Development and Implementation of a Diabetes Electronic Health Record in Ghana

Sunday, 17 November 2013: 3:25 PM

Gail D'Eramo Melkus, EdD, C-NP, FAAN1
Albert G.B. Amoah, MD, FRCPE, PhD2
Ann E. Kurth, PhD, RN, FAAN1
Gbenga Ogedegbe, MD, MS, MPH, FACP3
Kelley Newlin Lew, DNSc, ARNP-C, CDE4
(1)College of Nursing, New York University, New York, NY
(2)University of Ghana, Accra, Ghana
(3)School of Medicine, New York University, New York, NY
(4)University of Connecticut, Storrs, CT

Purpose: To develop an electronic health record (EHR) for diabetes patients receiving care at the Ghana National Diabetes Center (NDC). An open-source EHR for the NDC with extensibility to clinics throughout Ghana, will provide significant benefit for diabetes management and research to improve prevention and care of diabetes, a growing source of morbidity and premature mortality in Ghana and other developing countries.

Methods: Leveraging expertise at the Korle Bu Hospital National Diabetes Center, NYU diabetes care and research experts worked collaboratively with Ghanaian diabetes experts to conduct a needs assessment for EHR development by observation of the clinical setting, medical records area, and laboratory data repository. Currently used data-gathering patient forms were reviewed, as were EHR elements used in diabetes management in Kenya and the US.  Specifications for the EHR were provided to the Ghanaian software developer.

Results:The laboratory database contained 3,886 of 5,000 patients. Clinic data consisted primarily of demographics, physiologic data from laboratory assays, and clinical anthropometric measurements. The IT team connected all hospital and NatiNDC laboratory auto-analyzers to a main data warehouse supported by a server with extensive back-up system. Programming of the EHR is now underway and we will report on implementation.

Conclusions: Current paper-based data gathering has not resulted in 100% of patient data being entered into the NDC database. An EHR will provide a mechanism for direct entry of clinical data thereby capturing all diabetes patients receiving care. The software platform, used on clinician laptops and whereby clinical visit data is exported and merged with laboratory data warehoused in a local server, is the first step in the EHR implementation. Once the process is further refined, e-connectivity established at the hospital, and NDC staff trained to implement the EHR, this open-source web-based tool can be extended to other diabetes clinics throughout Ghana/regionally.