Fraser Hamish S F, Habib Ali, Goodrich Mark, Thomas David, Blaya Joaquin A, Fils-Aime Joseph Reginald, Jazayeri Darius, Seaton Michael, Khan Aamir J, Choi Sharon S, Kerrison Foster, Falzon Dennis, Becerra Mercedes C
Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA.
Stud Health Technol Inform. 2013;192:627-31.
Multi-drug resistant TB (MDR-TB) is a complex infectious disease that is a growing threat to global health. It requires lengthy treatment with multiple drugs and specialized laboratory testing. To effectively scale up treatment to thousands of patients requires good information systems to support clinical care, reporting, drug forecasting, supply chain management and monitoring.
Over the last decade we have developed the PIH-EMR electronic medical record system, and subsequently OpenMRS-TB, to support the treatment of MDR-TB in Peru, Haiti, Pakistan, and other resource-poor environments.
We describe here the experience with implementing these systems and evaluating many aspects of their performance, and review other systems for MDR-TB management.
We recommend a new approach to information systems to address the barriers to scale up MDR-TB treatment, particularly access to the appropriate drugs and lab data. We propose moving away from fragmented, vertical systems to focus on common platforms, addressing all stages of TB care, support for open data standards and interoperability, care for a wide range of diseases including HIV, integration with mHealth applications, and ability to function in resource-poor environments.
耐多药结核病（MDR-TB）是一种复杂的传染病，对全球健康构成日益严重的威胁。它需要使用多种药物进行长期治疗，并进行专门的实验室检测。要有效地将治疗扩大到数千名患者，需要良好的信息系统来支持临床护理、报告、药物预测、供应链管理和监测。
在过去十年中，我们开发了伙伴健康电子病历系统（PIH-EMR），随后又开发了OpenMRS-TB，以支持在秘鲁、海地、巴基斯坦和其他资源匮乏地区治疗耐多药结核病。
我们在此描述实施这些系统的经验，并评估其性能的多个方面，同时回顾其他耐多药结核病管理系统。
我们建议采用一种新的信息系统方法，以解决扩大耐多药结核病治疗规模的障碍，特别是获取适当药物和实验室数据的问题。我们提议摒弃分散的垂直系统，转而关注通用平台，涵盖结核病护理的各个阶段，支持开放数据标准和互操作性，照顾包括艾滋病毒在内的多种疾病，与移动健康应用程序集成，并具备在资源匮乏环境中运行的能力。
