An Electronic Medical Record System Tool for Homeless, With Check List

Introduction

Developing a streamlined preventive health checklist tool to be integrated in an EMR. The checklist will be geared specifically toward the homeless community in Toronto, which also comprises refugees and asylum seekers.

Background

The premise of the tool is to develop a preventive health care framework that addresses and prioritizes needs of this unique population. Often health practitioners see these patients in a one-off fashion due to the episodic nature of their health issues, and consequently the most important health needs don’t get attended to. It doesn’t make sense to prioritize pap smears in a patient who has inadequate housing much in the way it doesn’t make sense to give large sums of money to developing countries without the infrastructure to manage it.

Method

So how does it work? Vital information on patient’s immunization status, preventive health maneuvers, and extended health care such as vision and dental is captured in the system as well as the social determinants of health including that include social benefits and housing. Physicians will be taken through a checklist, which is intended to guide their care and clinical decision-making rather than act as an alternative. They will gain access to information such as dates when the last investigations were ordered, which vaccinations are not yet up to date, and their housing status; items that are particularly helpful when these patients have been been around the health system to various providers.

Summary

Having a checklist system enables physicians to easily view what needs to be addressed in a straightforward, user-friendly format. Having evidence-based recommendations can improve uptake of key screening practices as well as improve health outcomes, especially when tailored to specific populations. Identifying and providing a framework for marginalized populations is a cornerstone to good health care. Such a tool in an EMR would be generalizable both to other marginalized populations, as well as other health systems and countries. Adopting an electronic, comprehensive and tailored framework not only makes good sense, but is also a necessary step in bridging the gap in care between the rich and the poor.

Comments

Ultimately addressing the helathcare of the uninsured, the indigent and poor among our society is less costly than ignoring the issue.