Document Type : Original Article
Authors
1 Karuna Trust, Bengaluru
2 Department of Community Medicine, Yenepoya Medical College, Yenepoya (Deemed to be University), Mangalore, Karnataka
3 Karuna Trust, Bengaluru, The Union South‑East Asia Office, New Delhi, India, International Union Against Tuberculosis and Lung Diseases (The Union), Paris, France
Abstract
BACKGROUND: Government of India recognizes the use of “information, communication, and
technology” 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). Data
could be entered in an offline mode followed by syncing with cloud. The CPHM App was piloted in
primary health center (PHC) Gumballi, in Karnataka, with focus on household survey and maternal
and child health (MCH) services.
OBJECTIVES: To compare the consistency of selected MCH process indicators for Health
Management Information System [HMIS] available from paper‑based records and those generated
through the CPHM App (2016–2017). We also explored the implementation enablers, barriers, and
suggested solutions from the user perspective.
METHODS: A sequential mixed‑method study design was followed. Quantitative phase involved
aggregate data analysis looking into the consistency of selected MCH process indicators available
from paper‑based records and those generated through the CPHM App (2016–2017) followed by
thematic analysis of in‑depth interviews of healthcare providers. Consistency was defined as a
percentage where the numerator was the HMIS‑related process indicator data from CPHM App and
denominator was the data from paper‑based records.
RESULTS: Three out of 12 selected MCH indicators had consistency of >80%. The quarterly
consistency reduced over the 2 years. Dual burden of entry and regular monitoring of paper‑based
records by district health and family welfare department were the reasons why more importance was
given to entry in paper‑based records. Ability to generate aggregate indicators with CPHM App, easy
to use and retrieve data in the field, and reminder facility for planned health activities were some
of the factors facilitating CPHM implementation. The key barriers were limited technical expertise
and support from the technical team and no internet connectivity in the field and traveling to PHC
to sync the data. Provision of real‑time technical support and availability of data connectivity in the
field were some of the solutions suggested.
CONCLUSION: There should be a minimum of 1–2 years of simultaneous use of EHR and
paper‑based records after which one must shift to EHR.
Keywords
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