title: Lessons learned from implementing the HIV infant tracking system (HITSystem): A web-based intervention to improve early infant diagnosis in Kenya.
abstract: OBJECTIVE
  Guided by the RE-AIM model, we describe preliminary data and lessons learned from multiple serial implementations of an eHealth intervention to improve early infant diagnosis (EID) of HIV in Kenya.
  
  
  METHODS
  We describe the reach, effectiveness, adoption, implementation and maintenance of the HITSystem, an eHealth intervention that links key stakeholders to improve retention and outcomes in EID. Our target community includes mother-infant pairs utilizing EID services and government health care providers and lab personnel. We also explore our own role as program and research personnel supporting the dissemination and scale up of the HITSystem in Kenya.
  
  
  RESULTS
  Key findings illustrate the importance of continual adaptation of the HITSystem interface to accommodate varied stakeholders' workflows in different settings. Surprisingly, technology capacity and internet connectivity posed minimal short-term challenges. Early and sustained ownership of the HITSystem among stakeholders proved critical to reach, effectiveness and successful adoption, implementation and maintenance.
  
  
  CONCLUSIONS
  Preliminary data support the ability of the HITSystem to improve EID outcomes in Kenya. Strong and sustained collaborations with stakeholders improve the quality and reach of eHealth public health interventions.
authors.affiliation: University of Kansas Medical Center, Department of Family Medicine, Kansas City, KS, USA. Electronic address: Skessler2@kumc.edu.
authors.forename: S
authors.initials: S
authors.lastname: Finocchario-Kessler
authors.affiliation: Global Health Innovations, Nairobi, Kenya.
authors.forename: I
authors.initials: I
authors.lastname: Odera
authors.affiliation: Global Health Innovations, Nairobi, Kenya; Kenya Medical Research Institute, Nairobi, Kenya.
authors.forename: V
authors.initials: V
authors.lastname: Okoth
authors.affiliation: University of Kansas Medical Center, Department of Family Medicine, Kansas City, KS, USA.
authors.forename: C
authors.initials: C
authors.lastname: Bawcom
authors.affiliation: Global Health Innovations, Kansas City, MO, USA.
authors.forename: B
authors.initials: B
authors.lastname: Gautney
authors.affiliation: Kenya Medical Research Institute, Nairobi, Kenya.
authors.forename: S
authors.initials: S
authors.lastname: Khamadi
authors.affiliation: University of Kansas, Department of Global Studies, Lawrence, KS, USA.
authors.forename: K
authors.initials: K
authors.lastname: Clark
authors.affiliation: Children's Mercy Hospital, Health Services and Outcomes Research, Kansas City, MO, USA.
authors.forename: K
authors.initials: K
authors.lastname: Goggin
mesh_terms: D042241:Early Diagnosis; D062665:Epidemiological Monitoring; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D007630:Kenya; D011634:Public Health
keywords: Early infant diagnosis (EID); HIV infant tracking system (HITSystem); Implementation; Kenya; Lessons learned; Technology