The impact of routine data quality assessments on electronic medical record data quality in Kenya

Muthee, Veronica; Bochner, Aaron F.; Osterman, Allison; Liku, Nzisa; Akhwale, Willis; Kwach, James; Prachi, Mehta; Wamicwe, Joyce; Odhiambo, Jacob; Onyango, Fredrick; Puttkammer, Nancy

doi:10.1371/journal.pone.0195362

Cited by 48 publications

(60 citation statements)

References 34 publications

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“…Improvement in data accuracy observed from these assessments implies that the regular data quality assessments may have contributed positively to data accuracy and is consistent with ndings from repeated data quality audits conducted elsewhere [17][18][19]. Other contributors to improved data accuracy could be regular supportive supervision and shift to electronic reporting that were introduced simultaneously with the DQA.…”

Section: Discussionsupporting

confidence: 73%

Institutionalized Data Quality Assessments: A Critical Pathway to Improving the Accuracy of Integrated Disease Surveillance Data in Sierra Leone

Njuguna¹,

Vandi²,

Mugagga

et al. 2020

Preprint

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Background Public health agencies require valid, timely and complete health information for early detection of outbreaks. Towards the end of the Ebola Virus Disease (EVD) outbreak in 2015, the Ministry of Health and Sanitation (MoHS), Sierra Leone revitalized the Integrated Disease Surveillance and Response System (IDSR). Data quality assessments were conducted to monitor accuracy of IDSR data. Methods Starting 2016, data quality assessments (DQA) were conducted in randomly selected health facilities. Structured electronic checklist was used to interview district health management teams (DHMT) and health facility staff. We used malaria data, to assess data accuracy, as malaria was endemic in Sierra Leone. Verification factors (VF) calculated as the ratio of confirmed malaria cases recorded in health facility registers to the number of malaria cases in the national health information database, were used to assess data accuracy. Allowing a 5% margin of error, VF <95% were considered over reporting while VF >105 was underreporting. Differences in the proportion of accurate reports at baseline and subsequent assessments were compared using Z-test for two proportions. Results: Between 2016 -2018, four DQA were conducted in 444 health facilities where 1,729 IDSR reports were reviewed. Registers and IDSR technical guidelines were available in health facilities and health care workers were conversant with reporting requirements. Overall data accuracy improved from over- reporting of 4.7% (VF 95.3%) in 2016 to under-reporting of 0.2% (VF 100.2%) in 2018. Compared to 2016, proportion of accurate IDSR reports increased by 14.8 % (95% CI 7.2%, 22.3%) in May 2017 and 19.5% (95% CI 12.5% -26.5%) by 2018. Over reporting was more common in private clinics and not- for profit facilities while under-reporting was more common in lower level government health facilities. Leading reasons for data discrepancies included counting errors in 358 (80.6%) health facilities and missing source documents in 47 (10.6%) health facilities. Conclusion This is the first attempt to institutionalize routine monitoring of IDSR data quality in Sierra Leone. Regular data quality assessments may have contributed to improved data accuracy over time. Data compilation errors accounted for most discrepancies and should be minimized to improve accuracy of IDSR data.

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Section: Discussionsupporting

confidence: 73%

Institutionalized Data Quality Assessments: A Critical Pathway to Improving the Accuracy of Integrated Disease Surveillance Data in Sierra Leone

Njuguna¹,

Vandi²,

Mugagga

et al. 2020

Preprint

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“…The few attempts to measure antibiotic use in primary care in LMICs have relied on reviews of prescription and sales records, simulated clients or observed encounters 7. The use of routine data to measure and improve quality of primary healthcare delivery, while common in high-income countries,32 is rare in LMICs 20. The Guidelines Adherence in Slums Project has pioneered the use of rubber stamp templates and smartphones to deliver routine data on primary care delivery in low-resource settings.…”

Section: Discussionmentioning

confidence: 99%

“…While computer-based electronic medical record (EMR) systems are used to provide routine data on clinical care in high-income countries, paper is still a commonly used interface for documentation in LMICs 18. Besides the challenges of implementing EMR systems in low-resource settings,19 little is known about the quality of data entered into electronic systems in LMIC contexts 20. The recent revolution in access to mobile technologies provides a great opportunity to reach and support frontline health workers in LMICs 21.…”

