Arlex Sanchez ◽  
Zoran Vojinovic ◽  
Igor Nikolic
Keyword(s):  
Insurance Coverage ◽  
Household Survey ◽  
Lessons Learned ◽  
Extreme Weather Events ◽  
High Tendency ◽  
Household Level ◽  
Face To Face ◽  
Weather Events ◽  
Hurricane Irma

On September 5 2017, a Category 5 Hurricane, named Irma, struck the Caribbean island of Sint Maarten causing destruction and loss of life across the territory. This paper presents a household survey and the main findings related to vulnerability and risk to extreme weather events in the aftermath of Hurricane Irma. The post-disaster context posed challenges in relation to data collection, determination of sample size and timing of the fieldwork. The survey was conducted using a combination of face-to-face interviews and web-administered questionnaires. This method proved useful in achieving a better coverage of the study area as well as obtaining a greater overall response rate. With regards to the timing of the survey, it was found that a period of six months between Hurricane Irma’s landfall and the field data campaign was adequate in terms of availability of resources and emotional distress of respondents. Data collected in the survey was categorized into general household information, hurricane preparedness and reaction, and risk perception/awareness. Survey findings show that the factors that increased vulnerability and risk on the island include a high tenancy rate, low insurance coverage, lack of house maintenance, disregard to building regulations (particularly on leased lands), low evacuation rate, not receiving a clear warning, and lack of preparation. The factors that reduce vulnerability include high hurricane awareness at a household level and high tendency of rebuilding houses with comparable quality to houses that can sustain hurricanes. Finally, recommendations are provided that could potentially reduce communities’ vulnerability and risk to hurricanes, and lessons learned in conducting household surveys after disasters.

Leveraging Volunteered Geographic Information to Improve Disaster Resilience

2019 ◽  
pp. 1698-1723
Author(s):  
João Porto de Albuquerque ◽  
Flávio Eduardo Aoki Horita ◽  
Livia Castro Degrossi ◽  
Roberto dos Santos Rocha ◽  
Sidgley Camargo de Andrade ◽  
...  
Keyword(s):  
Interdisciplinary Research ◽  
Research Agenda ◽  
Volunteered Geographic Information ◽  
Geographic Information ◽  
Lessons Learned ◽  
Extreme Weather Events ◽  
Disaster Resilience ◽  
Weather Events ◽  
The Face ◽  
Source Of Information

Volunteered Geographic Information (VGI) has emerged as an important additional source of information for improving the resilience of cities and communities in the face of natural hazards and extreme weather events. This chapter summarizes the existing research in this area and offers an interdisciplinary perspective of the challenges to be overcome, by presenting AGORA: A Geospatial Open collaboRative Architecture for building resilience against disasters and extreme events. AGORA structures the challenges of using VGI for disaster management into three layers: acquisition, integration and application. The chapter describes the research challenges involved in each of these layers, as well as reporting on the results achieved so far and the lessons learned in the context of flood risk management in Brazil. Furthermore, the chapter concludes by setting out an interdisciplinary research agenda for leveraging VGI to improve disaster resilience.

scholarly journals CRITICAL ANALYSIS OF THE BRAZILIAN ENVIRONMENTAL SAFETY SYSTEM

2020 ◽  
Vol 3 (7) ◽  
pp. 9-35
Author(s):  
Eduardo Frederico Cabral de Oliveira ◽  
José Augusto Ferreira da Silva ◽  
José Francisco De Oliveira Júnior
Keyword(s):  
Environmental Control ◽  
Regional Analysis ◽  
Environmental Safety ◽  
Safety System ◽  
Lessons Learned ◽  
Extreme Weather Events ◽  
Nature Protection ◽  
Descriptive Research ◽  
Weather Events ◽  
The Military

Conflicts stemming from the dispute over natural resources have become increasingly more frequent. Extreme weather events have intensified and have equally become more frequent owing to global warming. Although the consequences of such phenomena have repercussions on public safety, the processes of analysis incorporating the environmental dimension in this context have not been fully understood. This paper assessed how systems of environmental protection interconnect with those of crime prevention, forming the environmental safety system. It is an exploratory-descriptive research carried out through questionnaires evaluated by State environmental control agencies, exploring eight major domains: their origins; their staff, distribution and organization; logistics and operational structures; the use of geotechnologies; integration; operational results; regional analysis; and the general analysis of military environmental police. The last section, in conclusion, reviews the main lessons learned and proposes future lines of research that can be developed based on this topic. It highlights that the military environmental police should be the most significant agent of nature protection in the country. It reveals the existence of weaknesses and opportunities for improvement to be implemented.

scholarly journals Feasibility, acceptability and validation of wearable devices for climate change and health research in the low-resource contexts of Burkina Faso and Kenya: Study protocol

