Traumatic Brain Injury in Myanmar: Preliminary Results and Development of an Adjunct Electronic Medical Record

Rock, Jack; Prentiss, Tyler; Mo, Su Myat; Aye, Nang Saw Myat Hnin; Asmaro, Karam; Win, Aung Thurein; Phyu, Aye Mya; Myat, Thint; Maung, Thet Maung; Khaing, Ai Ai; Naung, Zayya; Park, Kee B.; Hlaing, Kyi; Myaing, Win

doi:10.1016/j.wneu.2020.05.016

Cited by 7 publications

(28 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…More generally, EMR implementation in LMIC neurosurgical departments can improve overall departmental efficiency, reduce financial costs, and decrease the administrative burden among medical and non-medical professionals [4,10,11]. On the local level, EMR implementation promotes a more accurate estimation of long-term neurosurgical outcomes of various operations performed and diseases treated [9]. Examples of such organizational benefits of EMR adoption at NINS&H include streamlined patient tracking, reduced paperwork for neurosurgical department house-staff, and pre-propagated paperwork to facilitate hospital discharge and outpatient follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…Such efforts can improve measurements of incidence, prevalence, and treatment patterns of pediatric CNS tumors at the hospital and national level. This documentation can provide stakeholders with a comprehensive analysis of a particular geographic area's healthcare resource distribution and needs especially in LMICs lacking robust cancer registries; in turn, EMRs can aid overall national health care delivery and facilitate stakeholder collaboration [1,9,12,13]. For example, EMR implementation in Dhaka demonstrates NINS&H's impressive reach as an average patient travels 125 km, or 77 miles, to seek neurosurgical care.…”

Section: Discussionmentioning

confidence: 99%

“…Professional challenges toward EMR utilization include competing demands on neurosurgeon's time, and technical challenges include corrupted or locked records and incorrect or incomplete data entry. One proposed solution to this problem is to delegate EMR entry tasks to specific medical auxiliary staff to facilitate utilization [4,9]. Additional platform-specific improvements include "flagging" records with non-existent or incorrect data entry (i.e., listed date of surgery precedes date of hospital admission).…”

Section: Discussionmentioning

confidence: 99%

“…Alternatively, most hospitals based in lowand middle-income countries (LMICs) rely on paper-based documentation, thus providing fertile grounds for EMR adoption [3,4]. While EMR implementation has been welldocumented in various spheres in LMICs, no study to date has analyzed the impacts of EMR implementation on pediatric neurosurgical care in an LMIC neurosurgery department [4][5][6][7][8][9]. This study describes the design, implementation, and adoption of a novel EMR and its use in documenting pediatric central nervous system (CNS) tumors at a large national referral hospital in Dhaka, Bangladesh.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

EMR adoption in Dhaka, Bangladesh: a template to index pediatric central nervous system tumor care and a review of preliminary neuro-oncologic observations

et al. 2022

View full text Add to dashboard Cite

Purpose To describe the design, implementation, and adoption of a simplified electronic medical record (EMR) and its use in documenting pediatric central nervous system (CNS) tumors at a tertiary care referral hospital in South-East Asia. Methods A novel EMR, cataloguing pediatric CNS tumors was used to collect data from August 2017 to March 2020 at National Institute of Neurosciences and Hospital (NINS&H) in Dhaka, Bangladesh. Results Two hundred forty-nine pediatric patients with a CNS tumor were admitted to NINS&H. Fifty-eight percent of patients were male, and the median age was 8 years. A total of 188/249 patients (76%) underwent surgery during their index admission. Radiographic locations were known for 212/249 (85%) of cases; the most common radiographic locations were infratentorial (81/212; 38%), suprasellar (45/212; 21%), and supratentorial (29/212; 14%). A histopathological classification was reported on 156/249 (63%) of patients' cytology. The most common infratentorial pathologies were medulloblastoma (22/47; 47%) and pilocytic astrocytoma (14/47; 30%). The median time between admission and surgery was 36 days, while the median post-operation stay was 19.5 days. Conclusions The feasibility of a basic EMR platform for a busy pediatric neurosurgery department in a lower-middle income country is demonstrated, and preliminary clinical data is reviewed. A wide variety of pediatric CNS tumors were observed, spanning the spectrum of anatomic locations and histopathologic subtypes. Surgical intervention was performed for the majority of patients. Barriers to care include limited molecular diagnostics and unavailable data on adjuvant therapy. Future targets include improvement of clinical documentation in the pre-operative and post-operative period.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

