The role of digital clinical decision support tool in improving quality of intrapartum and postpartum care: experiences from two states of India
Abstract Background Computerized clinical decision support (CDSS) –digital information systems designed to improve clinical decision making by providers – is a promising tool for improving quality of care. This study aims to understand the uptake of ASMAN application (defined as completeness of elec...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-04-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-021-03710-y |
| _version_ | 1818730026968809472 |
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| author | Gulnoza Usmanova Kamlesh Lalchandani Ashish Srivastava Chandra Shekhar Joshi Deepak Chandra Bhatt Anand Kumar Bairagi Yashpal Jain Mohammed Afzal Rashmi Dhoundiyal Jyoti Benawri Tarun Chaudhary Archana Mishra Rajni Wadhwa Pompy Sridhar Nupur Bahl Pratibha Gaikwad Bulbul Sood |
| author_facet | Gulnoza Usmanova Kamlesh Lalchandani Ashish Srivastava Chandra Shekhar Joshi Deepak Chandra Bhatt Anand Kumar Bairagi Yashpal Jain Mohammed Afzal Rashmi Dhoundiyal Jyoti Benawri Tarun Chaudhary Archana Mishra Rajni Wadhwa Pompy Sridhar Nupur Bahl Pratibha Gaikwad Bulbul Sood |
| author_sort | Gulnoza Usmanova |
| collection | DOAJ |
| description | Abstract Background Computerized clinical decision support (CDSS) –digital information systems designed to improve clinical decision making by providers – is a promising tool for improving quality of care. This study aims to understand the uptake of ASMAN application (defined as completeness of electronic case sheets), the role of CDSS in improving adherence to key clinical practices and delivery outcomes. Methods We have conducted secondary analysis of program data (government data) collected from 81 public facilities across four districts each in two sates of Madhya Pradesh and Rajasthan. The data collected between August –October 2017 (baseline) and the data collected between December 2019 – March 2020 (latest) was analysed. The data sources included: digitized labour room registers, case sheets, referral and discharge summary forms, observation checklist and complication format. Descriptive, univariate and multivariate and interrupted time series regression analyses were conducted. Results The completeness of electronic case sheets was low at postpartum period (40.5%), and in facilities with more than 300 deliveries a month (20.9%). In multivariate logistic regression analysis, the introduction of technology yielded significant improvement in adherence to key clinical practices. We have observed reduction in fresh still births rates and asphyxia, but these results were not statistically significant in interrupted time series analysis. However, our analysis showed that identification of maternal complications has increased over the period of program implementation and at the same time referral outs decreased. Conclusions Our study indicates CDSS has a potential to improve quality of intrapartum care and delivery outcome. Future studies with rigorous study design is required to understand the impact of technology in improving quality of maternity care. |
| first_indexed | 2024-12-17T22:55:15Z |
| format | Article |
| id | doaj.art-d7a79697ecf14485ab4537f3220dd9e9 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-17T22:55:15Z |
| publishDate | 2021-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-d7a79697ecf14485ab4537f3220dd9e92022-12-21T21:29:33ZengBMCBMC Pregnancy and Childbirth1471-23932021-04-0121111210.1186/s12884-021-03710-yThe role of digital clinical decision support tool in improving quality of intrapartum and postpartum care: experiences from two states of IndiaGulnoza Usmanova0Kamlesh Lalchandani1Ashish Srivastava2Chandra Shekhar Joshi3Deepak Chandra Bhatt4Anand Kumar Bairagi5Yashpal Jain6Mohammed Afzal7Rashmi Dhoundiyal8Jyoti Benawri9Tarun Chaudhary10Archana Mishra11Rajni Wadhwa12Pompy Sridhar13Nupur Bahl14Pratibha Gaikwad15Bulbul Sood16Jhpiego-An Affiliate of Johns Hopkins UniversityJhpiego-An Affiliate of Johns Hopkins UniversityJhpiego-An Affiliate of Johns Hopkins UniversityJhpiego-An Affiliate of Johns Hopkins UniversityJhpiego-An Affiliate of Johns Hopkins UniversityJhpiego-An Affiliate of Johns Hopkins UniversityJhpiego-An Affiliate of Johns Hopkins UniversityJhpiego-An Affiliate of Johns Hopkins UniversityJhpiego-An Affiliate of Johns Hopkins UniversityJhpiego-An Affiliate of Johns Hopkins UniversityDepartment of Health and Family Welfare, NHMMaternal Health, NHMProject Management Unit, ASMAN: Alliance for Saving Mothers and NewbornsMSD for MothersReliance FoundationTata TrustsJhpiego-An Affiliate of Johns Hopkins UniversityAbstract Background Computerized clinical decision support (CDSS) –digital information systems designed to improve clinical decision making by providers – is a promising tool for improving quality of care. This study aims to understand the uptake of ASMAN application (defined as completeness of electronic case sheets), the role of CDSS in improving adherence to key clinical practices and delivery outcomes. Methods We have conducted secondary analysis of program data (government data) collected from 81 public facilities across four districts each in two sates of Madhya Pradesh and Rajasthan. The data collected between August –October 2017 (baseline) and the data collected between December 2019 – March 2020 (latest) was analysed. The data sources included: digitized labour room registers, case sheets, referral and discharge summary forms, observation checklist and complication format. Descriptive, univariate and multivariate and interrupted time series regression analyses were conducted. Results The completeness of electronic case sheets was low at postpartum period (40.5%), and in facilities with more than 300 deliveries a month (20.9%). In multivariate logistic regression analysis, the introduction of technology yielded significant improvement in adherence to key clinical practices. We have observed reduction in fresh still births rates and asphyxia, but these results were not statistically significant in interrupted time series analysis. However, our analysis showed that identification of maternal complications has increased over the period of program implementation and at the same time referral outs decreased. Conclusions Our study indicates CDSS has a potential to improve quality of intrapartum care and delivery outcome. Future studies with rigorous study design is required to understand the impact of technology in improving quality of maternity care.https://doi.org/10.1186/s12884-021-03710-yIntrapartum carePostpartum careMaternal healthNew-born healthCDSSmHealth |
| spellingShingle | Gulnoza Usmanova Kamlesh Lalchandani Ashish Srivastava Chandra Shekhar Joshi Deepak Chandra Bhatt Anand Kumar Bairagi Yashpal Jain Mohammed Afzal Rashmi Dhoundiyal Jyoti Benawri Tarun Chaudhary Archana Mishra Rajni Wadhwa Pompy Sridhar Nupur Bahl Pratibha Gaikwad Bulbul Sood The role of digital clinical decision support tool in improving quality of intrapartum and postpartum care: experiences from two states of India BMC Pregnancy and Childbirth Intrapartum care Postpartum care Maternal health New-born health CDSS mHealth |
| title | The role of digital clinical decision support tool in improving quality of intrapartum and postpartum care: experiences from two states of India |
| title_full | The role of digital clinical decision support tool in improving quality of intrapartum and postpartum care: experiences from two states of India |
| title_fullStr | The role of digital clinical decision support tool in improving quality of intrapartum and postpartum care: experiences from two states of India |
| title_full_unstemmed | The role of digital clinical decision support tool in improving quality of intrapartum and postpartum care: experiences from two states of India |
| title_short | The role of digital clinical decision support tool in improving quality of intrapartum and postpartum care: experiences from two states of India |
| title_sort | role of digital clinical decision support tool in improving quality of intrapartum and postpartum care experiences from two states of india |
| topic | Intrapartum care Postpartum care Maternal health New-born health CDSS mHealth |
| url | https://doi.org/10.1186/s12884-021-03710-y |
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