| 1. |
- Ammenwerth, Elske, et al.
(författare)
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International Comparison of Six Basic eHealth Indicators Across 14 Countries: An eHealth Benchmarking Study
- 2020
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Ingår i: Methods of Information in Medicine. - : Georg Thieme Verlag KG. - 0026-1270 .- 2511-705X. ; 59:S2, s. e46-e63
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Tidskriftsartikel (refereegranskat)abstract
- Background Many countries adopt eHealth applications to support patient-centered care. Through information exchange, these eHealth applications may overcome institutional data silos and support holistic and ubiquitous (regional or national) information logistics. Available eHealth indicators mostly describe usage and acceptance of eHealth in a country. The eHealth indicators focusing on the cross-institutional availability of patient-related information for health care professionals, patients, and care givers are rare. Objectives This study aims to present eHealth indicators on cross-institutional availability of relevant patient data for health care professionals, as well as for patients and their caregivers across 14 countries (Argentina, Australia, Austria, Finland, Germany, Hong Kong as a special administrative region of China, Israel, Japan, Jordan, Kenya, South Korea, Sweden, Turkey, and the United States) to compare our indicators and the resulting data for the examined countries with other eHealth benchmarks and to extend and explore changes to a comparable survey in 2017. We defined "availability of patient data" as the ability to access data in and to add data to the patient record in the respective country. Methods The invited experts from each of the 14 countries provided the indicator data for their country to reflect the situation on August 1, 2019, as date of reference. Overall, 60 items were aggregated to six eHealth indicators. Results Availability of patient-related information varies strongly by country. Health care professionals can access patients most relevant cross-institutional health record data fully in only four countries. Patients and their caregivers can access their health record data fully in only two countries. Patients are able to fully add relevant data only in one country. Finland showed the best outcome of all eHealth indicators, followed by South Korea, Japan, and Sweden. Conclusion Advancement in eHealth depends on contextual factors such as health care organization, national health politics, privacy laws, and health care financing. Improvements in eHealth indicators are thus often slow. However, our survey shows that some countries were able to improve on at least some indicators between 2017 and 2019. We anticipate further improvements in the future.
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| 2. |
- Gesicho, Milka B., et al.
(författare)
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Critical Issues in Evaluating National-Level Health Data Warehouses in LMICs: Kenya Case Study
- 2017
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Ingår i: Informatics Empowers Healthcare Transformation. - 9781614997801 - 9781614997818 ; , s. 201-204
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Konferensbidrag (refereegranskat)abstract
- Low-Middle-Income-Countries (LMICs) are beginning to adopt national health data warehousing (NHDWs) for making strategic decisions and for improving health outcomes. Given the numerous challenges likely to be faced in establishment of NHDWs by LMICs, it is prudent that evaluations are done in relation to the data warehouses (DWs), in order to identify and mitigate critical issues that arise. When critic issues are not identified, DWs are prone to suboptimal implementation with compromised outcomes. Despite the fact that several publications exist on evaluating DWs, evaluations specific to health data warehouses are scanty, with almost none evaluating NHDWs more so in LMICs. This paper uses a systematic approach guided by an evaluation framework to identify critical issues to be considered in evaluating Kenyas NHDW.
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| 3. |
- Gesicho, Milka B., et al.
(författare)
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Health Facility Ownership Type and Performance on HIV Indicator Data Reporting in Kenya
- 2020
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Ingår i: Digital Personalized Health and Medicine. - : IOS Press. - 9781643680828 - 9781643680835 ; , s. 1301-1302
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Konferensbidrag (refereegranskat)abstract
- In low- and middle-income countries, private and public facilities tend to have highly variable characteristics, which might affect their performance in meeting reporting requirements mandated by ministries of health. There is conflicting evidence on which facility type performs better across various care dimensions, and only few studies exist to evaluate relative performance around nationally-mandated indicator reporting to Ministries of Health. In this study, we evaluated the relationship between facility ownership type and performance on HIV indicator data reporting, using the case of Kenya. We conducted Mann-Whitney U tests using HIV indicator data extracted from years 2011 to 2018 for all the counties in Kenya, from the District Health Information Software 2 (DHIS2). Results from the study reveal that public facilities have statistically significant better performance compared to private facilities, with an exception of year 2017 in reporting of counselling and testing, and prevention of mother-to-child transmission indicator categories.
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| 4. |
- Gesicho, Milka B., et al.
(författare)
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K-Means Clustering in Monitoring Facility Reporting of HIV Indicator Data: Case of Kenya
- 2020
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Ingår i: The Importance of Health Informatics in Public Health during a Pandemic. - : IOS Press. - 9781643680927 - 9781643680934 ; , s. 143-146
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Konferensbidrag (refereegranskat)abstract
- Health management information systems (HMISs) in low- and middle-income countries have been used to collect large amounts of data after years of implementation, especially in support of HIV care services. National-level aggregate reporting data derived from HMISs are essential for informed decision-making. However, the optimal statistical approaches and algorithms for deriving key insights from these data are yet to be fully and adequately utilized. This paper demonstrates use of the k-means clustering algorithm as an approach in supporting monitoring of facility reporting and data-informed decision-making, using the case example of Kenya HIV national reporting data. Results reveal four homogeneous cluster categories that can be used in assessing overall facility performance and rating of that performance.
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| 5. |
- Ngugi, Philomena, et al.
(författare)
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A multivariate statistical evaluation of actual use of electronic health record systems implementations in Kenya
- 2021
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Ingår i: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 16:9
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Tidskriftsartikel (refereegranskat)abstract
- Background Health facilities in developing countries are increasingly adopting Electronic Health Records systems (EHRs) to support healthcare processes. However, only limited studies are available that assess the actual use of the EHRs once adopted in these settings. We assessed the state of the 376 KenyaEMR system (national EHRs) implementations in healthcare facilities offering HIV services in Kenya. Methods The study focused on seven EHRs use indicators. Six of the seven indicators were programmed and packaged into a query script for execution within each KenyaEMR system (KeEMRs) implementation to collect monthly server-log data for each indicator for the period 2012-2019. The indicators included: Staff system use, observations (clinical data volume), data exchange, standardized terminologies, patient identification, and automatic reports. The seventh indicator (EHR variable Completeness) was derived from routine data quality report within the EHRs. Data were analysed using descriptive statistics, and multiple linear regression analysis was used to examine how individual facility characteristics affected the use of the system. Results 213 facilities spanning 19 counties participated in the study. The mean number of authorized users who actively used the KeEMRs was 18.1% (SD = 13.1%, p<0.001) across the facilities. On average, the volume of clinical data (observations) captured in the EHRs was 3363 (SD = 4259). Only a few facilities(14.1%) had health data exchange capability. 97.6% of EHRs concept dictionary terms mapped to standardized terminologies such as CIEL. Within the facility EHRs, only 50.5% (SD = 35.4%, p< 0.001) of patients had the nationally-endorsed patient identifier number recorded. Multiple regression analysis indicated the need for improvement on the mode of EHRs use of implementation. Conclusion The standard EHRs use indicators can effectively measure EHRs use and consequently determine success of the EHRs implementations. The results suggest that most of the EHRs use areas assessed need improvement, especially in relation to active usage of the system and data exchange readiness.
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| 6. |
- Ngugi, Philomena, et al.
(författare)
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Development of standard indicators to assess use of electronic health record systems implemented in low-and medium-income countries
- 2021
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Ingår i: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Electronic Health Record Systems (EHRs) are being rolled out nationally in many low- and middle-income countries (LMICs) yet assessing actual system usage remains a challenge. We employed a nominal group technique (NGT) process to systematically develop high-quality indicators for evaluating actual usage of EHRs in LMICs. Methods An initial set of 14 candidate indicators were developed by the study team adapting the Human Immunodeficiency Virus (HIV) Monitoring, Evaluation, and Reporting indicators format. A multidisciplinary team of 10 experts was convened in a two-day NGT workshop in Kenya to systematically evaluate, rate (using Specific, Measurable, Achievable, Relevant, and Time-Bound (SMART) criteria), prioritize, refine, and identify new indicators. NGT steps included introduction to candidate indicators, silent indicator ranking, round-robin indicator rating, and silent generation of new indicators. 5-point Likert scale was used in rating the candidate indicators against the SMART components. Results Candidate indicators were rated highly on SMART criteria (4.05/5). NGT participants settled on 15 final indicators, categorized as system use (4); data quality (3), system interoperability (3), and reporting (5). Data entry statistics, systems uptime, and EHRs variable concordance indicators were rated highest. Conclusion This study describes a systematic approach to develop and validate quality indicators for determining EHRs use and provides LMICs with a multidimensional tool for assessing success of EHRs implementations.
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| 7. |
- Ngugi, Philomena N., et al.
(författare)
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Assessment of HIV Data Reporting Performance by Facilities During EMR Systems Implementations in Kenya
- 2020
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Ingår i: The Importance of Health Informatics in Public Health during a Pandemic. - : IOS Press. - 9781643680927 - 9781643680934 ; , s. 167-170
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Konferensbidrag (refereegranskat)abstract
- There is little evidence that implementations of Electronic Medical Record Systems (EMRs) are associated with better reporting completeness and timeliness of HIV routine data to the national aggregate system. We analyzed the reporting completeness and timeliness of HIV reports to Kenyas national aggregate reporting system from District Health Information Software 2 (DHIS2) for the period 2011 to 2018. On average, reporting completeness improved to 97% whilst timeliness increased to 83% in 2017 with similar performance for the facilities under study that implemented either KenyaEMR or IQCare. However, in 2018, the reporting rates dropped by 13% for completeness and 11% for timeliness most likely due to changed reporting procedures. This suggests that besides EMRs, there are other factors influencing reporting such as reporting routines, which need to be assessed separately. Nonetheless, the EMRs have facilitated the collection of HIV data for submission to the DHIS2, which in turn facilitates the reporting process for the data officers.
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| 8. |
- Waruhari, Philomena, et al.
(författare)
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A Review of Current Patient Matching Techniques
- 2017
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Ingår i: Informatics Empowers Healthcare Transformation. - : IOS Press. - 9781614997801 - 9781614997818 ; , s. 205-208
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Konferensbidrag (refereegranskat)abstract
- As healthcare organizations strive to improve quality of care and patient safety, it becomes paramount that they identify patients correctly and match records accurately both within and across institutions. Continuous care and population health benefits can be optimized when providers can have a comprehensive view of a patients health record through seamless health information exchange. Various patient matching techniques have emerged to facilitate accurate patient identification. In this paper, we present a review of existing patient matching techniques, analyzed based on accuracy, cost and execution time.
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