The Clinical & Global Health Informatics Evaluation Lab (CGHIE) Lab supports work in two main areas: (1) Global Health Informatics and (2) Diagnostic Decision Support. The lab has expertise in the development, implementation and evaluation of the open-source OpenMRS EHR system.
Current projects on OpenMRS include the development of a new module supporting the latest version of HL7 FHIR health data interoperability standard. The lab also supports work on the new user interface, and the use of OpenMRS as teaching EHR at Brown University. Several evaluation studies of OpenMRS use at scale are currently being completed in Rwanda. One evaluation study of usability and use of OpenMRS for HIV care in 54 health facilities in Rwanda was just published. Other work based on the same group of health facilities includes a data quality study and costing study. In Fall of 2020 Dr Fraser received an R01 grant from the NIH NIAID with Professor Joe Hogan to study the use of machine learning to improve decision support for clinicians caring for HIV patients in Kenya.
Diagnostic Decision Support
The lab is studying the use of mobile apps to help patients diagnose the cause of their symptoms and decide what action to take - known as Symptom Checkers. Projects include carrying out clinical studies of the use of a leading symptom checker with colleagues at Rhode Island Hospital and Brown Medicine, with the goal of evaluating the safety, diagnostic and triage accuracy and usability of these widely used tools. A study of 40 patients in the RIH emergency department was recently completed and showed that the commonly used Ada symptom checker has similar diagnostic accuracy to ED physicians using the same clinical data. However the Ada app required 5 diagnoses to the physicians’ 3 diagnoses. Triage performance was comparable to telephone triage for patients in other studies. Students in the lab are also working with existing data sets to evaluate symptom checker diagnostic performance for heart disease and patients presenting with chest pain. Dr Fraser and colleagues at Rhode Island Hospital and Brown Medicine received a 2022 OVPR Seed grant to study the performance of the Ada symptom checker in urgent primary care and to develop and test algorithms for diagnosis of stroke.