Electronic laboratory system reduces errors in National Tuberculosis Program: a cluster randomized controlled trial
Abstract:OBJECTIVE: To evaluate the impact of the e-Chasqui laboratory information system in reducing reporting errors compared to the current paper system.
DESIGN: Cluster randomized controlled trial in 76health 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.
Document Type: Regular Paper
Affiliations: 1: Decision Systems Group, Brigham & Women's Hospital, Boston, Massachusetts, USA; and Partners In Health, Boston, Massachusetts, USA 2: Partners In Health, Boston, Massachusetts, USA; and Division of Global Health Equity, Brigham & Women's Hospital, Boston, Massachusetts, USA 3: Dirección de Salud V Lima Ciudad, Lima, Peru 4: Dirección de Salud IV Lima Este, Lima, Peru 5: Instituto Nacional de Salud, Lima, Peru 6: Socios En Salud Sucursal Peru, Lima, Peru 7: Division of Biomedical Informatics, University of California, San Diego, California, USA 8: Centers for Disease Control and Prevention, Atlanta, Georgia, USA
Publication date: August 1, 2010
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