Using Touchscreen Electronic Medical Record Systems to Support and Monitor National Scale-Up of Antiretroviral Therapy in Malawi

Douglas, Gerald P.; Gadabu, Oliver Jintha; Joukes, Sabine; Mumba, Soyapi L.; McKay, Michael; Ben-Smith, Anne; Jahn, Andreas; Schouten, Erik J; Lewis, Zach Landis; Oosterhout, Joep J. van; Allain, Theresa J.; Zachariah, Rony; Berger, Selma Dar; Harries, Anthony; Chimbwandira, Frank

doi:10.1371/journal.pmed.1000319

Cited by 131 publications

(134 citation statements)

References 12 publications

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“…There is no paper-based record system EMR In the clinic, an EMR has been set up in a way similar to those being used in the antiretroviral therapy clinics throughout the country and the diabetic clinics in Blantyre, Zomba and Lilongwe, as previously described. 14,15 These use a touch screen, point-of-care electronic system that has data fields for NCDs and their management. Demographic, clinical and treatment information for the patient is collected during registration and entered in real time into the EMR.…”

Section: Discussionmentioning

confidence: 99%

Managing and monitoring chronic non-communicable diseases in a primary health care clinic, Lilongwe, Malawi

Manjomo

Mwagomba

Adè

et al. 2016

public health action

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KEY WORDS operational research; SORT IT; non-communicable disease; electronic medical record system; Malawi Managing and monitoring chronic non-communicable diseases in a primary health care clinic, Lilongwe, Malawi R. C. Manjomo, 1 B. Mwagomba, 2 S. Ade, 3,4 E. Ali, 5 A. Ben-Smith, 6 P. Khomani, 1 P. Bondwe, 1 D. Nkhoma, 1 G. P. Douglas, 7 K. Tayler-Smith, 5 L. Chikosi, 8 A. D. Harries,3,9 O. J. Gadabu 1 C hronic non-communicable diseases (NCDs) are now the world's leading cause of mortality, with a significant and rapidly growing impact in low-and middle-income countries (LMICs). 1,2 In 2010, there were 34.5 million deaths (two of every three deaths globally) due to NCDs, with cancer, ischaemic heart disease, stroke and diabetes being the predominant causes. 3 Despite the increasing burden of disease and associated mortality, access to prevention, care and treatment remains out of reach for most people in LMICs, and as a result there have been calls for action to improve the situation. 4,5 In September 2011, the United Nations convened a high-level meeting on NCDs, and agreement was reached on a goal to reduce NCD deaths by 25% by 2025 in people aged 30-70 years. 6,7 This was taken forward into the Sustainable Development Goals (SDG), with SDG 3.4 aiming to reduce premature mortality from NCDs by one third by 2030. 8 The targets selected to achieve this goal include reducing elevated blood pressure, smoking cessation, reducing salt intake and increasing physical activity. While there is increasing agreement about the upstream policies required to combat NCDs and reduce NCD mortality, far less is known downstream about how to deliver and monitor quality services for the prevention, care and treatment of chronic disease for the millions of people in need.In LMICs, patients with NCDs are usually managed in tertiary or secondary level hospitals, but there is an urgent and important need to know how to decentralise and integrate the management of NCDs into primary health care and how to monitor the incidence and prevalence of disease, treatment outcomes and associated morbidity and mortality in this setting. A recent study from Kenya reported on the integrated management of patients with hypertension and/or diabetes in a primary health care setting supported by Médecins Sans Frontières (MSF), with encouraging results. 9 There is little information, however, about how this could work at the peripheral level in government settings in other LMICs.In Malawi, a nationwide World Health Organization (WHO) STEPwise approach to Surveillance (STEPS) survey showed that in 2009 respectively 33% and 6% of the population surveyed had hypertension and diabetes mellitus (DM); 10 as a result, a Non-Communicable Diseases Management Unit was established within the Ministry of Health. A national strategy and action plan for NCDs has been developed, including the roll-out of the concept of a 'chronic care clinic'. Currently, most patients with NCDs such as hypertension, DM, asthma and epilepsy are managed in one of the four national te...

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Section: Discussionmentioning

confidence: 99%

Managing and monitoring chronic non-communicable diseases in a primary health care clinic, Lilongwe, Malawi

Manjomo

Mwagomba

Adè

et al. 2016

public health action

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show abstract

“…14,15 In low-and middle-income countries, electronic medical record systems, such as Dream, OpenMRS, Baobab Health (in Malawi) and the ZEPRS antenatal system (in Zambia), are available in some larger specialist hospitals but are rarely available in smaller health centres. [16][17][18][19] The use of picture archiving and communication systems in low-and middle-income countries is, however, increasing rapidly.…”

Section: Systems Facilitating Clinical Practice Examplesmentioning

confidence: 99%

Impacts of e-health on the outcomes of care in low- and middle-income countries: where do we go from here?

Piette

Lun

Moura³

et al. 2012

Bull World Health Org

165

142

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“…The underlying rationale for using this low-cost functionality is that high-performance devices are not required to transmit data. For example, the effects of mobile phone SMS on antiretroviral treatment adherence in Kenya was examined 17,18 . These studies provide empirical evidence that mobile health initiatives can improve HIV treatment outcomes.…”

mentioning

confidence: 99%

Contextual Barriers to Mobile Health Technology in African Countries: A Perspective Piece

O’Connor¹,

Donoghue²

2015

JournalMTM

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Using Touchscreen Electronic Medical Record Systems to Support and Monitor National Scale-Up of Antiretroviral Therapy in Malawi

Abstract: Gerry Douglas and colleagues describe the rationale and their experience with scaling up electronic health records in six antiretroviral treatment sites in Malawi.

Cited by 131 publications

References 12 publications

Managing and monitoring chronic non-communicable diseases in a primary health care clinic, Lilongwe, Malawi

Managing and monitoring chronic non-communicable diseases in a primary health care clinic, Lilongwe, Malawi

Impacts of e-health on the outcomes of care in low- and middle-income countries: where do we go from here?

Contextual Barriers to Mobile Health Technology in African Countries: A Perspective Piece

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