A web-based laboratory information system to improve quality of care of tuberculosis patients in Peru: functional requirements, implementation and usage statistics
A web-based laboratory information system to improve quality of care of tuberculosis patients in Peru: functional requirements, implementation and usage statistics
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DOI：
10.1186/1472-6947-7-33
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发表时间：
2007-10-28
影响因子：
3.5
通讯作者：
Fraser, Hamish S. F.
中科院分区：
文献类型：
--
作者：
Blaya, Joaquin A.;Shin, Sonya S.;Fraser, Hamish S. F.
背景资料：资源匮乏环境中的耐多药结核病患者在开始适当治疗方面会出现很大的延迟，并且可能由于实验室系统负担过重、结果沟通延迟以及实验室数据缺失或容易出错而无法得到适当监测。本文的目的是描述一个电子实验室信息系统的实施，以减轻这些问题，其扩大使用秘鲁公共部门，以及研究更广泛的问题，实施这样的系统在资源贫乏setting.Methods：一个基于网络的实验室信息系统“电子Chasqui”已被设计和实施，在秘鲁，以提高实验室数据的及时性和质量。它已部署在国家结核病实验室、两个区域实验室和十二个试点保健中心。使用需求评估和工作流程分析工具，e-Chasqui的目的是提供更好的病人护理，提高质量控制，更有效的实验室监测和reporting.Results：自2006年3月全面实施以来，29 944涂片显微镜检查，31 797文化和7 675药物敏感性测试结果已经进入。这些结果中有99%以上是由保健中心在线查看的。用户满意度高，使用量大，导致电子查斯基扩大到更多的机构。总的来说，e-Chasqui将为一个为310多万人提供医疗服务的机构网络提供服务。维护该系统的成本约为0.53美元每样本或1%的国家秘鲁结核病规划的2006年budget.Conclusion：电子实验室信息系统有很大的潜力，以改善病人的护理和公共卫生监测资源匮乏的环境。在这些环境中面临的一些挑战，如缺乏训练有素的人员，运输有限，覆盖范围大，是一个设计良好的系统可以克服的障碍。e-Chasqui有可能在秘鲁提供一个国家结核病实验室网络。此外，e-Chasqui的核心功能已在开放源码医疗记录系统OpenMRS http：//www.example.com中实施，供其他国家使用。www.openmrs.org
Background: Multi-drug resistant tuberculosis patients in resource-poor settings experience large delays in starting appropriate treatment and may not be monitored appropriately due to an overburdened laboratory system, delays in communication of results, and missing or error-prone laboratory data. The objective of this paper is to describe an electronic laboratory information system implemented to alleviate these problems and its expanding use by the Peruvian public sector, as well as examine the broader issues of implementing such systems in resource-poor settings.Methods: A web-based laboratory information system " e-Chasqui" has been designed and implemented in Peru to improve the timeliness and quality of laboratory data. It was deployed in the national TB laboratory, two regional laboratories and twelve pilot health centres. Using needs assessment and workflow analysis tools, e-Chasqui was designed to provide for improved patient care, increased quality control, and more efficient laboratory monitoring and reporting.Results: Since its full implementation in March 2006, 29,944 smear microscopy, 31,797 culture and 7,675 drug susceptibility test results have been entered. Over 99% of these results have been viewed online by the health centres. High user satisfaction and heavy use have led to the expansion of e-Chasqui to additional institutions. In total, e-Chasqui will serve a network of institutions providing medical care for over 3.1 million people. The cost to maintain this system is approximately US$ 0.53 per sample or 1% of the National Peruvian TB program's 2006 budget.Conclusion: Electronic laboratory information systems have a large potential to improve patient care and public health monitoring in resource-poor settings. Some of the challenges faced in these settings, such as lack of trained personnel, limited transportation, and large coverage areas, are obstacles that a well-designed system can overcome. e-Chasqui has the potential to provide a national TB laboratory network in Peru. Furthermore, the core functionality of e-Chasqui as been implemented in the open source medical record system OpenMRS http:// www.openmrs.org for other countries to use.