By Emma Folts
Each month in rural Haiti, hundreds of people rely on the House of David Community Health Center for dental work, blood pressure assessments, gynecological care and more. But because of its limited resources, the health center’s staff have struggled to effectively document patient care.
The health center often operates with limited electricity and internet access, meaning staff have used paper forms or Excel spreadsheets to create medical records. So FLM Haiti, a Pittsburgh-based nonprofit that runs the clinic abroad and provides education, literacy training, and other services to people in Haiti, partnered with a team of Heinz College graduate students this spring to develop a better system.
As part of their capstone project –– an essential component of the Heinz College curriculum –– the students created an electronic medical records (EMR) system that can be used without an internet connection. The system provides a centralized location and uniform way to create and store medical records, helping staff better understand patient needs and recognize health trends in the community.
The spring 2025 capstone team was composed of Hossein Khoshhal (MSPPM-DA ‘25), Riddhima Singh (MSPPM-DA ‘25), Anahita Subramanya (MSHCA ‘25) and Masahiko Shinjo (MSPPM-DA ‘25). Recent graduates Apoorva Shetty (MSPPM-DA ’24) and Manikandan Palaniappan (MSPPM-DA ’24) supported the team's efforts.
The group aimed to create a product that worked within the resource constraints the health center faces, Khoshhal said.
“We wanted to make sure the solution we came up with was something that could actually help them,” Khoshhal said. “We had to think way outside of the box to create an electronic medical record system that will function even when the clinic lacks electricity or a reliable internet connection.”
FLM Haiti has continued to advance the project with Heinz College and Carnegie Mellon University students and recent graduates since the spring 2025 capstone ended, working with teams throughout the summer and this fall.
This fall, a group of Heinz College students aim to expand the system’s functionalities by developing the front end of the desktop and mobile versions and implementing additional modules. The team is also creating a strategy for cloud backup, as well as analytic dashboards to support the clinic’s operations.
Use data analysis and evidence-based decisions to make an impact.
Our policy curriculum provides instruction in statistics, economics, finance, organizational design, and presentation skills. You'll leave here prepared to tackle policy in any realm you choose.
The spring 2025 capstone team assessed the pros and cons of creating their EMR system in a variety of different ways. They considered using existing tools, including open-source options and those created specifically for environments with limited resources, but found that these tools would not fully meet the health center’s needs. Some would not work without an internet connection; others would be challenging to set up.
Eventually, the group decided to build their system from scratch. Professor Michael McCarthy, an associate teaching professor of information systems at Heinz College and the capstone’s advisor, pointed out that Internet-of-Things devices could be a potential solution.
The students built a mobile application using FlutterFlow and, following McCarthy’s advice, paired it with a small, low-cost computer called a Raspberry Pi. The Raspberry Pi acts as a local server, creating its own Wi-Fi network that works even without internet access. Because the device uses very little electricity, it can run on minimal backup power, making it ideal for a clinic that doesn’t always have a steady power supply.
As long as staff have a charged phone, tablet, or laptop with the app installed, they can connect to the Raspberry Pi’s network and access the patient records server anytime.
The app’s user interface matches the paper forms the health center has been using to track patient visits. The students had to create every aspect of the app from scratch – including the Application Programming Interfaces (API) integration, essential to ensuring all health center staff could access the same patient data.
That work was challenging but fulfilling, Khoshhal said.
“We had to put together a lot of different work streams, and it kept compounding more and more as we went on,” Khoshhal said. “But, given the fact that we kept seeing a light at the end of the tunnel, and a solution we could put together for this clinic, we wanted to go as far as we could.”
Pastor Osse Paul, deputy executive director of FLM Haiti and the students’ point of contact in Haiti, was instrumental in helping the capstone team understand the constraints the clinic faces and create a system that meets the clinic’s needs.
To determine the best way to create their system, the team sought the insights of faculty and staff throughout Heinz College and the neighboring School of Computer Science. “The students did a great job,” McCarthy said.
“Working in a resource-constrained environment, the students delivered a cost-effective solution. They incorporated thoughtful user interface design and multilingual support, which greatly enhanced usability,” he said.
The language barrier was another challenge the students faced. The majority of the staff at the health center did not speak English, so all of the students’ communications had to be translated beforehand to Creole. Each week, the students sought feedback from the staff through translated surveys with photos that clearly demonstrated their progress.
“If there were any new pages, new menus, or any questionnaires that needed to be filled out for patients, we wanted the staff to do a thorough review,” Khoshhal said. “We wanted to make sure that when they got the system, they weren't going to be confused. They would know exactly what to expect.”
James Bryant II, executive board member of FLM Haiti, worked closely with and led the capstone team. He said the project was “transformational.”
“Think about this: The U.S. healthcare system's transition to electronic medical records reshaped how care was delivered, managed and improved — unlocking new levels of patient safety, operational efficiency, care coordination, data-driven insights and innovation. Haiti is not there yet countrywide, and our project can perhaps play a part in the national conversation,” Bryant said.
Leon Pamphile, executive director of FLM Haiti, said, “The outcome will be really helpful in order to advance the work done in Haiti."
The capstone team had to solve an extremely complex problem, but Khoshhal said his Heinz College education gave him the confidence to pursue a solution. “Before I came here, I would not have believed I would be able to fix a problem like this,” he said.
He described the project as a “sandbox” in which the students could propose different solutions and explore their ramifications. The group –– which was composed of students from a variety of Heinz College master’s programs –– learned from one another and practiced applying their knowledge of technical tools and organizational management.
In November, the students will discuss their work at the American Medical Informatics Association’s Annual Symposium, held in Atlanta. In the future, Khoshhal believes the tool could serve other poorly resourced clinics abroad and in rural parts of the U.S., where internet connectivity can be limited.
“Despite all of its constraints, I think the fact that we found a way for this to work –– that it's possible for you to have an EMR system even if you have limited resources –– that was the biggest sense of impact,” Khoshhal said.