Leveraging electronic medical records for HIV testing, care, and treatment programming in Kenya—the national data warehouse project
Abstract Background Aggregate electronic data repositories and population-level cross-sectional surveys play a critical role in HIV programme monitoring and surveillance for data-driven decision-making. However, these data sources have inherent limitations including inability to respond to public he...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | BMC Medical Informatics and Decision Making |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12911-023-02265-6 |
| _version_ | 1797452395863605248 |
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| author | Margaret Ndisha Amin S. Hassan Faith Ngari Evans Munene Mary Gikura Koske Kimutai Kennedy Muthoka Lisa Amai Murie Herman Tolentino Jacob Odhiambo Pascal Mwele Lydia Odero Kate Mbaire Gonza Omoro Davies O. Kimanga |
| author_facet | Margaret Ndisha Amin S. Hassan Faith Ngari Evans Munene Mary Gikura Koske Kimutai Kennedy Muthoka Lisa Amai Murie Herman Tolentino Jacob Odhiambo Pascal Mwele Lydia Odero Kate Mbaire Gonza Omoro Davies O. Kimanga |
| author_sort | Margaret Ndisha |
| collection | DOAJ |
| description | Abstract Background Aggregate electronic data repositories and population-level cross-sectional surveys play a critical role in HIV programme monitoring and surveillance for data-driven decision-making. However, these data sources have inherent limitations including inability to respond to public health priorities in real-time and to longitudinally follow up clients for ascertainment of long-term outcomes. Electronic medical records (EMRs) have tremendous potential to bridge these gaps when harnessed into a centralised data repository. We describe the evolution of EMRs and the development of a centralised national data warehouse (NDW) repository. Further, we describe the distribution and representativeness of data from the NDW and explore its potential for population-level surveillance of HIV testing, care and treatment in Kenya. Main body Health information systems in Kenya have evolved from simple paper records to web-based EMRs with features that support data transmission to the NDW. The NDW design includes four layers: data warehouse application programming interface (DWAPI), central staging, integration service, and data visualization application. The number of health facilities uploading individual-level data to the NDW increased from 666 in 2016 to 1,516 in 2020, covering 41 of 47 counties in Kenya. By the end of 2020, the NDW hosted longitudinal data from 1,928,458 individuals ever started on antiretroviral therapy (ART). In 2020, there were 936,869 individuals who were active on ART in the NDW, compared to 1,219,276 individuals on ART reported in the aggregate-level Kenya Health Information System (KHIS), suggesting 77% coverage. The proportional distribution of individuals on ART by counties in the NDW was consistent with that from KHIS, suggesting representativeness and generalizability at the population level. Conclusion The NDW presents opportunities for individual-level HIV programme monitoring and surveillance because of its longitudinal design and its ability to respond to public health priorities in real-time. A comparison with estimates from KHIS demonstrates that the NDW has high coverage and that the data maybe representative and generalizable at the population-level. The NDW is therefore a unique and complementary resource for HIV programme monitoring and surveillance with potential to strengthen timely data driven decision-making towards HIV epidemic control in Kenya. Database link ( https://dwh.nascop.org/ ). |
| first_indexed | 2024-03-09T15:07:54Z |
| format | Article |
| id | doaj.art-7bffe3bb4a3a4c4196389e523de6c33a |
| institution | Directory Open Access Journal |
| issn | 1472-6947 |
| language | English |
| last_indexed | 2024-03-09T15:07:54Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Informatics and Decision Making |
