Soti David O, Kinoti Stephen N, Omar Ahmeddin H, Logedi John, Mwendwa Teresa K, Hirji Zahra, Ferro Santiago
Division of Health Informatics and Monitoring and Evaluation, Ministry of Health, PO Box 30016-00100, Nairobi, Kenya.
Fio Corporation, Toronto, Canada.
Malar J. 2015 Nov 4;14:430. doi: 10.1186/s12936-015-0965-z.
The cornerstone of decision making aimed at improving health services is accurate and timely health information. The Ministry of Public Health and Sanitation in Kenya decided to pilot feasibility of Fionet, an innovation that integrates diagnostics, data capture and cloud services, in its malaria control programme to demonstrate usability and feasibility by primary level workers in a remote setting in Kenya.
Eleven sites comprising one sub-district hospital, ten health centres and dispensaries were selected in three districts of Kisumu County to participate. Two health workers per site were selected, trained over a two-day period in the use of the Deki Reader™ to undertake rapid diagnostic testing (RDT) for malaria and data capture of patients' records. Health managers in the three districts were trained in the use of Fionet™ portal (web portal to cloud based information) to access the data uploaded by the Deki Readers. Field Support was provided by the Fio Corporation representative in Kenya.
A total of 5812 malaria RDTs were run and uploaded to the cloud database during this implementation research study. Uploaded data were automatically aggregated into predetermined reports for use by service managers and supervisors. The Deki Reader enhanced the performance of the health workers by not only guiding them through processing of a malaria RDT test, but also by doing the automated analysis of the RDT, capturing the image, determining whether the RDT was processed according to guidelines, and capturing full patient data for each patient encounter. Supervisors were able to perform remote Quality assurance/Quality control (QA/QC) activities almost in real time.
Quality, complete and timely data collection by health workers in a remote setting in Kenya is feasible. This paperless innovation brought unprecedented quality control and quality assurance in diagnosis, care and data capture, all in the hands of the health worker at point of care in an integrated way.
旨在改善卫生服务的决策基石是准确及时的卫生信息。肯尼亚公共卫生和环境卫生部决定在其疟疾控制项目中试点Fionet的可行性，Fionet是一项整合诊断、数据采集和云服务的创新技术，以展示肯尼亚偏远地区基层工作人员的可用性和可行性。
在基苏木县的三个区选择了11个地点参与，包括一家分区医院、10个卫生中心和诊疗所。每个地点挑选两名卫生工作者，在为期两天的时间里接受使用Deki Reader™进行疟疾快速诊断检测（RDT）及患者记录数据采集的培训。三个区的卫生管理人员接受了使用Fionet™门户（基于云的信息网络门户）访问Deki Readers上传数据的培训。肯尼亚的Fio公司代表提供现场支持。
在这项实施研究中，共进行了5812次疟疾RDT检测并上传至云数据库。上传的数据会自动汇总成预定报告，供服务经理和主管使用。Deki Reader不仅指导卫生工作者进行疟疾RDT检测，还对RDT进行自动分析、捕捉图像、确定RDT是否按指南进行处理，并为每次患者诊疗采集完整的患者数据，从而提高了卫生工作者的工作效率。主管们几乎能够实时进行远程质量保证/质量控制（QA/QC）活动。
肯尼亚偏远地区的卫生工作者进行高质量、完整且及时的数据收集是可行的。这项无纸化创新在诊断、护理和数据采集方面带来了前所未有的质量控制和质量保证，所有这些都以综合的方式掌握在护理点的卫生工作者手中。
