Miyazaki Kazuki, Nozaki Ikuma, Tojo Bumpei, Moji Kazuhiko
Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan.
School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan.
Glob Health Med. 2020 Aug 31;2(4):247-254. doi: 10.35772/ghm.2020.01020.
Myanmar has launched an advanced tuberculosis examination policy, which involves specimen exchanges among clinics and referral laboratories. However, with the current paper-based operation, it is difficult to trace information accurately. Therefore, since April 2017, we introduced a pilot operation consisting of an electronic health information system (HIS) that uses QR codes for data sharing in the tuberculosis laboratory at seven facilities. This study aimed to assess the feasibility of introducing the electronic HIS into tuberculosis clinics and laboratories based on staff perception, workload and workflow, and data accuracy, and to clarify its advantages and disadvantages. The analysis was descriptive, and it involved a semi-structured interview for the staff, workflow observations to evaluate the workload and describe the change in workflow, and evaluation of the data accuracy by comparing the numbers yielded by the paper-based and HIS-based reports. The HIS was positively accepted as it improved work efficiency, while the operation still depended on paper-based reports. Parallel data registration using both paper-based and HIS-based reports increased the workload. Data discrepancies were found when comparing the paper-based and HIS-based reports, and these discrepancies were not directly attributed to the HIS introduction but individual factors. Crucial facilitating factors of the HIS were its operability and user-friendliness, because it does not require specific training. The additional workload translates into the need for additional human resources, and the parallel data registration remains a challenge. However, we consider that these challenges could be overcome as coverage of the HIS expands.
缅甸已推出一项先进的结核病检查政策，其中涉及诊所与转诊实验室之间的样本交换。然而，在当前基于纸质文件的操作模式下，准确追踪信息十分困难。因此，自2017年4月起，我们开展了一项试点工作，引入了一个电子健康信息系统（医院信息系统，HIS），该系统在七家机构的结核病实验室中使用二维码进行数据共享。本研究旨在基于工作人员的认知、工作量和工作流程以及数据准确性，评估将电子医院信息系统引入结核病诊所和实验室的可行性，并阐明其优缺点。分析采用描述性方法，包括对工作人员进行半结构化访谈、观察工作流程以评估工作量并描述工作流程的变化，以及通过比较纸质报告和基于医院信息系统的报告所产生的数据数量来评估数据准确性。医院信息系统因其提高了工作效率而得到了积极认可，但其操作仍依赖纸质报告。同时使用纸质报告和基于医院信息系统的报告进行并行数据登记增加了工作量。在比较纸质报告和基于医院信息系统的报告时发现了数据差异，这些差异并非直接归因于引入医院信息系统，而是个体因素所致。医院信息系统的关键促进因素在于其可操作性和用户友好性，因为它不需要专门培训。额外的工作量意味着需要额外的人力资源，并行数据登记仍然是一项挑战。然而，我们认为随着医院信息系统覆盖范围的扩大，这些挑战是可以克服的。
