Options for diabetes management in sub-Saharan Africa with an electronic medical record system.
BACKGROUND
An increase of diabetes prevalence of up to 80% is predicted in sub-Saharan Africa (SSA) by 2025 exceeding the worldwide 55%. Mortality rates of diabetes and HIV/AIDS are similar. Diabetes shares several common factors with HIV/AIDS and multidrug-resistant tuberculosis (MDR-TB). The latter two health problems have been efficiently managed by an open source electronic medical record system (EMRS) in Latin America. Therefore a similar solution for diabetes in SSA could be extremely helpful.


OBJECTIVE
The aim was to design and validate a conceptual model for an EMRS to improve diabetes management in SSA making use of the HIV and TB experience.


METHODS
A review of the literature addressed diabetes care and management in SSA as well as existing examples of information and communication technology (ICT) use in SSA. Based on a need assessment conducted in SSA a conceptual model based on the traditionally structured healthcare system in SSA was mapped into a three-layer structure. Application modules were derived and a demonstrator programmed based on an open source EMRS. Then the approach was validated by SSA experts.


RESULTS
A conceptual model could be specified and validated which enhances a problem-oriented approach to diabetes management processes. The prototyp EMRS demonstrates options for a patient portal and simulation tools for education of health professional and patients in SSA.


CONCLUSIONS
It is possible to find IT solutions for diabetes care in SSA which follow the same efficiency concepts as HIV or TB modules in Latin America. The local efficiency and sustainability of the solution will, however, depend on training and changes in work behavior.
Kouematchoua Tchuitcheu
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Department of Medical Informatics, University Medicine, Georg-August-University, Robert-Koch-Strasse 40, 37075 Goettingen, Germany. gkouema@med.uni-goettingen.de
Rienhoff
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D017954:Africa South of the Sahara / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality; D019468:Disease Management; D057286:Electronic Health Records / Q000458:organization & administration*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008962:Models, Theoretical; D020380:Needs Assessment; D011785:Quality Assurance, Health Care; D014584:User-Computer Interface