Creation and evaluation of EMR-based paper clinical summaries to support HIV-care in Uganda, Africa.
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.
Were
Martin C
MC
Regenstrief Institute, Inc., Indiana University School of Medicine, Indianapolis, IN, USA. mwere@regenstrief.org
Shen
Changyu
C
Bwana
Mwebesa
M
Emenyonu
Nneka
N
Musinguzi
Nicholas
N
Nkuyahaga
Frank
F
Kembabazi
Annet
A
Tierney
William M
WM
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