Mobilizing the medical record is a high impact opportunity, EMR adoption has direct and well documented health impact. However, EMRs are rarely implemented successfully in poor areas because of hardware that is expensive, unfamiliar, or unavailable locally, lack of internet and hassles associated with data re-entry. These issues can be address by SIM based phones.

• EMR will be used more broadly and effectively if more health workers (not just physicians) gather and make use of medical data. Health workers are often out in the field where they do not directly contribute data to EMR.
• Data collected off-site is often recorded on paper; it must be entered into a database by a different (more trained with computers) person, in a different place, at a different time. Unnecessary steps increase confusion, reduce efficiency and accuracy.
• Patients currently do not remotely report health issues (I'm out of insulin needles, where can I get condoms?). This impeeds data collection in poor areas where transportation to a clinic may be a serious investment and many patients walk. Remote reporting would facilitate preventative medicine.

Our goal is to produce software that can:

• Use SIM-based mobile phones. They are cheap, durable, prevalent, require less training and are less likely to make workers a target for theft/mugging (relative to smart phones).
• Use OpenMRS, an open source EMR. OpenMRS manages hundreds of thousands of patients records; existing installations will be able to plug and play with our software, increasing our project's potential to scale.
• Health workers or patients send data via SMS, it will be added to patient's medical record. Physicians will be notified of urgent situations (a hemorrhaging home-based childbirth), and worker/patient may receive SMS advice from clinician or an automated SMS based on electronic records.
• Builds on, smooths interoperability with existing OSS like OpenRosa and Mesh4x.

• Data transfer optimized for low-signal environments.

In addition: The greatest barrier to implementing distributed medical records is adapting organizational practices, not building software. Our development efforts will be put into action because our project was initiated and is being carried out by organizations that provide health care for the poor.

Health Bridges International has helped to develop and operate a clinic and community health care delivery program in the impoverished peri-urban communities of Alto Cayma, Peru.  The clinic consists of full time medical, dental, nursing, pharmacy and health education staffing.  In addition, the clinic has outreach workers who act as advocates in the communities (35k people total) to help identify the most marginalized populations and connect them to services.

Village Health Works is dedicated to the principle that all people, including the most oppressed and impoverished, are entitled to the highest standards of health care in their pursuit of happy and productive lives. VHW’s first project is to design, build, and operate a model community health clinic in Kigutu, Burundi. VHW serves about 30k people, regardless of ability to pay.

The primary directors of the project are two students, Isaac Holeman, a co-founder of Squarepeg, a N2Y3 featured project to help people find service and action opportunities on the Internet, and Daniel Bachhuber, the founder of Oregon Direct Action, an organization at the University of Oregon that is developing an open source organizational model for student groups.

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