Appl Clin Inform. 2013 Jan 23;4(1):25-36. doi: 10.4338/ACI-2012-10-RA-0044. Print 2013.
There are problems of quality in maternity services at primary health care level in South Africa. Many of these problems can be traced to non-adherence to the maternity care guidelines and lack of tools to support clinic staff and managers in their roles.
The aim of this research was to investigate the utility of e-health (computerized) decision support systems at addressing the problem of compliance of health workers to the maternity care guidelines at primary health care in South Africa. At present there are no documented studies on e-health clinical decision support systems for primary health care in South Africa, though clinical decision support systems for primary health care are listed as part of the e-health strategy of the National Department of Health.
An e-health decision support system named the Bacis (Basic Antenatal Care Information System) Program was developed, then implemented and evaluated at a primary health care clinic. The duration of the study was two years: this includes development, implementation and evaluation.
There was an overall improvement in compliance from 85.1 % to 89.3%. This result was not statistically significant. However when results were stratified into specific categories, the Bacis Program showed statistically significant improvement in compliance over the checklist system in three out of nine important categories. These are compliance at booking, patients younger than 18 years and patients booking after week 20. Further, insights and experience were also gained on development and implementation of clinical information systems at resource strained environments such as primary health care in South Africa. These results, insights and experience are invaluable for the implementation of the proposed e-health strategy in South Africa.
南非初级卫生保健水平的孕产妇服务存在质量问题。这些问题中的许多都可以追溯到不遵守孕产妇保健指南以及缺乏工具来支持诊所工作人员和管理人员履行职责。
本研究旨在探讨电子健康（计算机化）决策支持系统在解决南非初级卫生保健保健工作者遵守孕产妇保健指南方面的应用。目前，南非没有关于电子卫生临床决策支持系统用于初级卫生保健的记录研究，尽管初级卫生保健临床决策支持系统被列为国家卫生部电子卫生战略的一部分。
开发了一种名为 Bacis（基础产前保健信息系统）的电子健康决策支持系统，然后在一家初级卫生保健诊所进行实施和评估。研究的持续时间为两年：包括开发、实施和评估。
总体依从率从 85.1%提高到 89.3%。这一结果没有统计学意义。然而，当结果按特定类别分层时，Bacis 程序在九个重要类别中的三个方面显示出与清单系统相比具有统计学意义的依从性提高。这三个类别分别是在登记时、年龄在 18 岁以下的患者和登记后 20 周的患者。此外，在资源紧张的环境（如南非的初级卫生保健）中开发和实施临床信息系统方面也获得了见解和经验。这些结果、见解和经验对于在南非实施拟议的电子卫生战略非常宝贵。
