Evaluation of laboratory information systems in resource-poor settings

资源匮乏环境中实验室信息系统的评估

• 批准号: 7409916
• 负责人: Joaquin Andres Blaya
• 金额: $ 2.18万
• 依托单位: MASSACHUSETTS INSTITUTE OF TECHNOLOGY
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-06-05 至 2009-01-15
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7409916
• 关键词: Affect; Architecture; Bacteriology; Caring; Client; Clinical; Clinical Laboratory Information Systems; Clinical Research; Collection; Communicable Diseases; Communication; Data; Data Collection; Data Quality; Databases; Disease; Electronics; Emerging Communicable Diseases; Evaluation; Frequencies; Guidelines; Health; Healthcare Systems; Historical Cohort Studies; Information Systems; Institution; Internet; Laboratories; Location; Measures; Medical; Medical Records; Methods; Monitor; Morbidity - disease rate; Multi-Drug Resistance; Multidrug-Resistant Tuberculosis; Numbers; Online Systems; Outcome; Paper; Patients; Perception; Personal Digital Assistant; Pharmaceutical Preparations; Physicians; Predisposition; Process; Purpose; Qualitative Evaluations; Randomized; Reporting; Research; Resistance; Resources; Rifampin; Risk; Site; Specialist; Surveys; System; Technology; Test Result; Time; Tuberculosis; Validation; base; clinical research site; cost; day; experience; improved; isoniazid; killings; programs; prospective; tool; transmission process; tuberculosis drugs; usability; user-friendly

DESCRIPTION (provided by applicant): Multi-drug resistant tuberculosis (MDR-TB) patients in resource-poor settings experience large delays in starting appropriate therapy and are often not monitored appropriately due to an overburdened health care system, communication delays, and missing or error-prone data. This causes increased morbidity to patients, as well as further transmission of this deadly disease. This proposal is to develop, implement and formally evaluate medical information systems in a resource poor setting for institutions with and without internet. We hypothesize that applying these technologies will decrease delays and communications error to improve the health of those affected by this re-emerging infectious disease. In this study, we propose to create and quantitatively evaluate two laboratory information systems. The first provides electronic communication and reporting of tuberculosis (TB) laboratory information within a networked group of institutions to reduce the communication times of laboratory results, accelerate the startof treatment of high-risk patients and decrease the frequency of errors. The second creates a system of electronic collection of TB laboratory information from a physically distributed group of non-networked laboratories to reduce delays, errors and costs. These two complementary systems seek to verify the same hypothesis in two types of resource-poor scenarios, those with and without internet. There are six specific aims. 1) To develop and implement a handheld-based data system to collect TB bacteriological results from multiple sites lacking internet. 2) To evaluate the impact of this electronic system on the delays, errors, user perception and costs of the collection process by performing a randomized prospective and historical cohort study. 3) To develop and implement a web-based TB laboratory information system to enable health centers to access test results from the national and regional laboratories. 4) To evaluate the impact of this laboratory system on communication of results and costs compared to the current paper system by performing a randomized prospective and historical cohort study. 5) To investigate the impact of this system on the clinical outcome of high-risk patients. 6) To assess users' perception of this system and its potential use at a national level using a standardized survey instrument. This research will provide electronic information systems to decrease the morbidity of tuberculosis, a reemerging infectious disease which kills over 1.5 million people annually. It will evaluate these systems to formally prove their benefits for locations with and without internet. This will provide guidelines for other programs worldwide to implement these technologies.

描述（由申请人提供）：资源匮乏环境中的耐多药结核病（MDR-TB）患者在开始适当治疗时会出现很大延迟，并且由于医疗保健系统负担过重、通信延迟以及数据缺失或易出错而经常得不到适当监测。这导致患者发病率增加，以及这种致命疾病的进一步传播。本建议是开发，实施和正式评估医疗信息系统在资源贫乏的设置机构和没有互联网。我们假设，应用这些技术将减少延迟和通信错误，以改善受这种重新出现的传染病影响的人的健康。在这项研究中，我们建议创建和定量评估两个实验室信息系统。第一种是在联网的机构内提供结核病实验室信息的电子通信和报告， 减少实验室结果的交流时间，加快高危患者的治疗开始，减少错误的频率。第二个项目创建了一个从实际分布的非联网实验室组电子收集结核病实验室信息的系统，以减少延迟、错误和成本。这两个互补的系统试图在两种类型的资源贫乏的情况下，即有互联网和没有互联网的情况下，验证相同的假设。有六个具体目标。1)发展及推行手提式数据系统，从多个缺乏互联网的地点收集结核病细菌化验结果。2)通过进行随机前瞻性和历史队列研究，评价该电子系统对采集过程延迟、错误、用户感知和成本的影响。3)开发和实施基于网络的结核病实验室信息系统，使卫生中心能够获得国家和地区实验室的检测结果。4)通过进行随机、前瞻性和历史队列研究，评价该实验室系统与当前纸质系统相比对结果和成本沟通的影响。5)研究该系统对高危患者临床结局的影响。6)使用标准化调查工具评估用户对该系统的看法及其在国家一级的潜在用途。这项研究将提供电子信息系统，以降低结核病的发病率，结核病是一种重新出现的传染病，每年造成150多万人死亡。它将评估这些系统，以正式证明它们对有互联网和没有互联网的地点的好处。这将为全球其他项目实施这些技术提供指导。