An assessment of the accuracy and availability of data in electronic patient tracking systems for patients receiving HIV treatment in central Mozambique

Barrot H Lambdin,Kenneth Sherr,Stephen S Gloyd,Andy Stergachis,James P Hughes,Mark A Micek,Joseph Lara,Thomas D Koepsell,Marina Karagianis,James Pfeiffer

doi:10.1186/1472-6963-12-30

Abstract

BackgroundSince the rapid scale-up of antiretroviral therapy (ART) programs in sub-Saharan Africa, electronic patient tracking systems (EPTS) have been deployed to respond to the growing demand for program monitoring, evaluation and reporting to governments and donors. These routinely collected data are often used in epidemiologic and operations research studies intended to improve programs. To ensure accurate reporting and good quality for research, the reliability and completeness of data systems need to be assessed and reported. We assessed the completeness and reliability of EPTS used in 16 HIV care and treatment clinics in Manica and Sofala provinces of Mozambique.MethodsWe conducted a cross-sectional study to assess the completeness and reliability of key variables in the electronic data system for patients enrolling in 16 public sector HIV treatment clinics between 1 July 2004 and 30 June 2008. Data from the electronic database was compared with data abstracted from a stratified random sample of 520 patient charts. Percent agreement, kappa scores and concordance correlation coefficients were calculated for specified variables. Percentile bootstrap confidence intervals were calculated to account for the stratified nature of our sampling.ResultsA total of 16,149 patients with a median age of 33 years and a median CD4 count of 151 enrolled in these 16 clinics between 1 July 2004 and 30 June 2008. The level of completeness was high for most variables with height (18.6%) and weight (11.5%) having the highest amount of missing data. The level of agreement for available data was also high with reliability statistics of 0.95 (95% CI: 0.92-0.98) for gender, 0.91 (95% CI: 0.80-1.00) for pre-ART CD4 value and 0.97 (95% CI: 0.95-0.99) for patient retention.ConclusionsElectronic patient tracking systems have been deployed to respond to the growing monitoring, evaluation and reporting requirements. In our cross-sectional study of clinics in Manica and Sofala provinces of Mozambique, we found high levels of completeness and reliability for key variables indicating that these electronic databases provided adequate data not only for monitoring and evaluation but also for research. Routine evaluations of the completeness and reliability of these databases need to occur to ensure high quality data are being used for reporting and research.

Highlights

Since the rapid scale-up of antiretroviral therapy (ART) programs in sub-Saharan Africa, electronic patient tracking systems (EPTS) have been deployed to respond to the growing demand for program monitoring, evaluation and reporting to governments and donors
Clinic Characteristics A total of 16 of the 36 HIV care and treatment clinics recognized by the Ministry of Health from Manica and Sofala provinces were included in the analysis
Two of these clinics were a vertical, stand-alone HIV care and treatment clinics, 14 were clinics where HIV care and treatment was integrated with primary health care services; and one of the vertical model clinics shifted into an integrated model

Summary

Introduction

Since the rapid scale-up of antiretroviral therapy (ART) programs in sub-Saharan Africa, electronic patient tracking systems (EPTS) have been deployed to respond to the growing demand for program monitoring, evaluation and reporting to governments and donors. As antiretroviral treatment (ART) programs have been rapidly scaled up in sub-Saharan Africa, electronic data systems have been introduced to support program monitoring and evaluation imperatives [1] These data systems have facilitated the response to the growing demands of patient management and reporting to governments and donor groups specific for HIV care and treatment delivery, and they rely on complete and accurate charting by providers of laboratory, pharmacy and medical visits into patient charts. They were developed in parallel to national data systems due to the inadequacy of existing in-country information systems and data collection mechanisms [1]. These data are vital to adequately monitor site performance and inform national planning [4]

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Conclusion