Implementation of Provider-Based Electronic Medical Records and Improvement of the Quality of Data in a Large HIV Program in Sub-Saharan Africa

Barbara Castelnuovo, Agnes Kiragga, Victor Afayo, Malisa Ncube, Richard Orama, Stephen Magero, Peter Okwi, Yukari C Manabe, Andrew Kambugu

Research output: Contribution to journalArticle

Abstract

Introduction: Starting in June 2010 the Infectious Diseases Institute (IDI) clinic (a large urban HIV out-patient facility) switched to provider-based Electronic Medical Records (EMR) from paper EMR entered in the database by data-entry clerks. Standardized clinics forms were eliminated but providers still fill free text clinical notes in physical patients' files. The objective of this study was to compare the rate of errors in the database before and after the introduction of the provider-based EMR. Methods and Findings: Data in the database pre and post provider-based EMR was compared with the information in the patients' files and classified as correct, incorrect, and missing. We calculated the proportion of incorrect, missing and total error for key variables (toxicities, opportunistic infections, reasons for treatment change and interruption). Proportions of total errors were compared using chi-square test. A survey of the users of the EMR was also conducted. We compared data from 2,382 visits (from 100 individuals) of a retrospective validation conducted in 2007 with 34,957 visits (from 10,920 individuals) of a prospective validation conducted in April-August 2011. The total proportion of errors decreased from 66.5% in 2007 to 2.1% in 2011 for opportunistic infections, from 51.9% to 3.5% for ART toxicity, from 82.8% to 12.5% for reasons for ART interruption and from 94.1% to 0.9% for reasons for ART switch (all P

Original languageEnglish (US)
Article numbere51631
JournalPLoS One
Volume7
Issue number12
DOIs
StatePublished - Dec 17 2012

Fingerprint

Electronic medical equipment
Africa South of the Sahara
Electronic Health Records
Sub-Saharan Africa
Quality Improvement
electronics
HIV
Opportunistic Infections
Databases
Toxicity
toxicity
Chi-Square Distribution
infection
infectious diseases
Communicable Diseases
Data acquisition
Outpatients
Switches
Data Accuracy

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Implementation of Provider-Based Electronic Medical Records and Improvement of the Quality of Data in a Large HIV Program in Sub-Saharan Africa. / Castelnuovo, Barbara; Kiragga, Agnes; Afayo, Victor; Ncube, Malisa; Orama, Richard; Magero, Stephen; Okwi, Peter; Manabe, Yukari C; Kambugu, Andrew.

In: PLoS One, Vol. 7, No. 12, e51631, 17.12.2012.

Research output: Contribution to journalArticle

Castelnuovo, Barbara ; Kiragga, Agnes ; Afayo, Victor ; Ncube, Malisa ; Orama, Richard ; Magero, Stephen ; Okwi, Peter ; Manabe, Yukari C ; Kambugu, Andrew. / Implementation of Provider-Based Electronic Medical Records and Improvement of the Quality of Data in a Large HIV Program in Sub-Saharan Africa. In: PLoS One. 2012 ; Vol. 7, No. 12.
@article{4c424edfa7e44819b8141115656b3051,
title = "Implementation of Provider-Based Electronic Medical Records and Improvement of the Quality of Data in a Large HIV Program in Sub-Saharan Africa",
abstract = "Introduction: Starting in June 2010 the Infectious Diseases Institute (IDI) clinic (a large urban HIV out-patient facility) switched to provider-based Electronic Medical Records (EMR) from paper EMR entered in the database by data-entry clerks. Standardized clinics forms were eliminated but providers still fill free text clinical notes in physical patients' files. The objective of this study was to compare the rate of errors in the database before and after the introduction of the provider-based EMR. Methods and Findings: Data in the database pre and post provider-based EMR was compared with the information in the patients' files and classified as correct, incorrect, and missing. We calculated the proportion of incorrect, missing and total error for key variables (toxicities, opportunistic infections, reasons for treatment change and interruption). Proportions of total errors were compared using chi-square test. A survey of the users of the EMR was also conducted. We compared data from 2,382 visits (from 100 individuals) of a retrospective validation conducted in 2007 with 34,957 visits (from 10,920 individuals) of a prospective validation conducted in April-August 2011. The total proportion of errors decreased from 66.5{\%} in 2007 to 2.1{\%} in 2011 for opportunistic infections, from 51.9{\%} to 3.5{\%} for ART toxicity, from 82.8{\%} to 12.5{\%} for reasons for ART interruption and from 94.1{\%} to 0.9{\%} for reasons for ART switch (all P",
author = "Barbara Castelnuovo and Agnes Kiragga and Victor Afayo and Malisa Ncube and Richard Orama and Stephen Magero and Peter Okwi and Manabe, {Yukari C} and Andrew Kambugu",
year = "2012",
month = "12",
day = "17",
doi = "10.1371/journal.pone.0051631",
language = "English (US)",
volume = "7",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "12",

