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The goal of the PartoPen system is to enhance the partograph, a paper-based labor monitoring tool intended to promote timely delivery of quality care by birth attendants in developing countries. The PartoPen digital pen hardware and software system supports partograph use by providing audio instructions for measuring and recording labor progress indicators, real-time decision support based on recorded measurements, and time-based patient-specific reminders for taking measurements. Earlier work found the PartoPen system effective in nursing classrooms at the University of Nairobi (UoN), Kenya where the PartoPen was used to support teaching and training of students in maternal labor monitoring procedures. This paper presents the results of several follow-on studies conducted in the maternity ward of Kenyatta National Hospital (KNH) in Nairobi. Through these studies, we successively refine our understanding of the benefits of PartoPen use in this setting. We also identify and discuss the interrelated factors impacting PartoPen adoption and use in the labor ward at KNH, and review the challenges and opportunities likely to face digital pen deployments in other healthcare settings.

Problem Traditional medical school curricula lack specific training on caring for individuals experiencing homelessness, and the literature suggests that medical students’ attitudes toward these individuals become increasingly negative during medical school. Approach To increase discharge planning support for individuals experiencing homelessness, the Homeless Hospital Liaison (HHL) program was developed at the University Medical Center New Orleans in January 2017–May 2017. Student liaisons are recruited from all 4 years of medical school and a graduate-level social work program. Liaisons administer a social needs questionnaire to assess patients’ connections to services and identify gaps in care, coordinate with hospital social workers to avoid duplicating work, coordinate with the medical team, help patients complete any needed documentation or applications for social benefits, provide patients with referrals to outpatient resources, and provide patients assistance with a variety of basic needs. Outcomes As of December 2017, HHL has trained 70 students (65 medical students and 5 social work students) to serve as liaisons and has enrolled 99 patients. For the majority of these patients, student liaisons were able to facilitate successful referrals to community-based services. Next Steps Future directions of the HHL program include developing a formal, staffed consult service at the hospital (e.g., the HHL program was awarded hospital funding for 2 full-time staff in the summer of 2019, which will increase the HHL’s capacity); assessing the program’s effect on student knowledge, attitudes, and proficiency related to individuals experiencing homelessness and/or interprofessional collaboration; and assessing the impact of the program on patients’ experiences.