Improving the management of hypertension and diabetes: An implementation evaluation of an electronic medical record system in Nairobi County, Kenya

Oyugi, Boniface; Makunja, Sostine; Kabuti, Winfred; Nyongesa, Caroline; Schömburg, Martin; Kibe, Victor; Chege, Martha; Gathu, Susan; Wanyee, Steven; Sahal, Mohammed

doi:10.1016/j.ijmedinf.2020.104220

Cited by 7 publications

(14 citation statements)

References 23 publications

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“…For resource limited settings, innovative approaches using solar power(68), cloud-based systems (69), and mobile phone applications(70) for data entry have been developed to support EHRs in the context of intermittent, or non-existent, electricity. These have been successfully applied in Kenya (71), India (72), and other low to middle-income countries (73). They have already demonstrated effectiveness at improving the timing of ART in Kenya (69).…”

Section: Use Of Electronic Decision Support To Prompt and Facilitate ...mentioning

confidence: 99%

Delayed presentation of HIV among older individuals: a growing problem

Justice¹,

Goetz²,

Stewart³

et al. 2022

The Lancet HIV

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Section: Use Of Electronic Decision Support To Prompt and Facilitate ...mentioning

confidence: 99%

Delayed presentation of HIV among older individuals: a growing problem

Justice¹,

Goetz²,

Stewart³

et al. 2022

The Lancet HIV

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“…Many technologies focused on the creation and evaluation of customized clinical decision support tools. The application of these customized clinical decision support tools varied widely in context, including diagnostic support [ 17 , 132 ], antibiotic stewardship [ 36 , 70 ], screening for and management of chronic conditions [ 53 , 91 , 119 ], identifying individuals at risk for varied clinical outcomes [ 50 , 69 , 87 , 118 ].…”

Section: Resultsmentioning

confidence: 99%

“…In this synthesis, we focused on categorizing studies based on the expansion of health informatics design opportunities supported by the (relatively) recent ability to customize EHR interfaces, open APIs that allow developers to directly create new software tools leveraging EHR data, and increasingly accessible platforms for mobile app development. [53,91,119], identifying individuals at risk for varied clinical outcomes [50,69,87,118].…”

Section: Diversity In Technology Typesmentioning

confidence: 99%

Human Factors and Organizational Issues in Health Informatics: Innovations and Opportunities

Marquard

2021

Yearb Med Inform

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Objective: Human factors and ergonomics (HF/E) frameworks and methods are becoming embedded in the health informatics community. There is now broad recognition that health informatics tools must account for the diverse needs, characteristics, and abilities of end users, as well as their context of use. The objective of this review is to synthesize the current nature and scope of HF/E integration into the health informatics community. Methods: Because the focus of this synthesis is on understanding the current integration of the HF/E and health informatics research communities, we manually reviewed all manuscripts published in primary HF/E and health informatics journals during 2020. Results: HF/E-focused health informatics studies included in this synthesis focused heavily on EHR customizations, specifically clinical decision support customizations and customized data displays, and on mobile health innovations. While HF/E methods aimed to jointly improve end user safety, performance, and satisfaction, most HF/E-focused health informatics studies measured only end user satisfaction. Conclusion: HF/E-focused health informatics researchers need to identify and communicate methodological standards specific to health informatics, to better synthesize findings across resource intensive HF/E-focused health informatics studies. Important gaps in the HF/E design and evaluation process should be addressed in future work, including support for technology development platforms and training programs so that health informatics designers are as diverse as end users.

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“…EMRs allow providers to track individual patient clinical progress, but also to efficiently follow patient populations. In Uganda, EMRs have been shown to improve patient retention in HIV, and integrating an EMR into Kenyan health facilities improved hypertension and diabetes care through improved follow-up and standardization of care [ 39 , 40 ]. Novel approaches to building EMRs in low-resource settings is critical, given issues with reliable power and internet connectivity.…”

Section: Discussionmentioning

confidence: 99%

Patient-provider experiences with chronic non-communicable disease care during COVID-19 lockdowns in rural Uganda: A qualitative analysis

Olds,

Nuwagaba,

Obwoya

et al. 2023

PLoS ONE

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Non-communicable diseases (NCDs) are a growing health burden in Sub-Saharan Africa and especially Uganda, where they account for over one third of all deaths. During the COVID-19 pandemic, public health control measures such as societal “lockdowns” had a significant impact on longitudinal NCD care though no studies have looked at the lived experience around NCD care during the pandemic. Our objective was to understand the experience of NCD care for both patients and providers in southwestern Uganda during the COVID-19 pandemic. We conducted in-depth, in-person qualitative interviews with 20 patients living with hypertension, diabetes, and/or cardiac disease purposefully selected from the outpatient clinics at Mbarara Regional Referral Hospital and 11 healthcare providers from public health facilities in Mbarara, southwestern Uganda. We analyzed transcripts according to conventional content analysis. We identified four major themes that emerged from the interviews; (1) difficulty accessing medication; (2) food insecurity; (3) barriers to the delivery of NCD clinical care and (4) alternative forms of care. Pre-existing challenges with NCD care were exacerbated during COVID-19 lockdown periods and care was severely disrupted, leading to worsened patient health and even death. The barriers to care were exacerbations of underlying systemic problems with NCD care delivery that require targeted interventions. Future work should leverage digital health interventions, de-centralizing NCD care, improving follow-up, providing social supports to NCD patients, and rectifying supply chain issues.

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Improving the management of hypertension and diabetes: An implementation evaluation of an electronic medical record system in Nairobi County, Kenya

Cited by 7 publications

References 23 publications

Delayed presentation of HIV among older individuals: a growing problem

Delayed presentation of HIV among older individuals: a growing problem

Human Factors and Organizational Issues in Health Informatics: Innovations and Opportunities

Patient-provider experiences with chronic non-communicable disease care during COVID-19 lockdowns in rural Uganda: A qualitative analysis

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