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Title: | Changing course to make clinical decision support work in an HIV clinic in Kenya |
Authors: | Sheraz F., Noormohammada Burke W., Mamlin Paul G., Biondich Brian, McKown Sylvester N., Kimaiyo Martin C., Were |
Keywords: | Electronic medical record Clinical decision support Developing countries Technology adoption |
Issue Date: | 4-Jan-2010 |
Publisher: | Elservier |
Abstract: | Purpose:We implemented computer-based reminders for CD4 count tests at an HIV clinic in Western Kenya though an open-source Electronic Medical Record System.Within a month, providers had stopped complying with the reminders. Methods: We used a multi-method qualitative approach to determine reasons for failure to adhere to the reminders, and took multiple corrective actions to remedy the situation. Results: Major reasons for failure of the reminder system included: not considering delayed data entry and pending test results; relying on wrong data inadvertently entered into the system; inadequate training of providers who would sometimes disagree with the reminder suggestions; and resource issues making generation of reminders unreliable.With appropriate corrective actions, the reminder system has now been functional for over eight months. Conclusion: Implementing clinical decision support in resource-limited settings is challenging. Understanding and correcting root causes of problems related to reminders will facilitate successful implementation of the decision support systems in these settings |
URI: | http://ir.mu.ac.ke:8080/xmlui/handle/123456789/302 |
ISSN: | http://ir.mu.ac.ke:8080/xmlui/handle/123456789/302 |
Appears in Collections: | School of Medicine |
Files in This Item:
File | Description | Size | Format | |
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mamlin.pdf | 337.74 kB | Adobe PDF | View/Open |
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