A digital health registry with clinical decision support for improving quality of antenatal care in Palestine (eRegQual): a pragmatic, cluster-randomised, controlled, superiority trial

Venkateswaran, Mahima; Ghanem, Buthaina; Abbas, Eatimad; Khader, Khadija Abu; Ward, Itimad Abu; Awwad, Tamara; Baniode, Mohammad; Frost, Michael J.; Hijaz, Taghreed; Isbeih, Mervett; Mørkrid, Kjersti; Rose, Christopher James; Frøen, J Frederik

doi:10.1016/s2589-7500(21)00269-7

Cited by 19 publications

(36 citation statements)

References 25 publications

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“…Ao mesmo tempo em que os sistemas de informações possibilitam dados relevantes aos gestores e pesquisadores, estes também demostram limitações relacionadas ao processo de preenchimento correto. A principal limitação está associada ao preenchimento incompleto e/ou errôneo das informações pelos profissionais de saúde ou responsáveis por estes registros (VENKATESWARAN et al, 2022). Além da subnotificação, erros e a falta de indicadores, essas limitações não comprometeram a eficácia das produções.…”

Section: Resultados E Discussõesunclassified

Sistemas De Informação No Âmbito Da Gestão E Assistência Pré-Natal: Revisão Integrativa

PIRES¹,

FERREIRA²,

VIEIRA³

et al. 2022

Anais Do Simpósio De Ensino, Pesquisa E Extensão (SEPE 2022)

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Section: Resultados E Discussõesunclassified

Sistemas De Informação No Âmbito Da Gestão E Assistência Pré-Natal: Revisão Integrativa

PIRES¹,

FERREIRA²,

VIEIRA³

et al. 2022

Anais Do Simpósio De Ensino, Pesquisa E Extensão (SEPE 2022)

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“…All of the studies indicated no negative effects on clinical health outcomes when comparing conventional care to DHI-integrated care. Additionally, these studies reported that the use of DHI integrated care was safe and effective in providing proper care [77,42,60]. Most of the studies stated that digital health technology in ANC either improved healthcare service in general [33,91,68] or improved perinatal outcomes [89,86,73,63,82,76,83,70,59,68,74,75], improved the detection and screening process for high-risk conditions [34,67,70,77,80], and increased access to and utilisation of ANC services [72,37,38,40,42,88,48,50].…”

Section: Clinical Outcomesmentioning

confidence: 98%

“…The DHIs were categorised into two primary groups according to their intended purpose: as a supplementary or substitute to routine care. Among the 61 included studies, 32 ( [77,71,72,23,69,54,55,33,34,36,37,40,92,41,42,43,44,88,45,46,47,70,49,50,51,58,79,57,56].…”

Section: Purpose Of Digital Healthmentioning

confidence: 99%

“…By integrating technology and healthcare, DHIs offer innovative solutions to enhance access, convenience, and effectiveness in managing maternal health. The methodological approaches to examine maternal outcomes included RCTs [77,73,55,76,83,58,59,60,68,74,75], quasi-experimental studies [23,63,34,85], and observational studies [89,86,82,80,42,70]. All of the studies indicated no negative effects on clinical health outcomes when comparing conventional care to DHI-integrated care.…”

Section: Clinical Outcomesmentioning

confidence: 99%

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A Scoping Review of Digital Technologies in Antenatal Care: Recent Progress and Applications of Digital Technologies

Mohamed,

Ismail,

Sutan

et al. 2023

Preprint

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Introduction: Integrating digital health technology into antenatal care has revolutionised patient monitoring, diagnosis, and management. As expectant mothers increasingly embrace social media, the Internet, and smartphone applications, leveraging digital health interventions presents immense potential for enhancing maternal healthcare. Objective This review aims to assess digital health modalities, their applicability, and outcomes in maternal care. Method We conducted a scoping review by searching four electronic databases (Scopus, Web of Science, PubMed, EBSCOhost), performing manual searches of Google Scholar, and examining the references of relevant studies. Eligible studies included original research published in English between 2018 and January 2023 involving the usage of digital health interventions for antenatal care, complying with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping review guidelines. Results A total of 61 eligible articles were identified, where most (n = 37) were conducted in high-income countries such as the US, UK, and Australia. Over the past five years, digital intervention studies motivated by increased telehealth adoption in affluent nations have increased consistently. These interventions primarily encompass patient–provider consultations, remote monitoring, and health education, often supplementing or even replacing in-person visits. Notably, acceptance and satisfaction levels among patients and healthcare providers engaging with digital health interventions were high. The interventions primarily addressed general maternal care (n = 22, 36.06%), mental health issues (n = 7, 11.47%), high-risk pregnancies (n = 5, 8.19%), hypertensive disorders (n = 4, 6.55%), gestational diabetes mellitus (n = 7, 11.47%), antenatal education (n = 5, 8.19%), and gestational weight gain (n = 3, 4.91%). The review findings consistently demonstrated that digital health interventions yielded positive results in effectively managing clinical conditions, improving knowledge, and promoting birth preparedness during the perinatal period. Additionally, these interventions digitally enhanced antenatal care service access and utilisation. Conclusion Digital health is gaining importance in maternal and child care, where patients and healthcare providers demonstrate positive outcomes and high acceptance. Safety and privacy concerns are rarely discussed, but no adverse effects have been reported, and standard care is maintained. The increasing prevalence of digital technologies paves the way for the widespread adoption of digital health in antenatal care, shaping the future of maternal care.

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“…The longitudinal data captured in the eRegistry drive health worker clinical decision support based on national guidelines. Embedded in the implementation was a set of cluster-randomized controlled trials; the eRegQual trial assessed the effectiveness of eRegistry’s clinical decision support versus paper-based client records for improving the quality of antenatal care [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

eRegTime—Time Spent on Health Information Management in Primary Health Care Clinics Using a Digital Health Registry Versus Paper-Based Documentation: Cluster-Randomized Controlled Trial

Venkateswaran¹,

Nazzal²,

Ghanem³

et al. 2022

JMIR Form Res

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Background Digital health interventions have been shown to improve data quality and health services in low- and middle-income countries (LMICs). Nonetheless, in LMICs, systematic assessments of time saved with the use of digital tools are rare. We ran a set of cluster-randomized controlled trials as part of the implementation of a digital maternal and child health registry (eRegistry) in the West Bank, Palestine. Objective In the eRegTime study, we compared time spent on health information management in clinics that use the eRegistry versus the existing paper-based documentation system. Methods Intervention (eRegistry) and control (paper documentation) arms were defined by a stratified random subsample of primary health care clinics from the concurrent eRegQual trial. We used time-motion methodology to collect data on antenatal care service provision. Four observers used handheld tablets to record time-use data during one working day per clinic. We estimated relative time spent on health information management for booking and follow-up visits and on client care using mixed-effects linear regression. Results In total, 22 of the 24 included clinics (12 intervention, 10 control) contributed data; no antenatal care visits occurred in the other two clinics during the study period. A total of 123 and 118 consultations of new pregnancy registrations and follow-up antenatal care visits were observed in the intervention and control groups, respectively. Average time spent on health information management for follow-up antenatal care visits in eRegistry clinics was 5.72 minutes versus 8.10 minutes in control clinics (adjusted relative time 0.69, 95% CI 0.60-0.79; P<.001), and 15.26 minutes versus 18.91 minutes (adjusted relative time 0.96, 95% CI 0.61-1.50; P=.85) for booking visits. The average time spent on documentation, a subcategory of health information management, was 5.50 minutes in eRegistry clinics versus 8.48 minutes in control clinics (adjusted relative time 0.68, 95% CI 0.56-0.83; P<.001). While the average time spent on client care was 5.01 minutes in eRegistry clinics versus 4.91 minutes in control clinics, some uncertainty remains, and the CI was consistent with eRegistry clinics using less, the same, or more time on client care compared to those that use paper (adjusted relative time 0.85, 95% CI 0.64-1.13; P=.27). Conclusions The eRegistry captures digital data at point of care during client consultations and generates automated routine reports based on the clinical data entered. Markedly less time (plausibly a saving of at least 18%) was spent on health information management in eRegistry clinics compared to those that use paper-based documentation. This is likely explained by the fact that the eRegistry requires lesser repetitive documentation work than paper-based systems. Adoption of eRegistry-like systems in comparable settings may save valuable and scarce health care resources. Trial Registration ISRCTN registry ISRCTN18008445; https://doi.org/10.1186/ISRCTN18008445 International Registered Report Identifier (IRRID) RR2-10.2196/13653

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A digital health registry with clinical decision support for improving quality of antenatal care in Palestine (eRegQual): a pragmatic, cluster-randomised, controlled, superiority trial

Cited by 19 publications

References 25 publications

Sistemas De Informação No Âmbito Da Gestão E Assistência Pré-Natal: Revisão Integrativa

Sistemas De Informação No Âmbito Da Gestão E Assistência Pré-Natal: Revisão Integrativa

A Scoping Review of Digital Technologies in Antenatal Care: Recent Progress and Applications of Digital Technologies

eRegTime—Time Spent on Health Information Management in Primary Health Care Clinics Using a Digital Health Registry Versus Paper-Based Documentation: Cluster-Randomized Controlled Trial

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