Studies in health technology and informatics, 2013
Electronic Medical Records (EMR) are thought to improve healthcare through a variety of means. Ho... more Electronic Medical Records (EMR) are thought to improve healthcare through a variety of means. However, the study of EMR implementation in resource-poor settings has been minimal. Moi Teaching and Referral Hospital (MTRH) is the second largest tertiary care centre in Kenya, hosting a busy antenatal clinic serving Eldoret and surrounding regions. The recent transition from written to electronic antenatal records at MTRH permits the opportunity to study whether this change improves quality of care, in terms of: TIME: Does the patient or healthcare worker spend the same amount of time at the encounter? SATISFACTION: Is the patient or healthcare worker more or less satisfied with the encounter? COMPLETENESS: Does the antenatal record do a better job of recording key information in the antenatal history? Our Objective wasto determine the effects of EMR implementation on an antenatal clinic in a resource-limited setting.
Impact of international collaboration on surgical services in a Nigerian tertiary centre. A.A. Na... more Impact of international collaboration on surgical services in a Nigerian tertiary centre. A.A. Nasir,* A.S. Yusuf,† L.O. Abdur-Rahman,* B.A. Ahmed,‡ D. Panikar,§ M.K. Abraham.¶ From the Divisions of *Paediatric Surgery, †Neurosurgery and ‡Orthopaedic Surgery, Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Nigeria, and the Departments of §Neurosurgery and ¶Pediatric Surgery, Amrita Institute of Medical Sciences and Research Centre, Kochi, India
Background: Our aim was to highlight the impact of collaboration between 2 linked tertiary hospit... more Background: Our aim was to highlight the impact of collaboration between 2 linked tertiary hospitals in Nigeria and India. Methods: We conducted a review of a collaboration between the
Introduction: Electronic health records (EHRs) are receiving a lot of attention for their potenti... more Introduction: Electronic health records (EHRs) are receiving a lot of attention for their potential to improve care. Objective: To develop and implement EHRs in the antenatal clinic (ANC) of a teaching and referral hospital in Western Kenya. Results: A multidisciplinary team developed a phased implementation of EHRs in the ANC as part of a CDC-funded effort to develop and implement primary care EHRs in lower level and referral facilities in Kenya comprising a clinic registration system and initial- and return-visit encounter forms that captured and reported data required for reporting. This was successfully done, the EHR fully implemented in the ANC including a reminder system to enhance adherence to care guidelines. Conclusions: It is possible to implement EHRs in a referral hospital ANC.
Electronic Medical Records (EMR) are thought to improve healthcare through a variety of means. Ho... more Electronic Medical Records (EMR) are thought to improve healthcare through a variety of means. However, the study of EMR implementation in resource-poor settings has been minimal. Moi Teaching and Referral Hospital (MTRH) is the second largest tertiary care centre in Kenya, hosting a busy antenatal clinic serving Eldoret and surrounding regions. The recent transition from written to electronic antenatal records at MTRH permits the opportunity to study whether this change improves quality of care, in terms of: Time: Does the patient or healthcare worker spend the same amount of time at the encounter? Satisfaction: Is the patient or healthcare worker more or less satisfied with the encounter? Completeness: Does the antenatal record do a better job of recording key information in the antenatal history? Our Objective wasto determine the effects of EMR implementation on an antenatal clinic in a resource-limited setting.
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine, 1998
The vagina is formed by cells from the müllerian ducts and the urogenital sinus.1 Failure of müll... more The vagina is formed by cells from the müllerian ducts and the urogenital sinus.1 Failure of müllerian duct development or failure of ductal fusion with the urogenital sinus results in uterine and vaginal anom-alies. Disorders of vertical fusion represent faults in the junction between the down-...
