The Red Cross Red Crescent Health Information System (RCHIS) is an electronic medical record (EHR) and health information management system (HIS) which has been designed for international disaster responses with a cloud-based server and a local server to bridge temporary internet outages. This architecture allows for remote information management and operational support should data processing agreements allows it.

Describe adapting a cloud-based health information system to a fully offline setting and improve business continuity in case of a system failure.

An analysis of the existing architecture of RCHIS was conducted to identify components and procedures that only work on the cloud-based server with an existing internet connection. Offline alternatives were identified and developed to ensure full offline operational capacity and redundancy.

A mechanism to set up a second local server for redundancy improves business continuity planning, and having locally stored backup allows the recovery of data without an internet connection. Instead of creating new user accounts in the cloud and emailing a one-time password (OTP), a mechanism to create accounts on the local server and display the OTP was added. The offline generation of the WHO EMT MDS report was embedded.

Adding the capability to work fully offline to RCHIS meant significant software architecture changes. Despite losing some of the benefits, such as remote information management, RCHIS is now a robust offline tool for deployment in settings without any internet connectivity. Having a local server also means that we can comply with data sovereignty rules where they exist.

RCHIS is an Electronic Medical Record (EMR) and Health Information System (HIS) that has been purpose-built for use by Red Cross Red Crescent (RCRC) Emergency Response Units (ERUs), which are the equivalent of Type 1 (fixed and mobile) and Type 2 facilities in the Emergency Medical Teams (EMT) classification.

A three day in-person super user training was held with 13 participants: 9 first aid volunteers, 2 nurses and 2 medical doctors. Seven of the delegates had experience using an EMR. These super users served as trainers for staff at the pilot.

The pilot occurred with the Portuguese Red Cross (PRC) for the Peregrinação de Fátima, where 200,000 people were in attendance. The PRC was part of a wider coordination cell with the civil defense authority, who required live reporting from the three Type 1 fixed clinics PRC had set up.

In total there were 77 user accounts, of which, 243 patients were consulted with and either discharged or referred throughout the four day pilot.

The delegates shared feedback directly and through a survey. 88% stated that RCHIS was ‘very easy’ to use with the majority of delegates requiring less than 20 minutes of training to be using the application and inputting patient data related to their user role. Additionally, after their training 95% of delegates stated they had sufficient training to use RCHIS to its full extent. Informal feedback from delegates was hugely positive, indicating that it was improving patient care and also continuity of care when a patient returned the next day.

The civil defense authorities were able to utilize the real-time reporting to assist in their operational response. The application was well received by the wider civil defense authority.

The first RCHIS pilot was very successful from both a technical and organizational perspective.

Standardization of data collection and reporting within EMT’s is challenging. In past deployments, the Red Cross Red Crescent Type one and two facilities (Emergency Response Units- ERU’s) have collected data by hand using paper-based form and Excel spreadsheets. This process can be laborious, time consuming and often inaccurate.

RCHIS is both an electronic medical record (EMR) and health information system (HIS). RCHIS has been designed to produce pre-made reports including the MDS in seconds extracting data from the patient records. Through significant testing and pilot deployments in a domestic type one fixed clinic, the rapid production of reports such as the MDS has increased compliance and accuracy with reporting.

The utilization of an EMR and integrated HIS system for increasing compliance and accuracy with the MDS has been hugely successful. An in-depth analysis of the export data was done to confirm the 100% accuracy within the MDS report.

Furthermore, feedback from users and managers within the ERU’s expressed the excitement for the ease of reporting not only to the EMTCC, but also to IFRC and back-donors. Moving forwards, this data collection will also be used to collect essential data to audit and improve the quality of care provided within the RCRC ERU’s.

In conclusion, the utilization of RCHIS within a domestic ERU (equivalent to an EMT type one or two) has been hugely successful. The next steps will involve the deployment of RCHIS within an international deployment.

Standardization of data collection and reporting within EMTs is challenging. In past deployments, the Red Cross Red Crescent Type 1 and Type 2 facilities have collected data by hand using paper-based form and Excel spreadsheets. This process can be laborious, time-consuming, and often inaccurate.

To combat this issue with reporting, RCHIS (Red Cross Red Crescent Health Information System) has been designed to ensure that reporting is accurate and also very easy to complete, increasing compliance with the EMT-MDS reporting.

RCHIS is both an electronic medical record (EMR) and health information system (HIS). RCHIS has been designed to produce pre-made reports including the MDS in seconds, extracting data from the patient records. Through significant testing and pilot deployments in a domestic Type 1 fixed clinic, the rapid production of reports such as the MDS has increased compliance and accuracy with reporting.

Overall, the utilization of an electronic medical system for increasing compliance and accuracy with the MDS has been hugely successful. An in-depth analysis of the export data was done to confirm the 100% accuracy within the MDS report.

The utilization of RCHIS within a domestic ERU (equivalent to an EMT Type 1 or Type 2) has been hugely successful. The next steps will involve the deployment of RCHIS within an international deployment.

RCHIS is an Electronic Medical Record (EMR) and Health Information System (HIS) that has been purpose built for use by Red Cross Red Crescent (RCRC) Emergency Response Units (ERUs), which are the equivalent of Type 1 (fixed and mobile) and Type 2 facilities in the Emergency Medical Teams (EMT) classification.

To share the main lessons learned from the pilot to inform development and implementation of similar systems in other EMTs.

A three-day, in-person super user training was held with 13 participants: nine first aid volunteers, two nurses, and two medical doctors; seven delegates had experience using an EMR. These super users served as trainers for staff at the pilot.

The pilot occurred with the Portuguese Red Cross (PRC) for the Peregrinação de Fátima, where 200,000 people were in attendance. The PRC was part of a wider coordination cell with the civil defense authority, who required live reporting from the three clinics PRC had set up.

77 user accounts and 243 patient files were created during the four-day pilot.

The delegates shared feedback directly and through a survey. 88% stated that RCHIS was very easy to use with the majority of delegates requiring less than 30 minutes of training. 95% of delegates stated that they had sufficient training to use RCHIS to its full extent.

The civil defense authority was able to utilize the real-time reporting to assist in their operational response.

The first RCHIS pilot was very successful from both a technical and organizational perspective.