While its equipment and its US-trained staff makes it probably the best facility of its kind in all of the former Soviet-Union and Eastern Europe, its IT systems, and in particular its patient tracking systems were becoming more and more inadequate as the facility grew.  The staff was keeping track of the patients on Excell spreadsheets, wich was creating many problems and redundant work.  Every time a patient would come into the facility, the receptionists would enter his or her name and all other critical information, rather than retrieving it from a database.  All information was kept on paper, and too often the paper records, lab analyses, or other valuable documents would get lost or displaced.  Problems were also being caused by patients with identical family names, as the patients’ names were their only identifier.  As well, the AAWC did not have a network for their computers. 

“We have approximately ten computers in our four medical departments and other supporting departments, and currently they are not able to communicate which each other.” – said Liana Hakobyan, Deputy Director of PR and Development.  The lack of a network and of software that would allow the departments to communicate effectively had a negative effect on customer service, and inevitably also led to redundant administrative work.

Figure 1: The Armenian American Wellness Center's old patient tracking system.

In late March of 2005, Rita Balian, the founder of the Wellness Center, was approached by Gayane Dallakyan, project manager for Sourcio (www.sourcio.com).  Gayane consulted with Mrs. Balian and the staff at the clinic to gain a better understanding of the nature of the problems that needed to be solved, and to discuss the solutions that Sourcio could provide for AAWC.  In addition to wanting the daily document and paperowk problems resolved, Rita saw a need to understand their market better.  In particular, they needed better awareness of patient statistics and demographics.  Since the main goal of the Wellness Center is to prevent diseases, they wanted to be able to announce local disease statistics for the population to better understand who is more susceptible to which diseases.  The Center also wanted to be able to serve their customers better by getting statistical information on the numbers of patients, numbers of services performed, visits to each department, how their clients found out about them, and which promotional channels reach them best.  Finally, a better way to generate reports for the Wellness Center’s sponsors and partners was needed. 

“Each one of the four departments has to create monthly and quarterly reports for our benefactors.  Using the new system for this should give us quite a bit of time savings over the old method of inputing the information manually into Excel.” – stated Ms. Hakobyan.

Rita and Gayane decided that the best solution to the Wellness Center’s needs would be a basic HIS (Hospital Information System), also sometimes known as an EMR (Electronic Medical Record) or EPR (Electronic Patient Record).  The development team at Sourcio decided to use the open source HIS compenent of Care2x (www.care2X.com) as the main base upon which to build the new HIS system.  “We chose Care2x because of its good architecture” – said Aram Tadevosyan, a developer on the team assigned to the project.  While the architecture of Care2x was very sound, the team needed to streamline the code to get rid of bugs and inefficiencies.  Sourcio also added reports and dashboard modules, as well as medical forms customized to the needs of each one of the Center’s four departments: laboratory, gynecology, radiology, and primary health care.  The dashboard was also developed from an existing open-source component, while the reports module and the forms were created from scratch specifically for the project.  Dr. Noune Mashouryan, who works in the Breast Health Department at the Center, expressed her belief that the electronic forms will make it easier to input patient information and will help to ensure that the patients’ medical records are complete.  “Currently we are doing everything on paper forms, but if the electronic ones are easy to use, they will encourage us to keep a more detailed and up-to-date record of the patients’ medical histories.” – said Dr. Mashouryan.  Indeed, the ease of use of the system was a concern for both the Wellness Center and for Sourcio, as some of the staff has only basic computer skills.  With that in mind, the Sourcio developers created an intuitive system without too many unnecessary options, features, or procedures to inhibit ease of use.  “If they know how to use a mouse and a keyboard, they will almost certainly be able to use the new HIS.” – stated Gayane right before training on the use of the system was to begin.

Figure 2: Gayane Dallakyan demonstrating the new HIS system to a staff member.

 With the new system and network, all departments at the AAWC will be able to quickly and easily share patient information with each other; easy access and use of the patients’ records will allow for better follow-ups; the Center will be able to more easily generate descriptive statistics for the reports it needs to send to its partners and sponsors; it will be able to track its revenues and expenses through the system's medical billing software; and it should be simpler for the doctors at the Center to find relationships between demographics and diseases by using the raw patient data generated by the HIS in social scieneces statiscical programs.  The American Armenian Wellness Center is going to become the first hospital or clinic in all of Armenia to have a customized Health Information System, further enhancing its reputation as a leader in the area.  In the future, the system may be expanded to accommodate the growth of the Center within its current facilities and in its satellite branch in Gavar, a small town near Yerevan.  Also, Sourcio developers are looking at giving the administrator of the system the power to create his own custom forms, and an inventory system for the Center’s internal pharmacy is also being considered.

Figure 3: Part of the dashboard in the AAWC's new Hospital Information System

Figure 4: The radiology form, one of several custom forms that Sourcio developed for the AAWC

An online demo of the system is available username: "admin" password: "ani"