Blaya Joaquin, Fraser Hamish S F
Harvard-MIT Division of Health Sciences and Technology, Cambridge, USA.
AMIA Annu Symp Proc. 2006;2006:41-5.
Partners In Health (PIH) and its sister organization in Lima, Peru, Socios En Salud (SES), treat a majority of multidrug-resistant tuberculosis (MDR-TB) patients in Peru, in conjunction with the Peruvian National TB Program (NTP). Monthly bacteriology tests, which must be collected from health establishments located across this major city, are an integral part of this treatment. Currently, a SES employee visits each health establishment to collect this information by hand, process it and type it into an electronic medical record system (PIH-EMR). In this paper, we describe the development and implementation of a personal digital assistant (PDA)-based electronic system to collect, verify and upload monthly bacteriology data into the PIH-EMR. After an initial implementation period, we performed a pilot study to test the use of this system. We completed a baseline assessment in two health districts and then implemented the electronic system in one of the districts while the control site continued to use the paper-based system during the same period. The PDA-based system had a processing time of 6.2 days, significantly lower than measurements for both the baseline [54.8] and control sites [64.4] (both p<0.0001). It was also able to reduce the frequency of discrepancy from 10.1% to 2.8% (p<0.0001) and receive positive feedback from the users. Finally, the system's cost would be recuperated in three months from time savings due to increased work efficiency. This system will be the subject of a larger study to determine its impact on delays, errors and costs.
健康伙伴组织（PIH）及其在秘鲁利马的姊妹组织——健康伙伴组织（SES），与秘鲁国家结核病项目（NTP）合作，治疗秘鲁大多数耐多药结核病（MDR-TB）患者。每月的细菌学检测是该治疗不可或缺的一部分，这些检测样本必须从这座大城市各地的医疗机构收集。目前，SES的一名员工会走访每个医疗机构，手工收集这些信息，进行处理并录入电子病历系统（PIH-EMR）。在本文中，我们描述了一个基于个人数字助理（PDA）的电子系统的开发与实施情况，该系统用于收集、核实每月细菌学数据并上传至PIH-EMR。在初始实施阶段之后，我们进行了一项试点研究来测试该系统的使用情况。我们在两个健康区完成了基线评估，然后在其中一个区实施了电子系统，而对照站点在同一时期继续使用纸质系统。基于PDA的系统处理时间为６.２天，显著低于基线[54.8天]和对照站点[64.4天]的测量结果（p均<0.0001）。它还能够将差异频率从10.1%降至2.8%（p<0.0001），并获得用户的积极反馈。最后，由于工作效率提高节省了时间，该系统的成本将在三个月内收回。这个系统将成为一项更大规模研究的主题，以确定其对延误、错误和成本的影响。
