A new study is one of the first to explore and demonstrate the impact of electronic record systems on quality of medical care in a developing country. This study is conducted by researchers from the Regenstrief Institute and the schools of medicine at Indiana University and Moi University.
In a paper published in the March 2011 issue of the Journal of the American Medical Informatics Association, Martin Chieng Were, M.D., M.S., assistant professor of medicine at the IU School of Medicine and a Regenstrief Institute investigator, and colleagues report that computer-generated reminders about overdue tests yielded nearly a 50 percent increase in the appropriate ordering of CD4 blood tests. CD4 counts are critical to monitoring the health of patients with HIV and guide treatment decisions.
The research evaluating impact of just-in-time clinician support (implemented within electronic medical records) on health care provider behavior and quality of care was conducted in clinics in Eldoret, Kenya. The comparative study, which is one of the first to use computer-generated clinical reminders in sub-Saharan Africa, found that clinical summaries with computer-generated reminders significantly improved clinician adherence to CD4 testing guidelines.
"We need to improve quality of care in the developing world at a time when funding for HIV and other diseases is stagnating or decreasing - which means we will have to do it with fewer personnel as the number of patients increases. Finding innovative ways to improve care within these constraints is critical. This study shows how electronic medical record systems with clinical decision support capabilities can help fill this need," said Dr. Were. In a previous study, Dr. Were and colleagues reported on approaches that can be used to successfully implement computerized clinical decision support systems in resource-limited environments.
The Academic Model Providing Access to Healthcare (AMPATH) clinics in the study employOpenMRS, an open source electronic medical record system widely used in the developing world. AMPATH, which cares for more than 120,000 HIV-infected adults and children at 25 main clinical sites in Western Kenya, is one of Africa's largest, most comprehensive and effective HIV/AIDS control systems.