Creation and evaluation of EMR-based paper clinical summaries to support HIV-care in Uganda, Africa
International Journal of Medical Informatics
Regenstrief Institute, Inc., Indiana University School of Medicine, Indianapolis, IN, United States; Mbarara University of Science, Technology ISS Clinic, Mbarara, Uganda; Division of Infectious Diseases, UCSF, San Francisco, CA, United States; Faculty of Computing and IT, Makerere University, Kampala, Uganda
Purpose: Getting the right information to providers can improve quality of care. We set out to provide patient-specific Electronic Medical Record (EMR)-based clinical summaries for providers taking care of HIV-positive adult patients in the resource-limited setting of Mbarara, Uganda. Methods: We evaluated the impact of implementing these clinical summaries using time-motion techniques and provider surveys. Results: After implementation of EMR-based clinical summaries, providers spent more time in direct care of patients (2.9 min vs. 2.3 min, p < 0.001), and the length of patient visits was reduced by 11.5 min. Survey respondents indicated that clinical summaries improved care, reduced mistakes, and were generally accurate. Current antiretroviral medication, patient identifying information, adherence information, current medication, and current medical problems were among the highest-rated elements of the summary. Conclusions: By taking advantage of data stored in EMRs, efficiency and quality of care can be improved through clinical summaries, even in settings with limited resources. © 2009 Elsevier Ireland Ltd. All rights reserved.
Adult patients; Antiretrovirals; Clinical decision support; Electronic medical record; Medical informatics; Motion techniques; Provider surveys; Quality of care; Right information; Technology adoption; Decision support systems; Developing countries; Electric relays; Information science; Medical computing; Surveys; Viruses; Medical problems; adult; Africa; article; electronic medical record; evaluation; female; health survey; hospital organization; human; Human immunodeficiency virus infection; medical information system; patient care; patient information; patient satisfaction; priority journal; Adult; Efficiency, Organizational; Electronic Health Records; HIV Infections; HIV-1; Humans; Office Visits; Outcome Assessment (Health Care); Physician's Practice Patterns; Quality of Health Care; Time and Motion Studies; Uganda