Kang'a Samuel, Puttkammer Nancy, Wanyee Steven, Kimanga Davies, Madrano Jason, Muthee Veronica, Odawo Patrick, Sharma Anjali, Oluoch Tom, Robinson Katherine, Kwach James, Lober William B
International Training and Education Center for Health (I-TECH), Department of Global Health, University of Washington, USA.
Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), Kenya.
Int J Med Inform. 2017 Jan;97:68-75. doi: 10.1016/j.ijmedinf.2016.09.013. Epub 2016 Sep 23.
Variations in the functionality, content and form of electronic medical record systems (EMRs) challenge national roll-out of these systems as part of a national strategy to monitor HIV response. To enforce the EMRs minimum requirements for delivery of quality HIV services, the Kenya Ministry of Health (MoH) developed EMRs standards and guidelines. The standards guided the recommendation of EMRs that met a preset threshold for national roll-out.
Using a standards-based checklist, six review teams formed by the MoH EMRs Technical Working Group rated a total of 17 unique EMRs in 28 heath facilities selected by individual owners for their optimal EMR implementation. EMRs with an aggregate score of ≥60% against checklist criteria were identified by the MoH as suitable for upgrading and rollout to Kenyan public health facilities.
In Kenya, existing EMRs scored highly in health information and reporting (mean score=71.8%), followed by security, system features, core clinical information, and order entry criteria (mean score=58.1%-55.9%), and lowest against clinical decision support (mean score=17.6%) and interoperability criteria (mean score=14.3%). Four EMRs met the 60.0% threshold: OpenMRS, IQ-Care, C-PAD and Funsoft. On the basis of the review, the MoH provided EMRs upgrade plans to owners of all the 17 systems reviewed.
The standards-based review in Kenya represents an effort to determine level of conformance to the EMRs standards and prioritize EMRs for enhancement and rollout. The results support concentrated use of resources towards development of the four recommended EMRs. Further review should be conducted to determine the effect of the EMR-specific upgrade plans on the other 13 EMRs that participated in the review exercise.
电子病历系统（EMR）在功能、内容和形式上的差异，对这些系统作为国家监测艾滋病应对策略一部分的全国推广构成挑战。为了强制实施电子病历系统在提供优质艾滋病服务方面的最低要求，肯尼亚卫生部（MoH）制定了电子病历系统标准和指南。这些标准指导了对符合国家推广预设门槛的电子病历系统的推荐。
由卫生部电子病历技术工作组组建的六个审查小组，使用基于标准的清单，对个体业主选择的28个卫生设施中总共17个独特的电子病历系统进行了最佳电子病历实施情况评级。卫生部确定，在清单标准方面总分≥60%的电子病历系统适合升级并推广到肯尼亚的公共卫生设施。
在肯尼亚，现有电子病历系统在健康信息和报告方面得分较高（平均得分=71.8%），其次是安全性、系统功能、核心临床信息和医嘱录入标准（平均得分=58.1%-55.9%），而在临床决策支持（平均得分=17.6%）和互操作性标准方面得分最低（平均得分=14.3%）。四个电子病历系统达到了60.0%的门槛：OpenMRS、IQ-Care、C-PAD和Funsoft。基于审查结果，卫生部向所有接受审查的17个系统的业主提供了电子病历系统升级计划。
肯尼亚基于标准的审查是为了确定符合电子病历系统标准的程度，并对电子病历系统进行强化和推广的优先级排序。结果支持集中资源用于开发四个推荐的电子病历系统。应进行进一步审查，以确定特定电子病历系统升级计划对参与审查的其他13个电子病历系统的影响。