EMR adoption in Dhaka, Bangladesh: a template to index pediatric central nervous system tumor care and a review of preliminary neuro-oncologic observations

et al. 2022

View full text Add to dashboard Cite

show abstract

“…This may be a promising first step towards improved rehabilitation post-injury care in the LMIC SEA region. In addition, an electronic medical records system for rehabilitation, similar to that proposed by a study in Myanmar (Rock et al, 2020), may help shed light on the drawbacks of current rehabilitation systems in place. Besides that, collaborative efforts with HICs, such as the Cambridge-Yangon Trauma Intervention Project, may also advance LMIC rehabilitation care more effectively (Bashford et al, 2018).…”

Section: Interventions To Overcome the Barriersmentioning

confidence: 99%

Current status of post-traumatic brain injury rehabilitation care in LMI Southeast Asian Countries: A mini systematic review

2022

View full text Add to dashboard Cite

Low-to-middle income countries (LMICs) in Southeast Asia (SEA) had the highest global traumatic brain injury (TBI). However, post-TBI rehabilitation care may be limited in these countries, thereby contributing to the poorer quality of life (QoL) of patients with TBI. The present systematic review aimed to elucidate the current status of post-TBI rehabilitation care in the LMICs in the SEA region and to discuss the limitations that may hinder the advancement of TBI rehabilitation within this region. A literature search was carried out using five databases (PubMed, Ovid MEDLINE, EMBASE, CINAHL and Scopus), and the final number of articles were selected according to the PRISMA guidelines. This review selected four relevant research articles from Malaysia and Thailand for critical appraisal. These articles showed that the status of post-TBI rehabilitation care in these regions remains unclear based on the scarcity of available literature. Only early rehabilitation care strategies have been discussed in the literature, such as individualised structured cognitive rehabilitation, utilisation of humanoid robots and the implementation of sensory stimulation programs. This review also suggested that TBI rehabilitation improvements may be hindered by a lack of government funding, unequal distribution of care services and reliance on traditional care. Thus, more research into TBI rehabilitation care is significantly needed within the SEA region to overcome these barriers, leading to the preservation of patients’ QoL.

show abstract

Current trends and challenges: The landscape of perioperative mortality in intracranial surgeries in low‐ and middle‐income settings: A narrative review

Roy,

Awuah,

Ahluwalia

et al. 2024

Health Science Reports

View full text Add to dashboard Cite

Background and AimsIntracranial surgeries are pivotal in treating cerebral pathologies, particularly in resource‐limited contexts, utilizing techniques such as craniotomy, transsphenoidal approaches, and endoscopy. However, challenges in low and middle income countries (LMICs), including resource scarcity, diagnostic delays, and a lack of skilled neurosurgeons, lead to elevated perioperative mortality (POM). This review seeks to identify major contributors to these challenges and recommend solutions for improved patient outcomes in neurosurgical care within LMICs.MethodsThis review examines POM in LMICs using a detailed literature search, focusing on studies from these regions. Databases like PubMed, EMBASE, and Google Scholar were utilized using specific terms related to “intracranial surgery,” “perioperative mortality,” “traumatic brain injuries,” and “LMICs.” Inclusion criteria covered various study designs and both pediatric and adult populations while excluding stand‐alone abstracts and case reports.ResultsPOM rates for intracranial surgeries differ widely across many low and middle‐income regions: Africa sees rates from 2.5% to 39.1%, Asia between 3.6% and 34.8%, and Latin America and the Caribbean have figures ranging from 1.3% to 12%. The POM rates in LMICs were relatively higher compared to most first‐world countries. The high POM rates in LMICs can be attributed to considerable delays and compromises in neurosurgical care delivery, exacerbated by late diagnoses and presentations of neurosurgical pathologies. This, coupled with limited resources, underdeveloped infrastructure, and training gaps, complicates intracranial disease management, leading to elevated POM.ConclusionIntracranial POM is a pronounced disparity within the neurosurgical field in LMICs. To mitigate intracranial POM, it is imperative to bolster healthcare infrastructure, amplify personnel training, foster global partnerships, and harness technologies like telemedicine. Tackling socioeconomic obstacles and prioritizing early detection through sustained funding and policy shifts can substantially enhance patient outcomes.

show abstract

Traumatic Brain Injury in Myanmar: Preliminary Results and Development of an Adjunct Electronic Medical Record

Cited by 7 publications

References 14 publications

EMR adoption in Dhaka, Bangladesh: a template to index pediatric central nervous system tumor care and a review of preliminary neuro-oncologic observations

EMR adoption in Dhaka, Bangladesh: a template to index pediatric central nervous system tumor care and a review of preliminary neuro-oncologic observations

Current status of post-traumatic brain injury rehabilitation care in LMI Southeast Asian Countries: A mini systematic review

Current trends and challenges: The landscape of perioperative mortality in intracranial surgeries in low‐ and middle‐income settings: A narrative review

Contact Info

Product

Resources

About