Electronic laboratory system reduces errors in National Tuberculosis Program: a cluster randomized controlled trial.
OBJECTIVE
To evaluate the impact of the e-Chasqui laboratory information system in reducing reporting errors compared to the current paper system.


METHODS
Cluster randomized controlled trial in 76 health centers (HCs) between 2004 and 2008.


METHODS
Baseline data were collected every 4 months for 12 months. HCs were then randomly assigned to intervention (e-Chasqui) or control (paper). Further data were collected for the same months the following year. Comparisons were made between intervention and control HCs, and before and after the intervention.


RESULTS
Intervention HCs had respectively 82% and 87% fewer errors in reporting results for drug susceptibility tests (2.1% vs. 11.9%, P = 0.001, OR 0.17, 95%CI 0.09-0.31) and cultures (2.0% vs. 15.1%, P < 0.001, OR 0.13, 95%CI 0.07-0.24), than control HCs. Preventing missing results through online viewing accounted for at least 72% of all errors. e-Chasqui users sent on average three electronic error reports per week to the laboratories.


CONCLUSIONS
e-Chasqui reduced the number of missing laboratory results at point-of-care health centers. Clinical users confirmed viewing electronic results not available on paper. Reporting errors to the laboratory using e-Chasqui promoted continuous quality improvement. The e-Chasqui laboratory information system is an important part of laboratory infrastructure improvements to support multidrug-resistant tuberculosis care in Peru.
Blaya
J A
JA
Decision Systems Group, Brigham & Women's Hospital, Boston, Massachusetts 02215 , USA. jblaya@hms.harvard.edu
Shin
S S
SS
Yale
G
G
Suarez
C
C
Asencios
L
L
Contreras
C
C
Rodriguez
P
P
Kim
J
J
Cegielski
P
P
Fraser
H S F
HS
D002984:Clinical Laboratory Information Systems / Q000706:statistics & numerical data*; D019411:Clinical Laboratory Techniques / Q000706:statistics & numerical data*; D016000:Cluster Analysis; D003951:Diagnostic Errors / Q000517:prevention & control* / Q000706:statistics & numerical data; D001330:Electronic Data Processing / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D009313:National Health Programs / Q000706:statistics & numerical data*; D009862:Online Systems; D015995:Prevalence; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014376:Tuberculosis / Q000175:diagnosis* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology