The Commercial Bank of Ceylon donated the computers for the Pain Clinic and set up a Local Area Network (LAN) with laptops and PCs. WiFi provides the communication and connection to the Internet is established via a GSM modem. Lunar Technologies provided the software and training.

We initially installed the first version of HHIMS in September 2013 for training and for users to get used to the computer. However, as the development of the new version was being carried out at the same time, we could replace it with HHIMSv2 when actual patient data entry started, in March 2014. There was close collaboration with the Clinic staff during the development to design the Questionnaires – a major new feature of HHIMSv2. These are used to enter more details on patient registration, structured patient histories using Problem-Oriented Medical Records (POMR), follow-up consultation notes using SOAP records, and clinical diagrams on which symptoms and findings could be drawn by the doctors.

The introduction of the POMR and SOAP notes into the National Hospital might have far-reaching effects on the future direction of medical record software in Sri Lankan hospitals. The concept of flexible Questionnaires managed by hospital staff themselves and requiring little programming skill, might provide the breakthrough that those of us working in this field have been looking for. We will learn a lot more once more hospitals staff start to use the new version of HHIMSv2 (now in beta-test phase) to replace their current narrative manual notes.

The inventor of the Problem-Oriented Medical Record (POMR), Dr Lawrence Weed, once said: “Why do pilots, who are as well trained as doctors, rely on questionnaires and highly structured records while doctors rarely do? Perhaps it's because pilots fly in the same plane as the passengers.” If you want an introduction to the POMR and have an hour to spare, you should look at this excellent talk by

Dr. Weed:

We must acknowledge the help and collaboration of Dr. Gihan Piyasiri who worked tirelessly to advise us on the production of the questionnaires when he was the director of the NHC Pain Management Unit.