Scale-up of networked HIV treatment in Nigeria: creation of an integrated electronic medical records system.
Int J Med Inform
; 84(1): 58-68, 2015 Jan.
Article
em En
| MEDLINE
| ID: mdl-25301692
ABSTRACT
OBJECTIVES:
The implementation of PEPFAR programs in resource-limited settings was accompanied by the need to document patient care on a scale unprecedented in environments where paper-based records were the norm. We describe the development of an electronic medical records system (EMRS) put in place at the beginning of a large HIV/AIDS care and treatment program in Nigeria.METHODS:
Databases were created to record laboratory results, medications prescribed and dispensed, and clinical assessments, using a relational database program. A collection of stand-alone files recorded different elements of patient care, linked together by utilities that aggregated data on national standard indicators and assessed patient care for quality improvement, tracked patients requiring follow-up, generated counts of ART regimens dispensed, and provided 'snapshots' of a patient's response to treatment. A secure server was used to store patient files for backup and transfer.RESULTS:
By February 2012, when the program transitioned to local in-country management by APIN, the EMRS was used in 33 hospitals across the country, with 4,947,433 adult, pediatric and PMTCT records that had been created and continued to be available for use in patient care. Ongoing trainings for data managers, along with an iterative process of implementing changes to the databases and forms based on user feedback, were needed. As the program scaled up and the volume of laboratory tests increased, results were produced in a digital format, wherever possible, that could be automatically transferred to the EMRS. Many larger clinics began to link some or all of the databases to local area networks, making them available to a larger group of staff members, or providing the ability to enter information simultaneously where needed.CONCLUSIONS:
The EMRS improved patient care, enabled efficient reporting to the Government of Nigeria and to U.S. funding agencies, and allowed program managers and staff to conduct quality control audits.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Atitude do Pessoal de Saúde
/
Infecções por HIV
/
Sistemas Computadorizados de Registros Médicos
/
Sistemas de Informação Hospitalar
/
Implementação de Plano de Saúde
/
Recursos em Saúde
Tipo de estudo:
Diagnostic_studies
/
Sysrev_observational_studies
Limite:
Adult
/
Child
/
Humans
País/Região como assunto:
Africa
Idioma:
En
Revista:
Int J Med Inform
Assunto da revista:
INFORMATICA MEDICA
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Estados Unidos