Bridging the Gap Between Paper Patient Records and EHR Systems with the piClinic Console

Clinics with limited resources rely on paper patient records because they are easy to use, reliable, and can be supported by the clinics' financial and technical resources. Electronic health record (EHR) systems provide benefits in patient information management and reporting; however, they often require financial and technical resources that exceed those available to the clinics. This paper hypothesizes that limited-resource clinics could successfully install and sustain a patient-record automation system if it did not require resources beyond the reach of those clinics-if such a system was available. Because no system was found, the piClinic Console was developed to test this hypothesis. The piClinic Console is a Raspberry-Pi-based, patient-record automation system that provides essential patient-record automation functions and runs on hardware that costs less than $300 USD per clinic. This paper describes the features that provide the most benefit to the clinics and that run on a low-cost system as determined through end-user observation, participatory design, and iterative user testing. Preliminary testing shows that the piClinic Console can provide immediate benefits to clinic information processing and can prepare the clinic for a smoother transition to more complete EHR system when the resources to sustain one become available. The piClinic Console system is in its early stages of field testing and this paper describes the design and development process, the results of performance and user testing, and the plans for future research and development.