Kingsley Osei-Karikari '19 - Building an Electronic Medical Record System in Ghana

In the Fall of 2017, Kingsley set upon the task of building an electronic medical record system for the Brain Clinic and other mental health hospitals in Ghana. Going into the internship, Kingsley's research idea was to conduct a statistical analysis at the Brain Clinic and other mental health centers while also learning and observing about the diagnosis and treatment of mental illnesses in various regions of Ghana. However, once arriving and talking with colleagues, Kingsley decided that the best way to maximize his time would be to build an electronic medical record system.

By Kingsley Osei-Karikari '19 Class of '54 Named Intern

My time in Ghana was revealing, rewarding, and challenging: revealing because I was on a personal journey of self-discovery and awareness; rewarding because I appreciated both the successes I enjoyed and the failures I encountered as invaluable experiences in my professional development; challenging because I had to adapt my initial research ideas from a more backward-looking undertaking to a more forward-looking initiative.

 I envisioned this research in Ghana to serve a dual purpose. As a Ghanaian who has spent the past 6 years in America, I hoped that spending time in Ghana would help me understand the source of the beliefs I hold, the culture I embrace and the essence of the values I have grown up with despite living in a foreign country. I also hoped to aid my professional development by combining my passion for mental health awareness and treatment with my desire to practice medicine in a developing country like Ghana. After three months in Ghana, I am thankful to Dickey Center and my host organization, The Brain Clinic, for helping me achieve both goals.

My initial research idea was to conduct a statistical analysis at The Brain clinic and other mental health centers in Ghana. I planned to learn about the diagnosis and treatment of mental illnesses in various regions of Ghana, and also observe the social perceptions on mental illnesses in the general population. However, upon arriving in Ghana, my host doctor, Dr. Yao Mfodwo (chief psychiatrist at the Brain Clinic), and I deliberated about the long-term outcome of this research. We determined that while it will be worth informing the world about the state of mental health in Ghana in the past decade, it is hard to envision the practical effects such a research would have on Ghana's mental healthcare system. With other factors taken into consideration, it became clear that the best way to maximize the impact of my research would be to focus on building an Electronic Medical Record (EMR) system.

The interesting thing to note was that in my application to Dickey Center, I had stated that my goal was to transition The Brain Clinic from paper record-keeping system to electronic record-keeping. This was because before one can conduct analysis, one needs a reliable compilation of data, a requirement which the current paper record system does not meet. However, during the application, I had narrowly defined 'electronic record-keeping' as a platform I would help organize for The Brain Clinic by first digging through the clinic's paper records and entering all the data onto the digital platform, and training the healthcare personnel on how to maintain and continue using this digital system to store patient data. Indeed, I had thought a simple excel sheet would be enough for the Brain Clinic since it is an easy, straightforward software to use. In hindsight, I realize how naïve my reasoning was. A spreadsheet is simply not a good enough system to use to enter patient data.

But this EMR that Dr. Mfodwo and I started considering was specifically a healthcare centered platform for entering and storing patient data. I learned that there were several free Open Source EMR platforms that would only require us to customize the pages to suit the types of data we would like to enter. These free EMRs include Open MRS, Practice Fusion, among others. With my attention now turned from my earlier 'electronic record-keeping' idea to the more well-established and practical usage of EMR, I set out to find the best possible way to implement and maintain an EMR system in not just The Brain clinic, but across Ghana's mental health institutions. The enormity and longevity of the innovation to which I had now committed. myself demanded that I break up my approach in phases. My naïve idea had morphed into a concrete possible solution to the country's lack of an efficient record keeping in mental health. I embraced this change because Dickey had encouraged us to be open to possible adaptation of initial ideas.

On a personal level, I have come to embrace the person I am better than I did before I went to Ghana. Growing up in the Bronx had left me with so much conflict about who I was. I had felt like my parents' expectation of who they want me to be deviated in marked ways from who I was growing up to be. Often, I was torn between two different worlds. But I have gained heightened awareness of who I am, and who I want to be after I re-immersed myself in the culture that has shaped my most fundamental values, ideologies and principles. This personal rediscovery makes my experiences in Ghana not only a successful one, but a fulfilling one. My time in Ghana has taught me that there is a difference between success and fulfillment, and I am thankful to have experienced both.

Moreover, living in Ghana and pursuing this project have reinvigorated my desire to help battle mental illnesses in developing countries. While I was conflicted sometimes as to whether I was making the right choice in majoring in Neuroscience, working on this project in Ghana has provided me with more assurance that I am treading a path that I am truly passionate about. Finally, it was very rewarding to see a change from fear for CS classes to now being captivated by CS, a change I could hardly envision at the beginning of September 2017.