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Design to Implementation Study for Development and Patient Validation of Paper-Based Toehold Switch Diagnostics

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Leapfrogging paper-based records using handheld technology: experience from Western Kenya.

Martin C Were¹, James Kariuki, Viola Chepng'eno

¹Regenstrief Institute, Inc., Indianapolis, IN, USA.

Studies in Health Technology and Informatics

|September 16, 2010

Summary

A new PDA/GPS system enhances clinical care during home visits in sub-Saharan Africa. This mobile health technology improves data quality and efficiency, proving successful in resource-limited settings.

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Area of Science:

Global Health
Health Informatics
Mobile Health Technology

Background:

Limited experience exists with widespread handheld technology use for clinical care during home visits in sub-Saharan Africa.
Resource-limited settings present unique challenges for implementing and evaluating health information systems.

Purpose of the Study:

To describe the design, development, implementation, and evaluation of a Personal Digital Assistant (PDA)/Global Positioning System (GPS)-based system for home visits in Western Kenya.
To assess the feasibility and impact of mobile health technology in supporting clinical care in a resource-limited environment.

Main Methods:

Development of a PDA/GPS system using Pendragon Forms for electronic health record creation.
Implementation of the system for clinical care during home visits in Western Kenya.
Evaluation of user-perceived usability and data quality compared to paper-based systems.

Main Results:

The PDA/GPS system created electronic health records for over 40,000 individuals in three months.
End-users reported the handheld system as faster (4.4±0.9), easier to use (4.5±0.8), and producing higher quality data (4.7±0.7) compared to paper systems.
Projected costs for the handheld system were $0.15 per person over three years, compared to $0.21 per manual data entry from paper forms.

Conclusions:

A PDA/GPS system has been successfully and broadly implemented to support clinical care during home-based visits in a resource-limited setting.
The study demonstrates the effectiveness of mobile health technology in improving clinical care delivery and data management in challenging environments.