JMIR Publications

ABSTRACT

Background:

People experiencing unsheltered homelessness (PEUH) are a vulnerable patient cohort suffering high levels of disease morbidity and mortality alongside numerous barriers to care [1]. Street Medicine is a practice whereby medical providers travel to encampments, sidewalks, and overpasses to directly treat PEUH [2]. However, these organizations are typically volunteer-based and lack funding for robust electronic medical record systems, many of which are cost-prohibitive [3]. Research Electronic Data Capture (REDCap) is a web application that can be used to create databases for clinical research and projects [4]. It can also be customized for telemedicine consultations.

Objective:

This cross-sectional study describes the use of a custom, REDCap-based electronic medical record for the management of cutaneous diseases in a Miami-based Street Medicine organization.

Methods:

A custom, secure REDCap-based electronic medical record (EMR) was developed in June 2021 for use in a Miami-based Street Medicine organization (Multimedia Appendix 1). Approval was obtained by the University of Miami Institutional Review Board to review records of cutaneous disease among this PEUH patient cohort. Between July 2021 - January 2022, REDCap records were retrieved pertaining to skin or nail-based problems.

Results:

Among 140 unique patients seen in a street setting, 112 diagnoses were recorded. The sample evaluated included 68.1% males and 31.9% females.The most common dermatologic diagnosis outside of the miscellaneous category was acute infections (20.5% of total diagnoses made) with the most common type of medication dispensed being wound care (32.5% of total medications dispensed).

Conclusions:

The use of a free, customizable REDCap system was instrumental in recording the high burden of cutaneous diseases among our cohort of PEUH. REDCap can be used by charitable healthcare organizations with limited funding by virtue of its cost-effective and accessible management of patient data.