Slashdot Mirror
Ask Slashdot: Printing Options For Low-Resource Environments?
bjhonermann writes "The Zambian government (along with partners) are currently rolling out an electronic medical records (EMR) system in public health facilities. The project has been going on for some time and is already in 600+ facilities with more than 700,000 patient records. One problem we're facing is that most information is still being double entered in the EMR as well as on primary paper documents at the facility, and sometimes additionally transcribed to paper registers. This double/triple entry takes time away from nurses who are already in short supply. There's an inability to fully move away from partially paper based systems both because clients often move between 'paper clinics' and 'electronic clinics' in the same communities and for follow-up care, and because the power systems in many sites are unreliable and require that there be sufficient paper backups of records for operations during periods where power is unavailable — perhaps for weeks at a time. We're providing solar panels and battery backups for sites, which work increasingly well with newer low power CPUs, but even if the power issue were solved this would not address the need for portable paper documents. The key objective of eliminating redundant manual entry of forms and paper registers by nurses might be accomplished if we had low cost low power B/W printers available at sites so that critical information could be entered electronically and then printed out as needed, either for client carried purposes (transfers/visits to 'paper facilities') or to serve as local backup when power is an issue. However, we've yet to find printing solutions that seem appropriate to the context and are hopeful the Slashdot crowd may have some ideas."
Read on for some more specific criteria.
bjhonerman continues,
"Criteria we're looking at:
1. Reliability: The printers need to be very low maintenance and be able to cope with dusty environments.
2. Cost: Obviously, costs need to be kept as low as possible. No cap on the cost of printers precisely, but the net cost per page over time is critical. More expensive printers with cheaper and standard consumables are likely to be preferred to cheaper printers with expensive consumables.
3. Ink duration/lifespan: While all sites would be printing at least weekly, the amount actually printed may vary between no more than a few pages each week to several hundreds of pages. This means that whatever ink/toner cartridge/etc needs to have a long shelf life as well as lifespan. Zambia is not terribly hot, but has a humid rainy season and no climate control can be expected.
4. Low power consumption: As stated, ~15% of sites (and growing) are operating only with solar panels.
5. Quality: The quality of the printing can be quite low. Must be legible but can be ugly. No need for color. However, the pages/text need to have approximately a 5yr duration before the ink is unreadable.
6. Label Printing: There is also a need to print labels for specimens (freezer tolerant) and for drug dispensations. This may well be a different product, and early implementations will be in higher volume facilities that might not be as sensitive to power, but there will be a need for a low-power version eventually.
Our instinct is that dot-matrix printers would fit the bill nicely, but the options there seem to be limited and the long-term sourcing of supplies (ribbons, perforated paper) isn't entirely clear. What other options would the Slashdot community recommend?"
"Criteria we're looking at:
1. Reliability: The printers need to be very low maintenance and be able to cope with dusty environments.
2. Cost: Obviously, costs need to be kept as low as possible. No cap on the cost of printers precisely, but the net cost per page over time is critical. More expensive printers with cheaper and standard consumables are likely to be preferred to cheaper printers with expensive consumables.
3. Ink duration/lifespan: While all sites would be printing at least weekly, the amount actually printed may vary between no more than a few pages each week to several hundreds of pages. This means that whatever ink/toner cartridge/etc needs to have a long shelf life as well as lifespan. Zambia is not terribly hot, but has a humid rainy season and no climate control can be expected.
4. Low power consumption: As stated, ~15% of sites (and growing) are operating only with solar panels.
5. Quality: The quality of the printing can be quite low. Must be legible but can be ugly. No need for color. However, the pages/text need to have approximately a 5yr duration before the ink is unreadable.
6. Label Printing: There is also a need to print labels for specimens (freezer tolerant) and for drug dispensations. This may well be a different product, and early implementations will be in higher volume facilities that might not be as sensitive to power, but there will be a need for a low-power version eventually.
Our instinct is that dot-matrix printers would fit the bill nicely, but the options there seem to be limited and the long-term sourcing of supplies (ribbons, perforated paper) isn't entirely clear. What other options would the Slashdot community recommend?"
Honestly, electronic records are a problem. The systems tend to be unsecurable, so much so that it gets shrugged off and swept under the rug because, shit, it's just not at all securable and we have to get with the times, you know?
No, we don't need to get with the times. We need the right information at the right place and at the right time.
That isn't a given result from going to electronic records, in fact often the opposite. But electronicising is being used as "proof of progress" and all too often as an excuse to not actually think about what is really needed.
I say you're probably better off with a full paper system and perhaps a fax at every facility. But that'd be too low-tech, now, wouldn't it?
So I don't know why I bother, but you really need to get your consumerist (inket printers? haven't noticed they're an ink-upselling scam yet?) head out where it should be. Printing is more or less a solved problem.
Have you considered dot matrix or even daisywheel printers? If you order in large enough volumes maybe you can get ones that'll run off the old typewriter ribbons. For larger volumes, say in larger facilities, line printers. Loud, noisy, and so dusty themselves that a little extra won't hurt much. Though if the facility is large enough they can keep the dust out and use a large volume laser printers. The math of cost-effectiveness in an environment where maintenance must be simple or it won't get done left as an exercise.
Labels? Industrial label printers. Thermo-transfer instead of direct thermal so the labels last longer.
It's not hard. Why do you need to ask slashdot about it? Oh yes, that's right. You didn't know what the goal was in the first place.