School of Industrial Engineering, Purdue University, West Lafayette, IN, 47907, USA.
Health Economic and Decision Sciences, Merck & Co., Inc., Kenilworth, NJ, 07033, USA.
BMC Med Inform Decis Mak. 2022 Sep 12;22(1):239. doi: 10.1186/s12911-022-01982-8.
Thirteen essential maternal child health (MCH) commodities, identified by the UN Commission on Life-Saving Commodities for Women and Children, could save the lives of more than 6 million women and children in Low-and-Middle-Income Countries (LMICs) if made available at the point of care. To reduce stockout of those commodities and improve the health supply chains in LMICs, the Electronic TRAcking system for healthcare commodities (E+TRA Health), an all-in-one out-of-box solution, was developed to track and manage medical commodities at lower-level health facilities in rural areas. It aims to support real-time monitoring and decision-making to (1) reduce the time needed to prepare orders, (2) reduce stockout and overstock cases of targeted medical supplies, (3) help improve patient outcomes. In this study, we adopted an integrated approach to analyze the process of information flow, identify and address critical paths of essential supplies associated with maternal health in the Ugandan health system.
We apply system engineering principles and work with community partners in hospitals to develop care process workflow charts (based on essential services) for the lifecycle of maternal health continuum of care. Based on this chart, we develop a cloud-based offline-compatible smart sync platform named "E+TRA Health" to triangulate (1) patient admission, diagnoses, delivery information, testing reports from laboratories, (2) inventory information from main store, stores in MCH unit, and (3) lab, to identify the critical list of medical and laboratory supplies, their lead times for procurement and then generate reports and suggested procurement plans for real time decision-making.
The E+TRA Health platform was piloted in two Healthcare Center IV facilities in Uganda over a period of 6 months. The system collected more than 5000 patient records and managed more than 500 types of medicines. The pilot study demonstrated the functionalities of E+TRA Health and its feasibility to sense demand from point of care.
E+TRA Health is the first to triangulate supply and demand data from three different departments (main store, lab, and MCH) to forecast and generate orders automatically to meet patient demands. It is capable of generating reports required by Ministry of Health in real time compared to one-week lead-time using paper-based systems. This prompts frontline stakeholders to generate efficient, reliable and sustainable strategic healthcare plans with real time data. This system improves patient outcomes through better commodity availability by sensing true patient demands.
联合国妇女儿童生存委员会确定了 13 项基本母婴保健（MCH）商品，如果在护理点提供这些商品，将能够拯救中低收入国家（LMICs）的 600 多万名妇女和儿童的生命。为了减少这些商品的缺货情况并改善 LMICs 的卫生供应链，开发了电子医疗商品追踪系统（E+TRA Health），这是一种集大成的即用型解决方案，旨在追踪和管理农村地区基层卫生设施的医疗商品。它旨在支持实时监测和决策，以（1）减少准备订单所需的时间，（2）减少目标医疗用品的缺货和积压情况，（3）帮助改善患者的治疗效果。在这项研究中，我们采用综合方法来分析信息流过程，确定并解决乌干达卫生系统中与母婴健康相关的基本供应的关键路径。
我们应用系统工程原理，并与医院的社区合作伙伴合作，根据母婴保健的基本服务，开发了母婴保健服务的生命周期的护理流程工作图表。基于该图表，我们开发了一个名为“E+TRA Health”的基于云的离线兼容智能同步平台，用于三角测量（1）患者入院、诊断、分娩信息、实验室检测报告，（2）主库存、MCH 单元存储库和（3）实验室的库存信息，以确定关键的医疗和实验室用品清单、采购的前置时间，然后生成报告和建议的采购计划，以进行实时决策。
E+TRA Health 平台在乌干达的两个医疗中心 IV 设施中进行了为期 6 个月的试点。该系统收集了超过 5000 名患者的记录，并管理了 500 多种药品。试点研究展示了 E+TRA Health 的功能及其从护理点感知需求的可行性。
E+TRA Health 是第一个从三个不同部门（主库、实验室和 MCH）三角测量供应和需求数据，以预测和自动生成订单，以满足患者的需求。与使用纸质系统需要一周的前置时间相比，它能够实时生成卫生部要求的报告。这促使一线利益相关者使用实时数据制定高效、可靠和可持续的战略医疗计划。通过感知真实的患者需求，该系统通过提高商品的可获得性来改善患者的治疗效果。
