Experience with an electronic health record for a homeless population

The health care needs of the homeless population are unique. People who are homeless are less likely to seek ambulatory medical care with their multiple medical problems until their conditions have worsened. There is a high prevalence of mental-health illness and substance abuse among this population. Certain medical conditions like diseases and disorders of the skin , human immunodeficiency virus infection, tuberculosis and gynecologic problems are more prevalent in the homeless.Homeless children have a higher incidence of injuries related to trauma and chronic diseases. Obesity is the major nutritional problem in the homeless children due to high content of carbohydrates and fat in their food sources.

An electronic medical record system was designed by the laboratory of computer science Massachusetts general hospital to try to meet the particular needs of the Boston Health Care for the Homeless Program (BHCHP) which was established in 1985.

A central server running Windows NT and Shiva remote access technology are located at the BHCHP respite.Using portable computers and work stations and regular telephone lines, provider dial via modems int to this server from various remote sites in the Boston area where medical care is being delivered.