Assessing the implementation of a mobile App‑based electronic health record: A mixed‑method study from South India
نویسندگان
1 Department of Community Medicine, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangalore, Karnataka
2 Karuna Trust, Bengaluru, The Union South‑East Asia Office, New Delhi, India, International Union Against Tuberculosis and Lung Diseases (The Union), Paris, France
3 Karuna Trust, Bengaluru
4 Karuna Trust, Bengaluru
doi
چکیده
BACKGROUND: Government of India recognizes the use of “information, communication, andtechnology” in the provision of comprehensive primary healthcare. In 2014–2015, Karuna Trust,a nongovernmental organization, Bengaluru, India, introduced an electronic health record (EHR)innovation, namely “Comprehensive Public Health Management” application (CPHM App). Datacould be entered in an offline mode followed by syncing with cloud. The CPHM App was piloted inprimary health center (PHC) Gumballi, in Karnataka, with focus on household survey and maternaland child health (MCH) services.OBJECTIVES: To compare the consistency of selected MCH process indicators for HealthManagement Information System [HMIS] available from paper‑based records and those generatedthrough the CPHM App (2016–2017). We also explored the implementation enablers, barriers, andsuggested solutions from the user perspective.METHODS: A sequential mixed‑method study design was followed. Quantitative phase involvedaggregate data analysis looking into the consistency of selected MCH process indicators availablefrom paper‑based records and those generated through the CPHM App (2016–2017) followed bythematic analysis of in‑depth interviews of healthcare providers. Consistency was defined as apercentage where the numerator was the HMIS‑related process indicator data from CPHM App anddenominator was the data from paper‑based records.RESULTS: Three out of 12 selected MCH indicators had consistency of >80%. The quarterlyconsistency reduced over the 2 years. Dual burden of entry and regular monitoring of paper‑basedrecords by district health and family welfare department were the reasons why more importance wasgiven to entry in paper‑based records. Ability to generate aggregate indicators with CPHM App, easyto use and retrieve data in the field, and reminder facility for planned health activities were someof the factors facilitating CPHM implementation. The key barriers were limited technical expertiseand support from the technical team and no internet connectivity in the field and traveling to PHCto sync the data. Provision of real‑time technical support and availability of data connectivity in thefield were some of the solutions suggested.CONCLUSION: There should be a minimum of 1–2 years of simultaneous use of EHR andpaper‑based records after which one must shift to EHR.