| spelling | doaj.art-7bffe3bb4a3a4c4196389e523de6c33a2023-11-26T13:32:12ZengBMCBMC Medical Informatics and Decision Making1472-69472023-09-0123111210.1186/s12911-023-02265-6Leveraging electronic medical records for HIV testing, care, and treatment programming in Kenya—the national data warehouse projectMargaret Ndisha0Amin S. Hassan1Faith Ngari2Evans Munene3Mary Gikura4Koske Kimutai5Kennedy Muthoka6Lisa Amai Murie7Herman Tolentino8Jacob Odhiambo9Pascal Mwele10Lydia Odero11Kate Mbaire12Gonza Omoro13Davies O. Kimanga14Division for Global HIV & TB (DGHT), Centres for Global Health, US Centres for Disease Control and Prevention (CDC)KEMRI/Wellcome Trust Research ProgrammeNational AIDS and STI Control Programme (NASCOP), Ministry of HealthPalladium GroupPalladium GroupPalladium GroupPalladium GroupDivision for Global HIV & TB (DGHT), Centres for Global Health, US Centres for Disease Control and Prevention (CDC)Division for Global HIV & TB (DGHT), Centres for Global Health, US Centres for Disease Control and Prevention (CDC)Palladium GroupPalladium GroupUnited States Agency for International Development (USAID)PEPFAR Coordinating Office (PCO)US Department of Defence (DOD)Division for Global HIV & TB (DGHT), Centres for Global Health, US Centres for Disease Control and Prevention (CDC)Abstract Background Aggregate electronic data repositories and population-level cross-sectional surveys play a critical role in HIV programme monitoring and surveillance for data-driven decision-making. However, these data sources have inherent limitations including inability to respond to public health priorities in real-time and to longitudinally follow up clients for ascertainment of long-term outcomes. Electronic medical records (EMRs) have tremendous potential to bridge these gaps when harnessed into a centralised data repository. We describe the evolution of EMRs and the development of a centralised national data warehouse (NDW) repository. Further, we describe the distribution and representativeness of data from the NDW and explore its potential for population-level surveillance of HIV testing, care and treatment in Kenya. Main body Health information systems in Kenya have evolved from simple paper records to web-based EMRs with features that support data transmission to the NDW. The NDW design includes four layers: data warehouse application programming interface (DWAPI), central staging, integration service, and data visualization application. The number of health facilities uploading individual-level data to the NDW increased from 666 in 2016 to 1,516 in 2020, covering 41 of 47 counties in Kenya. By the end of 2020, the NDW hosted longitudinal data from 1,928,458 individuals ever started on antiretroviral therapy (ART). In 2020, there were 936,869 individuals who were active on ART in the NDW, compared to 1,219,276 individuals on ART reported in the aggregate-level Kenya Health Information System (KHIS), suggesting 77% coverage. The proportional distribution of individuals on ART by counties in the NDW was consistent with that from KHIS, suggesting representativeness and generalizability at the population level. Conclusion The NDW presents opportunities for individual-level HIV programme monitoring and surveillance because of its longitudinal design and its ability to respond to public health priorities in real-time. A comparison with estimates from KHIS demonstrates that the NDW has high coverage and that the data maybe representative and generalizable at the population-level. The NDW is therefore a unique and complementary resource for HIV programme monitoring and surveillance with potential to strengthen timely data driven decision-making towards HIV epidemic control in Kenya. Database link ( https://dwh.nascop.org/ ).https://doi.org/10.1186/s12911-023-02265-6Electronic medical recordsRepositoryData warehouseHIVSurveillance |
| spellingShingle | Margaret Ndisha Amin S. Hassan Faith Ngari Evans Munene Mary Gikura Koske Kimutai Kennedy Muthoka Lisa Amai Murie Herman Tolentino Jacob Odhiambo Pascal Mwele Lydia Odero Kate Mbaire Gonza Omoro Davies O. Kimanga Leveraging electronic medical records for HIV testing, care, and treatment programming in Kenya—the national data warehouse project BMC Medical Informatics and Decision Making Electronic medical records Repository Data warehouse HIV Surveillance |
| title | Leveraging electronic medical records for HIV testing, care, and treatment programming in Kenya—the national data warehouse project |
| title_full | Leveraging electronic medical records for HIV testing, care, and treatment programming in Kenya—the national data warehouse project |
| title_fullStr | Leveraging electronic medical records for HIV testing, care, and treatment programming in Kenya—the national data warehouse project |
| title_full_unstemmed | Leveraging electronic medical records for HIV testing, care, and treatment programming in Kenya—the national data warehouse project |
| title_short | Leveraging electronic medical records for HIV testing, care, and treatment programming in Kenya—the national data warehouse project |
| title_sort | leveraging electronic medical records for hiv testing care and treatment programming in kenya the national data warehouse project |
| topic | Electronic medical records Repository Data warehouse HIV Surveillance |
| url | https://doi.org/10.1186/s12911-023-02265-6 |
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