Abstract
BackgroundImplementation of user-friendly, real-time, electronic medical records for patient management may lead to improved adherence to clinical guidelines and improved quality of patient care. We detail the systematic, iterative process that implementation partners, Lighthouse clinic and Baobab Health Trust, employed to develop and implement a point-of-care electronic medical records system in an integrated, public clinic in Malawi that serves HIV-infected and tuberculosis (TB) patients.MethodsBaobab Health Trust, the system developers, conducted a series of technical and clinical meetings with Lighthouse and Ministry of Health to determine specifications. Multiple pre-testing sessions assessed patient flow, question clarity, information sequencing, and verified compliance to national guidelines. Final components of the TB/HIV electronic medical records system include: patient demographics; anthropometric measurements; laboratory samples and results; HIV testing; WHO clinical staging; TB diagnosis; family planning; clinical review; and drug dispensing.ResultsOur experience suggests that an electronic medical records system can improve patient management, enhance integration of TB/HIV services, and improve provider decision-making. However, despite sufficient funding and motivation, several challenges delayed system launch including: expansion of system components to include of HIV testing and counseling services; changes in the national antiretroviral treatment guidelines that required system revision; and low confidence to use the system among new healthcare workers. To ensure a more robust and agile system that met all stakeholder and user needs, our electronic medical records launch was delayed more than a year. Open communication with stakeholders, careful consideration of ongoing provider input, and a well-functioning, backup, paper-based TB registry helped ensure successful implementation and sustainability of the system. Additional, on-site, technical support provided reassurance and swift problem-solving during the extended launch period.ConclusionEven when system users are closely involved in the design and development of an electronic medical record system, it is critical to allow sufficient time for software development, solicitation of detailed feedback from both users and stakeholders, and iterative system revisions to successfully transition from paper to point-of-care electronic medical records. For those in low-resource settings, electronic medical records for integrated care is a possible and positive innovation.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-016-1943-4) contains supplementary material, which is available to authorized users.
Highlights
Implementation of user-friendly, real-time, electronic medical records for patient management may lead to improved adherence to clinical guidelines and improved quality of patient care
As the numbers of patients co-infected with human immunodeficiency virus (HIV) and tuberculosis (TB) increase in sub-Saharan Africa, reliance on paper-based registers may result in poor record management and, suboptimal clinical care
In 2005, Lighthouse Trust, the largest public provider of antiretroviral therapy (ART) and TB services in Malawi’s central region, in partnership with Baobab Health Trust, a local non-governmental organisation that leads the development of electronic medical record (EMR) system in the country, developed and launched an ART-focused EMR system
Summary
Implementation of user-friendly, real-time, electronic medical records for patient management may lead to improved adherence to clinical guidelines and improved quality of patient care. Iterative process that implementation partners, Lighthouse clinic and Baobab Health Trust, employed to develop and implement a point-of-care electronic medical records system in an integrated, public clinic in Malawi that serves HIVinfected and tuberculosis (TB) patients. One innovative approach to improve data quality and strengthen the continuum of care is the implementation of user-friendly, real-time electronic medical record (EMR) system. By 2006, both of Lighthouse Trust’s clinics, Lighthouse and Martin Preuss centre (MPC), successfully employed the real-time, touchscreen-based EMR system to manage ART patients. Data management for more than 36,000 ART patients at both clinics is entirely based on the EMR system resulting in near completeness of patient level data. At national level, monitoring and evaluation of the ART program, including timely generation of ART supervision reports, improved dramatically as a result of the ART EMR system roll-out
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
