The Development of an Electronic Medical Record System to Improve Quality of Care for Individuals With Type 1 Diabetes in Rwanda: Qualitative Study.

Journal: JMIR diabetes

Volume: 9

Issue: 

Year of Publication: 

Affiliated Institutions:  Section of Global Health, Department of Public Health, University of Copenhagen, Copenhagen K, Denmark. Department of Clinical Epidemiology, Clinical Research, Copenhagen University Hospital, Steno Diabetes Center Copenhagen, Herlev, Denmark. Department of Digital Health Solutions, World Diabetes Foundation, Bagsværd, Denmark. Rwanda Diabetes Association, Kigali, Rwanda. Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

Abstract summary 

Electronic medical record (EMR) systems have the potential to improve the quality of care and clinical outcomes for individuals with chronic and complex diseases. However, studies on the development and use of EMR systems for type 1 (T1) diabetes management in sub-Saharan Africa are few.The aim of this study is to analyze the need for improvements in the care processes that can be facilitated by an EMR system and to develop an EMR system for increasing quality of care and clinical outcomes for individuals with T1 diabetes in Rwanda.A qualitative, cocreative, and multidisciplinary approach involving local stakeholders, guided by the framework for complex public health interventions, was applied. Participant observation and the patient's personal experiences were used as case studies to understand the clinical care context. A focus group discussion and workshops were conducted to define the features and content of an EMR. The data were analyzed using thematic analysis.The identified themes related to feature requirements were (1) ease of use, (2) automatic report preparation, (3) clinical decision support tool, (4) data validity, (5) patient follow-up, (6) data protection, and (7) training. The identified themes related to content requirements were (1) treatment regimen, (2) mental health, and (3) socioeconomic and demographic conditions. A theory of change was developed based on the defined feature and content requirements to demonstrate how these requirements could strengthen the quality of care and improve clinical outcomes for people with T1 diabetes.The EMR system, including its functionalities and content, can be developed through an inclusive and cocreative process, which improves the design phase of the EMR. The development process of the EMR system is replicable, but the solution needs to be customized to the local context.

Authors & Co-authors:  Bille Nathalie N Christensen Dirk Lund DL Byberg Stine S Calopietro Michael M Gishoma Crispin C Villadsen Sarah Fredsted SF

Study Outcome 

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Statistics
Citations : 
Authors :  6
Identifiers
Doi : 10.2196/52271
SSN : 2371-4379
Study Population
Male,Female
Mesh Terms
Other Terms
DM;EHR;Rwanda;chronic disease;chronic diseases;clinical outcome;clinical outcomes;complex interventions;design;diabetes;diabetes mellitus;diabetic;electronic health record;electronic health records;electronic medical record systems;focus group;intervention development;medical record;medical records;public health intervention;public health interventions;qualitative;quality of care;type 1 diabetes
Study Design
Case Study
Study Approach
Qualitative
Country of Study
Rwanda
Publication Country
Canada