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Evaluating a scalable model for implementing electronic health records in resource-limited settings.


ABSTRACT: Current models for implementing electronic health records (EHRs) in resource-limited settings may not be scalable because they fail to address human-resource and cost constraints. This paper describes an implementation model which relies on shared responsibility between local sites and an external three-pronged support infrastructure consisting of: (1) a national technical expertise center, (2) an implementer's community, and (3) a developer's community. This model was used to implement an open-source EHR in three Ugandan HIV-clinics. Pre-post time-motion study at one site revealed that Primary Care Providers spent a third less time in direct and indirect care of patients (p<0.001) and 40% more time on personal activities (p=0.09) after EHRs implementation. Time spent by previously enrolled patients with non-clinician staff fell by half (p=0.004) and with pharmacy by 63% (p<0.001). Surveyed providers were highly satisfied with the EHRs and its support infrastructure. This model offers a viable approach for broadly implementing EHRs in resource-limited settings.

SUBMITTER: Were MC 

PROVIDER: S-EPMC2995711 | biostudies-literature | 2010 May-Jun

REPOSITORIES: biostudies-literature

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Evaluating a scalable model for implementing electronic health records in resource-limited settings.

Were Martin C MC   Emenyonu Nneka N   Achieng Marion M   Shen Changyu C   Ssali John J   Masaba John P M JP   Tierney William M WM  

Journal of the American Medical Informatics Association : JAMIA 20100501 3


Current models for implementing electronic health records (EHRs) in resource-limited settings may not be scalable because they fail to address human-resource and cost constraints. This paper describes an implementation model which relies on shared responsibility between local sites and an external three-pronged support infrastructure consisting of: (1) a national technical expertise center, (2) an implementer's community, and (3) a developer's community. This model was used to implement an open-  ...[more]

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