The Development of an Electronic Medical Record System to Improve Quality of Care for Individuals With Type 1 Diabetes in Rwanda: Qualitative Study.

Q2 Medicine
JMIR Diabetes Pub Date : 2024-09-20 DOI:10.2196/52271
Nathalie Bille, Dirk Lund Christensen, Stine Byberg, Michael Calopietro, Crispin Gishoma, Sarah Fredsted Villadsen
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引用次数: 0

Abstract

Background: Electronic medical record (EMR) systems have the potential to improve the quality of care and clinical outcomes for individuals with chronic and complex diseases. However, studies on the development and use of EMR systems for type 1 (T1) diabetes management in sub-Saharan Africa are few.

Objective: The aim of this study is to analyze the need for improvements in the care processes that can be facilitated by an EMR system and to develop an EMR system for increasing quality of care and clinical outcomes for individuals with T1 diabetes in Rwanda.

Methods: A qualitative, cocreative, and multidisciplinary approach involving local stakeholders, guided by the framework for complex public health interventions, was applied. Participant observation and the patient's personal experiences were used as case studies to understand the clinical care context. A focus group discussion and workshops were conducted to define the features and content of an EMR. The data were analyzed using thematic analysis.

Results: The identified themes related to feature requirements were (1) ease of use, (2) automatic report preparation, (3) clinical decision support tool, (4) data validity, (5) patient follow-up, (6) data protection, and (7) training. The identified themes related to content requirements were (1) treatment regimen, (2) mental health, and (3) socioeconomic and demographic conditions. A theory of change was developed based on the defined feature and content requirements to demonstrate how these requirements could strengthen the quality of care and improve clinical outcomes for people with T1 diabetes.

Conclusions: The EMR system, including its functionalities and content, can be developed through an inclusive and cocreative process, which improves the design phase of the EMR. The development process of the EMR system is replicable, but the solution needs to be customized to the local context.

开发电子病历系统以提高卢旺达 1 型糖尿病患者的护理质量:定性研究。
背景:电子病历(EMR)系统有可能提高慢性复杂疾病患者的护理质量和临床疗效。然而,在撒哈拉以南非洲地区,有关开发和使用电子病历系统管理 1 型糖尿病的研究却很少:本研究的目的是分析改善护理流程的需求,这些流程可通过电子病历系统加以促进,并开发电子病历系统,以提高卢旺达 1 型糖尿病患者的护理质量和临床疗效:方法:在复杂公共卫生干预框架的指导下,采用定性、共同创造和多学科的方法,让当地利益相关者参与其中。参与观察和患者的个人经历被用作案例研究,以了解临床护理背景。通过焦点小组讨论和工作坊,确定了电子病历的特点和内容。采用主题分析法对数据进行了分析:与功能要求相关的主题包括:(1)易用性;(2)自动报告准备;(3)临床决策支持工具;(4)数据有效性;(5)患者随访;(6)数据保护;以及(7)培训。已确定的与内容要求相关的主题是:(1) 治疗方案;(2) 心理健康;(3) 社会经济和人口状况。根据所确定的功能和内容要求,提出了变革理论,以说明这些要求如何能够加强 T1 型糖尿病患者的护理质量并改善临床疗效:医疗记录系统,包括其功能和内容,可以通过一个包容和共同创造的过程来开发,从而改善医疗记录系统的设计阶段。电子病历系统的开发过程是可复制的,但需要根据当地情况定制解决方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
JMIR Diabetes
JMIR Diabetes Computer Science-Computer Science Applications
CiteScore
4.00
自引率
0.00%
发文量
35
审稿时长
16 weeks
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