Development of standard indicators to assess use of electronic health record systems implemented in low-and medium-income countries.

Development of standard indicators to assess use of electronic health record systems implemented in low-and medium-income countries.

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BackgroundElectronic Health Record Systems (EHRs) are being rolled out nationally in many low- and middle-income countries (LMICs) yet assessing actual system usage remains a challenge.We employed a nominal group technique (NGT) process to systematically develop high-quality indicators for evaluating actual usage of EHRs in LMICs.MethodsAn initial set of 14 candidate indicators two tone woven basket were developed by the study team adapting the Human Immunodeficiency Virus (HIV) Monitoring, Evaluation, and Reporting indicators format.A multidisciplinary team of 10 experts was convened in a two-day NGT workshop in Kenya to systematically evaluate, rate (using Specific, Measurable, Achievable, Relevant, and Time-Bound (SMART) criteria), prioritize, refine, and identify new indicators.

NGT steps included introduction to candidate indicators, silent indicator 2004 hyundai santa fe catalytic converter ranking, round-robin indicator rating, and silent generation of new indicators.5-point Likert scale was used in rating the candidate indicators against the SMART components.ResultsCandidate indicators were rated highly on SMART criteria (4.05/5).

NGT participants settled on 15 final indicators, categorized as system use (4); data quality (3), system interoperability (3), and reporting (5).Data entry statistics, systems uptime, and EHRs variable concordance indicators were rated highest.ConclusionThis study describes a systematic approach to develop and validate quality indicators for determining EHRs use and provides LMICs with a multidimensional tool for assessing success of EHRs implementations.