title: Leapfrogging paper-based records using handheld technology: experience from Western Kenya.
abstract: OBJECTIVE
  There is limited experience with broad-based use of handheld technologies for clinical care during home visits in sub-Saharan Africa.
  
  
  OBJECTIVE
  We describe the design, development, implementation, and evaluation of a PDA/GPS-based system currently used during home visits in Western Kenya.
  
  
  RESULTS
  The system, built on Pendragon Forms, was used to create electronic health records for over 40,000 individuals over a three-month period. Of these, 1900 represented cases where the individual had never received care for the identified condition in an established care facility. On a five-point scale, and compared to paper-and-pen systems, end-users felt that the handheld system was faster (4.4±0.9), easier to use (4.5±0.8), and produced higher quality data (4.7±0.7). Projected over three years to cover two million people, use of the handheld technologies would cost about $0.15 per person--compared to $0.21 per individual encounter entered manually into a computer from a paper form.
  
  
  CONCLUSIONS
  A PDA/GPS system has been successfully and broadly implemented to support clinical care during home-based visits in a resource-limited setting.
authors.affiliation: Regenstrief Institute, Inc., Indianapolis, IN, USA.
authors.forename: Martin C
authors.initials: MC
authors.lastname: Were
authors.forename: James
authors.initials: J
authors.lastname: Kariuki
authors.forename: Viola
authors.initials: V
authors.lastname: Chepng'eno
authors.forename: Margaret
authors.initials: M
authors.lastname: Wandabwa
authors.forename: Samson
authors.initials: S
authors.lastname: Ndege
authors.forename: Paula
authors.initials: P
authors.lastname: Braitstein
authors.forename: Juddy
authors.initials: J
authors.lastname: Wachira
authors.forename: Sylvester
authors.initials: S
authors.lastname: Kimaiyo
authors.forename: Burke
authors.initials: B
authors.lastname: Mamlin
mesh_terms: D034201:Computers, Handheld; D057286:Electronic Health Records; D006699:Home Care Services; D007630:Kenya; D008904:Miniaturization; D012984:Software; D014584:User-Computer Interface