Implementing Electronic Surgical Registries in Lower-Middle Income
                        Countries: Experiences in Latin America

Dasari, Mohini; Asturias, Sabrina; Garbett, Marcelo; Zargaran, Eiman; Machaín, Gustavo M.; Hameed, Morad; Puyana, Juan Carlos

doi:10.1016/j.aogh.2016.09.007

Cited by 7 publications

(23 citation statements)

References 9 publications

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“…The data software included Research Electronic Data Capture (REDCap) used by three hospitals [15][16][17]; four further studies used unspecified apps, two of which were hosted in the United States of America (USA), where the principal investigators were located [18][19][20][21], one used FILE MAKER Pro [22], and the remaining two registries used locally designed software [23,24]. The databases were located outside the nations where the data collection was conducted in four sites, mainly in the USA and the remaining sites used local storage [18,19]. Researchers with specific registry objectives typically initiated implementation efforts (n = 10) [15][16][17][18][19][22][23][24][25][26].…”

Section: Resultsmentioning

confidence: 99%

“…The databases were located outside the nations where the data collection was conducted in four sites, mainly in the USA and the remaining sites used local storage [18,19]. Researchers with specific registry objectives typically initiated implementation efforts (n = 10) [15][16][17][18][19][22][23][24][25][26]. Details of the included studies are shown in Table 1.…”

Section: Resultsmentioning

confidence: 99%

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Indications, Challenges, and Characteristics of Successful Implementation of Perioperative Registries in Low Resource Settings: A Systematic Review

et al. 2023

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Perioperative registries can be utilised to track outcomes, develop risk prediction models, and make evidence-based decisions and interventions. To better understand and support initiatives to establish clinical registries, this study aimed to assess the indications, challenges, and characteristics of successful perioperative registries in low-resource settings, where there is unmet surgical demand and patients have a mortality rate up to double that of high-income countries. We conducted a librarian-assisted literature search of international research databases of articles published between January 1969 and January 2021. Studies were filtered using predefined criteria and responses to two Mixed Method Appraisal Tool screening questions. A Direct Content Analysis Method was used to synthesis. e data for eligible studies based on predefined criteria. The search identified 2793 abstracts. After removing duplicates and excluding studies that did not meet eligibility criteria, twelve studies were included, conducted in South America (n = 4), Africa (n = 5), the Middle East (n = 2), and Asia (n = 1). The lack of context-specific data for determining and evaluating patient outcomes (n = 7) was the major indication for implementation. Organising local research teams and engaging stakeholders in the host country were associated with successful implementation. Inadequate funding for data collectors and monitoring data quality were identified as challenges (n = 4). The goal of a perioperative registry is to generate data to influence and support quality improvement, and national surgical policies. Efforts to establish perioperative registries in low- and middle-income countries should engage local teams and stakeholders and seek to overcome challenges in data collection and monitoring.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Indications, Challenges, and Characteristics of Successful Implementation of Perioperative Registries in Low Resource Settings: A Systematic Review

et al. 2023

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“…The main barrier identi ed was related to the transition of information from paper to an electronic record. Guatemalan investigators considered that medical errors could increase the cost of care and analysis of appropriate medical data can improve the patient's care [17].…”

Section: A Summary Of Existing Trauma Data Collection Efforts In Latimentioning

confidence: 99%

“…The main barriers to implementing this project related to the lack of hospital WiFi connectivity, required for the operation of the electronic data collection tool. Additionally, equipment safety and theft presented barriers to EHR implementation [17,18].…”

Section: A Summary Of Existing Trauma Data Collection Efforts In Latimentioning

confidence: 99%

A Consensus Statement for Trauma Surgery Capacity Building in Latin America

Dasari

Johnson

Montenegro

et al. 2021

Preprint

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Background: Trauma is a significant public health problem in Latin America (L.A.), contributing to substantial death and disability in the region. Several LA countries have implemented trauma registries and injury surveillance systems. However, the region lacks an integrated trauma system. The consensus conference's goal was to integrate existing L.A. trauma data collection efforts into a regional trauma program and encourage the use of the data to inform health policy.Methods: We created a consensus group of 25 experts in trauma and emergency care with previous data collection and injury surveillance experience in the L.A. region. Experts participated in a consensus conference to discuss the state of trauma data collection in L.A. We utilized the Delphi method to build consensus around strategic steps for trauma data management in the region. Consensus was defined as the agreement of ≥ 70% among the expert panel. Results: The consensus conference determined that action was necessary from academic bodies, scientific societies, and ministries of health to encourage a culture of collection and use of health data in trauma. The panel developed a set of recommendations for these groups to encourage the development and use of robust trauma information systems in L.A. Consensus was achieved in one Delphi round.Conclusions: The expert group successfully reached a consensus on recommendations to key stakeholders in trauma information systems in L.A. These recommendations may be used to encourage capacity-building in trauma research and trauma health policy in the region.

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“…Guatemala does not have a national universal health coverage policy or strategy, and it also lacks a national eHealth policy or strategy. EMR adoption in Latin America, including Guatemala, has been sparse, with only one example in the literature of an emergency surgery registry implemented in an urban hospital in Guatemala City [22]. However, after a one-year pilot in 2017 this registry was ultimately not adopted secondary to lack of optimization for hospital workflow, insufficient number of devices, and lack of end-user training.…”

Section: Emr Adoption In Guatemalamentioning

confidence: 99%

A Case Study of a Point-of-Care Electronic Medical Record [SABER] in Totonicapán, Guatemala: Benefits, Challenges, and Future Directions

Aldredge

Rodriguez²,

González³

et al. 2020

Annals of Global Health

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Background: The adoption of electronic medical records (EMRs) in lower-income nations has progressed slowly due to the lack of adequate infrastructure, funding, and training. However, EMRs have been successfully implemented previously in resource-limited health systems in South Africa, Haiti, Cameroon, Kenya, and Peru. Detailed, organized, and easily accessible medical records are particularly important in emergency departments due to the volume and acuity of the patient population. Methods: In order to further study the plausibility of an EMR in a resource-limited emergency department, a web-based, Spanish-language EMR known as SABER was developed for use in Hospital Nacional José Felipe Flores in Totonicapán, Guatemala. The software collects patient data including demographics, triage, initial evaluation, review of systems, physical exam, and evaluation and plan. It then generates a .pdf file consistent with information requirements of the Guatemalan Ministry of Health. Local physicians, medical students, and nurses were trained in the use of the software, which debuted in July 2016. To assess the effectiveness of SABER as an EMR, focus groups and Likert scale surveys were conducted with six physicians and 31 medical students working in the Hospital Nacional emergency department. Results: Thirty of 32 medical students and six of six doctors would recommend SABER to another provider. Positive aspects identified by staff include ease of use, quick data entry, and the potential for large data set research. Discussion: Remaining challenges include incorporating electronic nursing orders and lab results, troubleshooting technology problems including printer difficulties, a lack of electronic signature capability, and lack of integration with the rest of the hospital. Our study is consistent with other studies that show use of an EMR may help to reduce health disparities through improved patient records, medical data collection, and organization.

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Implementing Electronic Surgical Registries in Lower-Middle Income Countries: Experiences in Latin America

Cited by 7 publications

References 9 publications

Indications, Challenges, and Characteristics of Successful Implementation of Perioperative Registries in Low Resource Settings: A Systematic Review

Indications, Challenges, and Characteristics of Successful Implementation of Perioperative Registries in Low Resource Settings: A Systematic Review

A Consensus Statement for Trauma Surgery Capacity Building in Latin America

A Case Study of a Point-of-Care Electronic Medical Record [SABER] in Totonicapán, Guatemala: Benefits, Challenges, and Future Directions

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