Each year, hundreds of international medical teams travel to Haiti and provide short-term care. And that's just Haiti. Internists, students, nurses, dentists and surgeons, armed with thousands of dollars of supplies, set up clinics around the world (and at home in resource-limited regions of developed countries). These teams can treat up to 600 patients in a day, often stay for one week, and do everything from prevention education on sexually transmitted diseases to conducting complicated surgeries. All at no cost to the patient.
However, the debate on the impact and efficacy of the short term mission is a hot topic in global health. On the one hand, highly trained medical teams risk their personal safety to provide care otherwise not available to residents of resource-limited environments. The average trip can cost up to $60,000 per team! On the other hand, medical missions can disrupt local healthcare infrastructures -- and many question whether this money can be better spent. Since teams return home after a short stay, follow-up care is difficult and there is little continuity and collaboration between groups working in the same region.
Yet one thing is certain -- medical missions are not going anywhere. In fact, medical mission volunteerism is exploding worldwide. This is why it is paramount to establish better guidelines, work with in-country collaborators, promote innovation, and continually evaluate long-term impact.
Establishing local partnerships and obtaining proper governmental approvals are central to improved impact. Prior to any mission, international groups should partner with local institutions, providers and communities to determine the major healthcare gaps and challenges. This is a crucial first step in ensuring that medical missions work within the existing framework to strengthen local healthcare infrastructure, rather than inadvertently undermining or dismantling it. Guatemala, for example, has taken the lead in this field and set up a review committee to approve short term medical groups.
Secondly, groups should continually be looking for areas where there is need for both innovation and improvement to continuity of care. Upon returning home from a medical mission trip to Haiti, a group of Detroit-based students believed there was more work to be done. Particularly concerning to the students was that although they provided free care to patients, they believed that their preparation prior to the mission was lacking and hampered their ability to do all they could. This concern is not uncommon; groups generally have no access to medical records of their patient population prior to their visit, and therefore no data to use in preparation of trips. Records can help teams manage what medicines to bring, and can provide life-saving information about a patient's medical history.
The student's proposed solution? A relatively simple, yet innovative plan -- Electronic Medical Records (EMR) tailored for short-term clinics. Several EMR software systems are already in use in resource-limited settings, but none are distinct to the needs of short-term, high volume mobile clinics. These innovative students developed a novel software application to enter and retain patient information in the field. The system easily operates on iPads or Tablet Computers at little cost to medical mission teams. The goal: when teams return, they are better prepared to serve the patients.
This new EMR software has the potential to make significant advancements for anyone setting up a mobile clinic -- whether abroad or in the underserved neighborhoods of Detroit. The students identified space for improvement, formulated a solution, and acted -- we need more of this.
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