Learning Objective #1: Describe the process of developing a database for evidence-based community health initiatives

Learning Objective #2: Identify issues and challeges associated with database development for community practice

---

In January 2004, New York University Division of Nursing launched a mobile health clinic for the purpose of providing primary healthcare to low-income communities in Brooklyn, NY. One of the major challenges was developing a paperless medical record system and a database for determining the population characteristics, healthcare needs and health outcomes. After a number of iterations that also included maintaining a manual system, the team finally succeeded in developing a user-friendly database that allows users to store and retrieve clinical information, trend and track patient data, generate reports, and project healthcare needs of the communities we serve. Assessment tools were identified and integrated into the database. Simple and complex indicators were developed to create triggers and reminders for practitioners. In this paper, we describe the steps of the process, role of clinical and management staff in developing an electronic health record for a primary health care setting and challenges faced in the process.