An open source API for real time drug prescription monitoring at the point of care in low resource settings

Introduction: Since 2012, electronic hospital information management systems (HIMS) have progressively found their way to Burundian health facilities. Private clinics and the military hospital in Bujumbura have been amongst the earliest adopters. Since 2014, the Ministry of Public Health and Fight against AIDS (MSPLS) with the aid of the Belgian Technical Cooperation, have started implementing HIMS in Burundi’s public health facilities. The positive impact of HIMS on the management of financial, human and material hospital resources has been demonstrated by a growing number of studies. However, less evidence is available when it comes to impact measurement on the quality of care. Aim: The purpose of the study was to develop a set of simple metrics with predictive value for the performance of clinical data registration in hospitals, providing a building block for future quality of care measurement in HIMS. Methods: A reference set of 1,511 electronic patient records was manually scored for clinical data completeness. A series of 11 simplified, easy to measure candidate primitive metrics for predicting completeness of clinical documentation in health records have then been calculated on the same set of records and correlations between the candidate metrics and the manual clinical data completeness scores have been evaluated. Results: The study resulted in the identification of 4 primitive metrics with statistically significant predictive value (r>0.75 with p<0.01 for F-Test, confidence level 95%), namely: (i) the clinical document density, (ii) the information density, (iii) the reason for encounter density and (iv) the diagnostic density. Reference values for each metric have been calculated for outpatient and inpatient settings, targeting >70% and >80% clinical documentation completeness. Conclusion: The study produced 4 primitive, easy to calculate metrics, predicting the completeness of clinical documentation. They have been integrated in the OpenClinic GA HIMS package that is being deployed by the Ministry of Health in the public hospitals of Burundi. The metrics are early building blocks for the future development of a more comprehensive solution for quality of care evaluation and their isolated or individual use is insufficient for measuring

Jaar van publicatie:2017

Auteurs:International

Toegankelijkheid:Closed