1. Godwin N. Mugo (MBChB, MPH)1 Victor Ogoti (BscIT)1
7th East African Health and Scientific Conference-Dar es Salaam Use of Electronic Medical Records to Improve Accuracy and Timeliness of Viral Load Documentation in a Faith Based HIV Program in Kenya
Godwin N. Mugo (MBChB, MPH)1
Victor Ogoti (BscIT)1
1Christian Health Association of Kenya

2. Background
Electronic medical records critical in strengthening health system decision making and program performance.
Timeliness, accuracy and completeness of data is important to inform data quality improvement.
2017 national HIV services data quality audit highlighted gaps in viral load documentation in both paper and EMR based sites.
IQCare EMR implemented to bridge these gaps in the CHAK-HIV Program
Provides care and treatment to over 48,000 patients
Supported by robust data quality audits, data demand and information use processes to drive quality improvement activities.

3. Study Objective
To demonstrate improved accuracy, timeliness and completeness of VL data through the use of IQCare EMR in CHAK-HIV Program.

4. Methods (1) Study design: Retrospective dynamic cohort
Study Period: January 2015-September 2018
Study Location: 79 facilities supported by CHAK-HIV Program,Kenya
Data: De-identified patient level data
Data source: Medical records from IQCare EMR , using SQL queries.
Inclusion-all records of patients in care
Study variables-VL results duration to entry, completeness of entry
Sample size-37435, 39075, and records were reviewed for year 2015, 2016, 2017 and respectively

5. Methods (2) Data analysis ANOVA between annual time periods
Post hoc comparisons to compare the effect of use of EMR on accuracy and timeliness of VL documentation
Two sample t test to compare percentage erroneous entries between study years compared to baseline year.

6. Results 1: Timeliness and Accuracy of Documentation
SOURCE OF VARIATION DF
SUM OF SQUARES
MEAN SQUARES
F RATIO
PROBABILITY
BETWEEN
3.00
165.09
0.0000
WITHIN
728.20
TOTAL
Significant effect of the use of EMR on improving timeliness and accuracy of documentation for the four time periods [F (3, ) = , p<0.001].

7. Results 2: EMR Utilization
Year
T VALUE DF
P value
2015
2016
0.0000
2017
2018
0.390
0.6969
2.621
0.0089
18.082
15.898
Post hoc comparisons indicated that the mean score for EMR utilization was significantly different at p<0.05 except in the 2018 year comparison (µ , , , ).

8. Results 3: Erroneous and Incomplete Entries
Year
Sample size
Erroneous entries
t statistic df
P value
2015
37435
0.07%
2016
39075
0.24%
5.940
0.0000
2017
41856
0.30%
7.397
2018
43518
0.18%
4.345
There was significant reduction in erroneous and incomplete entries at p<0.001 for year 2016 t(76508)=5.940, 2017 t(79289)=7.397 and 2018 t(80951)=4.345.

9. Conclusions
EMRs improve the timeliness and accuracy of patient level VL data.
Programs should adopt and expand their utilization to improve data quality for health system decision making.

10. CHAK-HIV Program staff
Acknowledgements
Victor Ogoti
Dr Catherine Njigua
Dr Douglas Gaitho
CHAK-HIV Program staff