title: Creation and evaluation of EMR-based paper clinical summaries to support HIV-care in Uganda, Africa.
abstract: OBJECTIVE
  Getting the right information to providers can improve quality of care. We set out to provide patient-specific Electronic Medical Record (EMR)-based clinical summaries for providers taking care of HIV-positive adult patients in the resource-limited setting of Mbarara, Uganda.
  
  
  METHODS
  We evaluated the impact of implementing these clinical summaries using time-motion techniques and provider surveys.
  
  
  RESULTS
  After implementation of EMR-based clinical summaries, providers spent more time in direct care of patients (2.9 min vs. 2.3 min, p<0.001), and the length of patient visits was reduced by 11.5 min. Survey respondents indicated that clinical summaries improved care, reduced mistakes, and were generally accurate. Current antiretroviral medication, patient identifying information, adherence information, current medication, and current medical problems were among the highest-rated elements of the summary.
  
  
  CONCLUSIONS
  By taking advantage of data stored in EMRs, efficiency and quality of care can be improved through clinical summaries, even in settings with limited resources.
authors.affiliation: Regenstrief Institute, Inc., Indiana University School of Medicine, Indianapolis, IN, USA. mwere@regenstrief.org
authors.forename: Martin C
authors.initials: MC
authors.lastname: Were
authors.forename: Changyu
authors.initials: C
authors.lastname: Shen
authors.forename: Mwebesa
authors.initials: M
authors.lastname: Bwana
authors.forename: Nneka
authors.initials: N
authors.lastname: Emenyonu
authors.forename: Nicholas
authors.initials: N
authors.lastname: Musinguzi
authors.forename: Frank
authors.initials: F
authors.lastname: Nkuyahaga
authors.forename: Annet
authors.initials: A
authors.lastname: Kembabazi
authors.forename: William M
authors.initials: WM
authors.lastname: Tierney
mesh_terms: D000328:Adult; D017598:Efficiency, Organizational / Q000592:standards*; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000628:therapy*; D015497:HIV-1; D006801:Humans; D009819:Office Visits / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care; D010818:Practice Patterns, Physicians'; D011787:Quality of Health Care; D013996:Time and Motion Studies; D014454:Uganda