Section: Introductionmentioning

confidence: 99%

Using rubber stamps and mobile phones to help understand and change antibiotic prescribing behaviour in private sector primary healthcare clinics in Kenya

et al. 2019

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BackgroundAntibiotic use in primary care can drive antimicrobial resistance (AMR) in the community. However, our understanding of antibiotic prescribing in low- and middle-income countries (LMICs) stems mostly from hospital-based studies or prescription/sales records, with little information available on routine primary care practices. We used an innovative, paper-to-digital documentation approach to deliver routine data and understand antibiotic use for common infections in low-resource primary healthcare clinics (PHCs).MethodsRubber stamps were introduced in nine private sector PHCs serving Nairobi’s informal settlements to ‘print-on-demand’ clinical documentation templates into paper charts. The intervention included one mobile phone per PHC to take and share images of filled templates, guideline compilation booklets and monthly continuing medical education (CME) sessions. Templates for upper respiratory tract (URTI), urinary tract (UTI), sexually transmitted (STI) and gastrointestinal infection (GI) management were used in eight PHCs. Information in templates from 889 patient encounters was digitised from smartphone images, analysed, and fed back to clinicians during monthly CME sessions. UTI charts (n=130 and 96, respectively) were audited preintervention and postintervention for quality of clinical documentation and management.ResultsAntibiotics were prescribed in 94.3%±1.6% of all patient encounters (97.3% in URTI, 94.2% in UTI, 91.6% in STI and 91.3% in GI), with 1.4±0.4 antibiotics prescribed per encounter. Clinicians considered antibiotic use appropriate in only 58.6% of URTI and 47.2% of GI cases. While feedback did not affect the number of antibiotics prescribed for UTIs, the use of nitrofurantoin, an appropriate, narrow-spectrum antibiotic, increased (9.2% to 29.9%; p<0.0001) and use of broad spectrum quinolones decreased (30.0% to 16.1%; p<0.05).ConclusionAntibiotic use for common infections is high in private sector PHCs in Kenya, with both knowledge and ‘know-do’ gaps contributing to inappropriate prescription. Paper-based templates in combination with smartphone technologies can sustainably deliver routine primary care case management data to support the battle against AMR.

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“…EMR is efficient because it provides many features and supports the use of WSN. EMR is defined as a one-organization system [39]. Currently, most Australian professionals use an EMR, which is rated similarly in several countries such as Germany, New Zealand, and the Netherlands [40].…”

Section: Overview Of Techniques Used In Reisch • Electronic Medical Rmentioning

confidence: 99%

REISCH: Incorporating Lightweight and Reliable Algorithms into Healthcare Applications of WSNs

Al-Zubaidie

Zhang

2020

Applied Sciences

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Healthcare institutions require advanced technology to collect patients’ data accurately and continuously. The tradition technologies still suffer from two problems: performance and security efficiency. The existing research has serious drawbacks when using public-key mechanisms such as digital signature algorithms. In this paper, we propose Reliable and Efficient Integrity Scheme for Data Collection in HWSN (REISCH) to alleviate these problems by using secure and lightweight signature algorithms. The results of the performance analysis indicate that our scheme provides high efficiency in data integration between sensors and server (saves more than 24% of alive sensors compared to traditional algorithms). Additionally, we use Automated Validation of Internet Security Protocols and Applications (AVISPA) to validate the security procedures in our scheme. Security analysis results confirm that REISCH is safe against some well-known attacks.

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The impact of routine data quality assessments on electronic medical record data quality in Kenya

Cited by 48 publications

References 34 publications

Institutionalized Data Quality Assessments: A Critical Pathway to Improving the Accuracy of Integrated Disease Surveillance Data in Sierra Leone

Institutionalized Data Quality Assessments: A Critical Pathway to Improving the Accuracy of Integrated Disease Surveillance Data in Sierra Leone

Using rubber stamps and mobile phones to help understand and change antibiotic prescribing behaviour in private sector primary healthcare clinics in Kenya

REISCH: Incorporating Lightweight and Reliable Algorithms into Healthcare Applications of WSNs

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