Studies in health technology and informatics, 2010
Efficient use of health care resources in low-income countries by providers and local and nationa... more Efficient use of health care resources in low-income countries by providers and local and national managers requires timely access to patient data. To implement electronic health records (EHRs) in HIV clinics in Kenya, Tanzania, and Uganda. We initially developed and implemented an EHR in Kenya through a mature academic partnership. The EHR was then implemented in six HIV clinics in Tanzania and Uganda in collaboration with their National AIDS Control Programmes. All implementations were successful, but the system's use and sustainability varied depending on who controlled clinic funding. Successful EHR use and sustainability were enhanced by local control of funds, academic partnerships (mainly by leveraging research funds), and in-country technology support.
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstétrique et gynécologie du Canada : JOGC, 2002
To compare rectal misoprostol with oxytocin for routine management of the third stage of labour. ... more To compare rectal misoprostol with oxytocin for routine management of the third stage of labour. A total of 240 parturient women were randomized, at three University of Toronto teaching hospitals, to receive either rectal misoprostol (400 microg) after delivery of the infant or parenteral oxytocin (5 units i.v. or 10 units i.m.) with the delivery of the anterior shoulder, when possible, or 5 units i.v. or i.m after the delivery of the placenta. The primary outcome measure was change in hemoglobin (Delta[Hgb]) from admission in early labour to day one postpartum. The labour ward of three University of Toronto teaching hospitals: St. Michael's, Toronto General, and Mount Sinai. Labouring women either nulliparous or multiparous with no known risk for excessive third stage blood loss; vertex presentation; no previous Caesarean delivery; induced, spontaneous, or augmented labour. No difference in Delta[Hgb] was observed between the two groups; the Delta[Hgb] in the oxytocin and misop...
International Journal of Gynecology & Obstetrics, 2014
One-year evaluation of the impact of an emergency obstetric and neonatal care training program in... more One-year evaluation of the impact of an emergency obstetric and neonatal care training program in Synopsis: Emergency obstetric and neonatal care training in a low-resource tertiary care center improved maternal outcomes, including those related to postpartum hemorrhage.
Studies in health technology and informatics, 2013
Electronic Medical Records (EMR) are thought to improve healthcare through a variety of means. Ho... more Electronic Medical Records (EMR) are thought to improve healthcare through a variety of means. However, the study of EMR implementation in resource-poor settings has been minimal. Moi Teaching and Referral Hospital (MTRH) is the second largest tertiary care centre in Kenya, hosting a busy antenatal clinic serving Eldoret and surrounding regions. The recent transition from written to electronic antenatal records at MTRH permits the opportunity to study whether this change improves quality of care, in terms of: TIME: Does the patient or healthcare worker spend the same amount of time at the encounter? SATISFACTION: Is the patient or healthcare worker more or less satisfied with the encounter? COMPLETENESS: Does the antenatal record do a better job of recording key information in the antenatal history? Our Objective wasto determine the effects of EMR implementation on an antenatal clinic in a resource-limited setting.
Impact of international collaboration on surgical services in a Nigerian tertiary centre. A.A. Na... more Impact of international collaboration on surgical services in a Nigerian tertiary centre. A.A. Nasir,* A.S. Yusuf,† L.O. Abdur-Rahman,* B.A. Ahmed,‡ D. Panikar,§ M.K. Abraham.¶ From the Divisions of *Paediatric Surgery, †Neurosurgery and ‡Orthopaedic Surgery, Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Nigeria, and the Departments of §Neurosurgery and ¶Pediatric Surgery, Amrita Institute of Medical Sciences and Research Centre, Kochi, India
Background: Our aim was to highlight the impact of collaboration between 2 linked tertiary hospit... more Background: Our aim was to highlight the impact of collaboration between 2 linked tertiary hospitals in Nigeria and India. Methods: We conducted a review of a collaboration between the
Introduction: Electronic health records (EHRs) are receiving a lot of attention for their potenti... more Introduction: Electronic health records (EHRs) are receiving a lot of attention for their potential to improve care. Objective: To develop and implement EHRs in the antenatal clinic (ANC) of a teaching and referral hospital in Western Kenya. Results: A multidisciplinary team developed a phased implementation of EHRs in the ANC as part of a CDC-funded effort to develop and implement primary care EHRs in lower level and referral facilities in Kenya comprising a clinic registration system and initial- and return-visit encounter forms that captured and reported data required for reporting. This was successfully done, the EHR fully implemented in the ANC including a reminder system to enhance adherence to care guidelines. Conclusions: It is possible to implement EHRs in a referral hospital ANC.
Electronic Medical Records (EMR) are thought to improve healthcare through a variety of means. Ho... more Electronic Medical Records (EMR) are thought to improve healthcare through a variety of means. However, the study of EMR implementation in resource-poor settings has been minimal. Moi Teaching and Referral Hospital (MTRH) is the second largest tertiary care centre in Kenya, hosting a busy antenatal clinic serving Eldoret and surrounding regions. The recent transition from written to electronic antenatal records at MTRH permits the opportunity to study whether this change improves quality of care, in terms of: Time: Does the patient or healthcare worker spend the same amount of time at the encounter? Satisfaction: Is the patient or healthcare worker more or less satisfied with the encounter? Completeness: Does the antenatal record do a better job of recording key information in the antenatal history? Our Objective wasto determine the effects of EMR implementation on an antenatal clinic in a resource-limited setting.
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine, 1998
The vagina is formed by cells from the müllerian ducts and the urogenital sinus.1 Failure of müll... more The vagina is formed by cells from the müllerian ducts and the urogenital sinus.1 Failure of müllerian duct development or failure of ductal fusion with the urogenital sinus results in uterine and vaginal anom-alies. Disorders of vertical fusion represent faults in the junction between the down-...
Studies in health technology and informatics, 2010
Efficient use of health care resources in low-income countries by providers and local and nationa... more Efficient use of health care resources in low-income countries by providers and local and national managers requires timely access to patient data. To implement electronic health records (EHRs) in HIV clinics in Kenya, Tanzania, and Uganda. We initially developed and implemented an EHR in Kenya through a mature academic partnership. The EHR was then implemented in six HIV clinics in Tanzania and Uganda in collaboration with their National AIDS Control Programmes. All implementations were successful, but the system's use and sustainability varied depending on who controlled clinic funding. Successful EHR use and sustainability were enhanced by local control of funds, academic partnerships (mainly by leveraging research funds), and in-country technology support.
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstétrique et gynécologie du Canada : JOGC, 2002
To compare rectal misoprostol with oxytocin for routine management of the third stage of labour. ... more To compare rectal misoprostol with oxytocin for routine management of the third stage of labour. A total of 240 parturient women were randomized, at three University of Toronto teaching hospitals, to receive either rectal misoprostol (400 microg) after delivery of the infant or parenteral oxytocin (5 units i.v. or 10 units i.m.) with the delivery of the anterior shoulder, when possible, or 5 units i.v. or i.m after the delivery of the placenta. The primary outcome measure was change in hemoglobin (Delta[Hgb]) from admission in early labour to day one postpartum. The labour ward of three University of Toronto teaching hospitals: St. Michael's, Toronto General, and Mount Sinai. Labouring women either nulliparous or multiparous with no known risk for excessive third stage blood loss; vertex presentation; no previous Caesarean delivery; induced, spontaneous, or augmented labour. No difference in Delta[Hgb] was observed between the two groups; the Delta[Hgb] in the oxytocin and misop...
International Journal of Gynecology & Obstetrics, 2014
One-year evaluation of the impact of an emergency obstetric and neonatal care training program in... more One-year evaluation of the impact of an emergency obstetric and neonatal care training program in Synopsis: Emergency obstetric and neonatal care training in a low-resource tertiary care center improved maternal outcomes, including those related to postpartum hemorrhage.
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