title: Personal digital assistants to collect tuberculosis bacteriology data in Peru reduce delays, errors, and workload, and are acceptable to users: cluster randomized controlled trial.
abstract: OBJECTIVE
  To evaluate the effectiveness of a personal digital assistant (PDA)-based system for collecting tuberculosis test results and to compare this new system to the previous paper-based system. The PDA- and paper-based systems were evaluated based on processing times, frequency of errors, and number of work-hours expended by data collectors.
  
  
  METHODS
  We conducted a cluster randomized controlled trial in 93 health establishments in Peru. Baseline data were collected for 19 months. Districts (n=4) were then randomly assigned to intervention (PDA) or control (paper) groups, and further data were collected for 6 months. Comparisons were made between intervention and control districts and within-districts before and after the introduction of the intervention.
  
  
  RESULTS
  The PDA-based system had a significant effect on processing times (p<0.001) and errors (p=0.005). In the between-districts comparison, the median processing time for cultures was reduced from 23 to 8 days and for smears was reduced from 25 to 12 days. In that comparison, the proportion of cultures with delays >90 days was reduced from 9.2% to 0.1% and the number of errors was decreased by 57.1%. The intervention reduced the work-hours necessary to process results by 70% and was preferred by all users.
  
  
  CONCLUSIONS
  A well-designed PDA-based system to collect data from institutions over a large, resource-poor area can significantly reduce delays, errors, and person-hours spent processing data.
authors.affiliation: Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA, USA. jblaya@hms.harvard.edu
authors.forename: Joaquín A
authors.initials: JA
authors.lastname: Blaya
authors.forename: Ted
authors.initials: T
authors.lastname: Cohen
authors.forename: Pablo
authors.initials: P
authors.lastname: Rodríguez
authors.forename: Jihoon
authors.initials: J
authors.lastname: Kim
authors.forename: Hamish S F
authors.initials: HS
authors.lastname: Fraser
mesh_terms: D003151:Community Health Centers; D034201:Computers, Handheld; D003906:Developing Countries; D006801:Humans; D008491:Medical Informatics Applications; D016347:Medical Records Systems, Computerized / Q000458:organization & administration*; D019982:Organizational Case Studies; D010568:Peru; D011159:Population Surveillance; D011635:Public Health Administration; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis*