The Efficiency of Health Information Management using an Electronic Registry for Maternal Health in West Bank –A Time- Motion Study in a Cluster Randomized Trial

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خريوش, رهام نافذ سامح
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A-Najah National University
Introduction: Primary Health Care aspires to achieve health care for maternal and child health with high quality. To this purpose, healthcare clinics must be assisted by an efficient health information system (HIS) that encourages and maintains coordination between all centers on patient data. Paper-based routine health information systems often require repetitive data entry. In the West Bank, the health system was paper-based, with care providers spending considerable time maintaining multiple files and client registers. Primary healthcare clinics have started using an electronic health information system that has replaced this paper based system – the electronic registry for maternal and new-born care. Objectives: The study aimed to evaluate whether an electronic registry's use changes care providers' time-efficiency in primary healthcare clinics for antenatal care. This was assessed by measuring the time spent by the care providers on health information management during consultations. Methods: The electronic Registry Time study collects data using the time- motion design. The observations were conducted in a random sub-sample of intervention and control clusters (primary healthcare clinics) of the eRegQual CRCT. This study had been in action from August 2018 to December 2018 in 24 primary health care clinics (12 clinics with paper-based systems) control group, and (12 clinics with electronic registry system) intervention group. Results: In our study results for clinic nurse's information, we found that all variable between the control and intervention clinic (nurse educational level, Ultrasound availability, Lab service availability, nurse age, nurse experience, ANC visits per month, booking visit per month, booking visit at the day of data collection, days of service provision per week) that is no significant difference between the two groups. Control clinics have more booking visits than the intervention clinics, but this difference is not significant. For the study's primary outcomes, the intervention clinics have less time-consuming during the consultation than the control clinics. There are three primary variables (health information management, client care, and miscellaneous). The difference between the control and intervention clinics for miscellaneous and client care is not significant, but for HIM that reflects the patient documentation, and for writing on paper and computer of the workflow of the care provider in the clinics for intervention, the time consuming is 6.6 min and for control 9.9. This means that electronic registries in PHC clinics take less time, and this difference is significant. Conclusion: The electronic registry improves time efficiency during the appointment and promotes coordination between all primary health care centers. Also, it fosters cooperation between all members of primary health clinics that increase the quality of care delivered and improve health outcomes.