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Free Content Electronic laboratory system reduces errors in National Tuberculosis Program: a cluster randomized controlled trial

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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.

Keywords: evaluation; information systems; laboratory; randomized controlled trial; tuberculosis

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

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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