}

TY - JOUR

T1 - Implementation of Provider-Based Electronic Medical Records and Improvement of the Quality of Data in a Large HIV Program in Sub-Saharan Africa

AU - Castelnuovo, Barbara

AU - Kiragga, Agnes

AU - Afayo, Victor

AU - Ncube, Malisa

AU - Orama, Richard

AU - Magero, Stephen

AU - Okwi, Peter

AU - Manabe, Yukari C

AU - Kambugu, Andrew

PY - 2012/12/17

Y1 - 2012/12/17

N2 - Introduction: Starting in June 2010 the Infectious Diseases Institute (IDI) clinic (a large urban HIV out-patient facility) switched to provider-based Electronic Medical Records (EMR) from paper EMR entered in the database by data-entry clerks. Standardized clinics forms were eliminated but providers still fill free text clinical notes in physical patients' files. The objective of this study was to compare the rate of errors in the database before and after the introduction of the provider-based EMR. Methods and Findings: Data in the database pre and post provider-based EMR was compared with the information in the patients' files and classified as correct, incorrect, and missing. We calculated the proportion of incorrect, missing and total error for key variables (toxicities, opportunistic infections, reasons for treatment change and interruption). Proportions of total errors were compared using chi-square test. A survey of the users of the EMR was also conducted. We compared data from 2,382 visits (from 100 individuals) of a retrospective validation conducted in 2007 with 34,957 visits (from 10,920 individuals) of a prospective validation conducted in April-August 2011. The total proportion of errors decreased from 66.5% in 2007 to 2.1% in 2011 for opportunistic infections, from 51.9% to 3.5% for ART toxicity, from 82.8% to 12.5% for reasons for ART interruption and from 94.1% to 0.9% for reasons for ART switch (all P

AB - Introduction: Starting in June 2010 the Infectious Diseases Institute (IDI) clinic (a large urban HIV out-patient facility) switched to provider-based Electronic Medical Records (EMR) from paper EMR entered in the database by data-entry clerks. Standardized clinics forms were eliminated but providers still fill free text clinical notes in physical patients' files. The objective of this study was to compare the rate of errors in the database before and after the introduction of the provider-based EMR. Methods and Findings: Data in the database pre and post provider-based EMR was compared with the information in the patients' files and classified as correct, incorrect, and missing. We calculated the proportion of incorrect, missing and total error for key variables (toxicities, opportunistic infections, reasons for treatment change and interruption). Proportions of total errors were compared using chi-square test. A survey of the users of the EMR was also conducted. We compared data from 2,382 visits (from 100 individuals) of a retrospective validation conducted in 2007 with 34,957 visits (from 10,920 individuals) of a prospective validation conducted in April-August 2011. The total proportion of errors decreased from 66.5% in 2007 to 2.1% in 2011 for opportunistic infections, from 51.9% to 3.5% for ART toxicity, from 82.8% to 12.5% for reasons for ART interruption and from 94.1% to 0.9% for reasons for ART switch (all P

UR - http://www.scopus.com/inward/record.url?scp=84871291546&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84871291546&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0051631

DO - 10.1371/journal.pone.0051631

M3 - Article

VL - 7

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 12

M1 - e51631

ER -