Implementation and Evaluation of an Electronic Medical Record for Medical Student-Led Homeless Outreach
Introduction: University of Rochester (UR) Street Medicine is a medical student-run organization that seeks to improve the health and well being of Rochester’s homeless population by providing healthcare services to individuals where they reside. This article will demonstrate the use of an electronic medical record for medical student-led homeless outreach and review the demographics and medical needs of this underserved population.
Methods: UR Street Medicine data was collected from June 2016 to September 2018 using REDCap (Research Electronic Data Capture), a free, secure, HIPAA-compliant, web-based application hosted at University of Rochester Medical Center. We provide an overview of the electronic medical record system and perform a retrospective analysis of de-identified records including patient demographics and needs, chief complaints, and outcomes of patient interactions.
Results: From June 2016 to September 2018, 189 UR Street Medicine rounds took place, with an average of 12.1 (±8.7) total homeless individuals encountered and 6.7 (±5.4) individuals with whom medical/social issues were discussed. Out of 338 individuals with recorded demographics, 25% were current smokers and 26% had known substance abuse. Thirty percent were without a primary care physician and 12% were without insurance. Out of 632 patient encounters, most common chief complaints included blood pressure checks (22.6% of visits), musculoskeletal pain (12.7% of visits), and foot or skin problems (8.1% of visits). Referral to primary care physician occurred at 24% of all visits, referral to other medical services occurred at 19%, referral to social work occurred at 3.7%, and referral to emergency care occurred at 2.7%. Follow up visits occurred 330 times out of the 492 visits that required follow up, for a success rate of 67%.
Conclusion: UR Street Medicine demonstrates the use of REDCap as an electronic medical record for medical-student led homeless outreach in order to capture the needs of Rochester’s homeless population and facilitate patient follow up.