ObjectivesThe objective of this study was to assess the impact of electronic health records (EHRs) on health outcomes and care of displaced people with chronic health conditions and determine barriers and facilitators to EHR implementation in displaced populations.DesignA systematic review protocol was developed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Systematic Reviews.Data sourcesMEDLINE, Embase, PsycINFO, CINAHL, Health Technology Assessment, Epub Ahead of Print, In-Process and Other Non-Indexed Citations, Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews was searched from inception to 12 April 2021.Eligibility criteria for selected studiesInclusion criteria were original research articles, case reports and descriptions of EHR implementation in populations of displaced people, refugees or asylum seekers with related chronic diseases. Grey literature, reviews and research articles unrelated to chronic diseases or the care of refugees or asylum populations were excluded. Studies were assessed for risk of bias using a modified Cochrane, Newcastle-Ottawa and Joanna Briggs Institute tools.Data extraction and synthesisTwo reviewers independently extracted data from each study using Covidence. Due to heterogeneity across study design and specific outcomes, a meta-analysis was not possible. An inductive thematic analysis was conducted using NVivo V.12 (QSR International, Melbourne, Australia). An inductive analysis was used in order to uncover patterns and themes in the experiences, general outcomes and perceptions of EHR implementation.ResultsA total of 32 studies across nine countries were included: 14 in refugee camps/settlements and 18 in asylum countries. Our analysis suggested that EHRs improve health outcomes for chronic diseases by increasing provider adherence to guidelines or treatment algorithms, monitoring of disease indicators, patient counselling and patient adherence. In asylum countries, EHRs resource allocation to direct clinical care and public health services, as well as screening efforts. EHR implementation was facilitated by their adaptability and ability to integrate into management systems. However, barriers to EHR development, deployment and data analysis were identified in refugee settings.ConclusionOur results suggest that well-designed and integrated EHRs can be a powerful tool to improve healthcare systems and chronic disease outcomes in refugee settings. However, attention should be paid to the common barriers and facilitating actions that we have identified such as utilising a user-centred design. By implementing adaptable EHR solutions, health systems can be strengthened, providers better supported and the health of refugees improved.

Endothelium from discrete vascular segments within the lung displays phenotypic and functional heterogeneity. However, isolation of segment specific endothelial cells (ECs) is a time and cost intensive process. Thus the aim of this current work was to develop an efficient method for obtaining ECs from rat pulmonary artery (PAECs), pulmonary vein (PVECs) and pulmonary microvasculature (PMVECs). Following surgical removal, vessels were digested using type II collagenase and trypsin. The enzymatically obtained cells were plated in D‐valine/heparin endothelial selective growth media on standard culture dishes. Non‐ECs resistant to the D‐valine media were removed by scraping. Lectin panning and differential cell binding were utilized to remove any remaining contaminating cells. Cell cultures were characterized using an EC marker panel: platelet endothelial cell adhesion molecule 1 (PECAM1), endothelial nitric oxide synthase (eNOS), von Willebrand factor (vWF), vascular endothelial cadherin (VE‐cadherin), and acetylated LDL uptake. Specific lectin binding was used to confirm the segmental origin of the ECs. PAECs bound Helix pomatia and Sambucus nigra, while PMVECs bound Griffonia simplicifolia. This combinatorial approach to isolating rat lung endothelial cells consistently yields multiple cell lines from individual animals. Supported by 5PO1HL066299.

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