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257170
Author(s):  
Sandra Barteit ◽  
Valentin Boudo ◽  
Aristide Ouedraogo ◽  
Pascal Zabré ◽  
Lucienne Ouremi ◽  
...  
Keyword(s):  
Climate Change ◽  
Heat Stress ◽  
Health Outcomes ◽  
Burkina Faso ◽  
Burden Of Disease ◽  
Vital Signs ◽  
Wearable Devices ◽  
Extreme Weather Events ◽  
Low Resource ◽  
Weather Events

As the epidemiological transition progresses throughout sub-Saharan Africa, life lived with diseases is an increasingly important part of a population’s burden of disease. The burden of disease of climate-sensitive health outcomes is projected to increase considerably within the next decades. Objectively measured, reliable population health data is still limited and is primarily based on perceived illness from recall. Technological advances like non-invasive, consumer-grade wearable devices may play a vital role in alleviating this data gap and in obtaining insights on the disease burden in vulnerable populations, such as heat stress on human cardiovascular response. The overall goal of this study is to investigate whether consumer-grade wearable devices are an acceptable, feasible and valid means to generate data on the individual level in low-resource contexts. Three hundred individuals are recruited from the two study locations in the Nouna health and demographic surveillance system (HDSS), Burkina Faso, and the Siaya HDSS, Kenya. Participants complete a structured questionnaire that comprises question items on acceptability and feasibility under the supervision of trained data collectors. Validity will be evaluated by comparing consumer-grade wearable devices to research-grade devices. Furthermore, we will collect demographic data as well as the data generated by wearable devices. This study will provide insights into the usage of consumer-grade wearable devices to measure individual vital signs in low-resource contexts, such as Burkina Faso and Kenya. Vital signs comprising activity (steps), sleep (duration, quality) and heart rate (hr) are important measures to gain insights on individual behavior and activity patterns in low-resource contexts. These vital signs may be associated with weather variables—as we gather them from weather stations that we have setup as part of this study to cover the whole Nouna and Siaya HDSSs—in order to explore changes in behavior and other variables, such as activity, sleep, hr, during extreme weather events like heat stress exposure. Furthermore, wearable data could be linked to health outcomes and weather events. As a result, consumer-grade wearables may serve as a supporting technology for generating reliable measurements in low-resource contexts and investigating key links between weather occurrences and health outcomes. Thus, wearable devices may provide insights to better inform mitigation and adaptation interventions in these low-resource settings that are direly faced by climate change-induced changes, such as extreme weather events.

Innovating through integration with electronic health records: The UCSF Digital Diagnostics and Therapeutics Committee (Preprint)

2019 ◽  
Author(s):  
Andrew Auerbach ◽  
Russell Cucina ◽  
Kelsey Sobomehein ◽  
Priyanka Agarwal ◽  
Aaron Neinstein ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Health Systems ◽  
Digital Health ◽  
Software Tools ◽  
Lessons Learned ◽  
Health Records ◽  
Review Team ◽  
Wide Availability ◽  
Electronic Health ◽  
Therapeutics Committee

UNSTRUCTURED Despite the wide availability of Digital Health Software Tools (DHSTs) and increasing technical ease with which they can be added to Electronic Health Records (EHRs), many hospitals and health systems struggle with how to select, screen, and then implement them in actual practice. Developing a multidisciplinary review team – one we call the ‘Digital Diagnostics and Therapeutics’ Committee at UCSF – represents a key solution to ensuring innovations are vetted and adopted effectively, and allows health systems and providers to evaluate DHST in practice. In this paper, we describe the rationale, early work, and lessons learned from our team’s efforts.

scholarly journals Stress Testing the Capacity of Health Systems to Manage Climate Change-Related Shocks and Stresses

2018 ◽  
Vol 15 (11) ◽  
pp. 2370 ◽  
Author(s):  
Kristie Ebi ◽  
Peter Berry ◽  
Katie Hayes ◽  
Christopher Boyer ◽  
Samuel Sellers ◽  
...  
Keyword(s):  
Climate Change ◽  
Health System ◽  
Health Systems ◽  
Stress Test ◽  
Extreme Weather Events ◽  
Recent Experience ◽  
Stress Tests ◽  
Potential Health ◽  
Weather Events ◽  
Climate And Health

Vulnerability and adaptation assessments can provide valuable input to foster climate-resilient health systems. However, these assessments often do not explore the potential health risks of climate change far outside the range of recent experience with extreme weather events and other climate-related hazards. Climate and health stress tests are designed to increase the capacity of health systems and related sectors to manage potentially disruptive climate-related shocks and stresses. Stress tests focus on hypothetical scenarios, during which it would be difficult for the health system to maintain its essential function of providing services to protect population health. The stress test explores approaches to effectively manage acute and chronic climate-related events and conditions that could directly impact health systems, and climate-related events in non-health sectors that can indirectly impact health outcomes and/or health system function. We provide detailed methods and guidance for conducting climate and health stress tests, centering on three primary activities: (1) preparing and scoping the stress test; (2) successfully conducting the stress test; and (3) communicating the results to key stakeholders to facilitate policy and programmatic reforms.

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