(EMR_Site)Number of PEPFAR-supported facility-based service delivery points supported by your organization that have an electronic medical record system

Export Indicator

Number of PEPFAR-supported facility-based service delivery points supported by your organization that have an electronic medical record system
What it measures

This indicator can be used as a cross-sectional indicator at Q4. It can be used to better understand our investments in Strategic information; and to support the understanding of data quality for other indicators. Timely access to up-to-date patient information plays a vital role in the provision of effective clinical care by health professionals. Diagnosis and treatment can be improved if health professionals have easy access to accurate and comprehensive medical records of patients

Numerator

Number of PEPFAR-supported facility-based service delivery points supported by your organization that have an electronic medical record system. (Record answer separately for each service delivery point)

Denominator

N/A (This is not collected as part of this indicator; however should be the total number of PEPFAR supported active service delivery points (those sites that reported either targets or results for the service delivery area at each site)

Calculation

This indicator can be used as a cross-sectional indicator at Q4, to determine the number of function-able, working EMR supporting clinical management and data reporting in the PEPFAR- support sites.

Method of measurement

- The partner should indicate whether the PEPFAR-Supported service delivery areas listed below have implemented and are actively using an electronic medical record system (also known as electronic patient tracking systems). (EMR/EPTS) to assist clinical service provision or for patient or program monitoring and reporting. Specifically for PEPFAR reporting a minimum of 6 months of retrospective data should be included in the EMR. (For example, an ART EMR can be set up in Sept 2016, and contain at least 6 months of retrospective data (current patients that have been enrolled on ART) and can be included for Q4 reporting.

- The partner should indicate whether the PEPFAR-Supported service delivery areas listed below have NOT implemented an EMR/EPTS

- This should be used if the site has this service delivery area, but the partner does not support these services; OR the site does not include this service (N/A).

NOTE: If a service is offered at the site but integrated into another service delivery point do not record N/A, but rather document whether the EMR/EPTS at that site is inclusive of those services (for example this site does not have PEPFAR funded targets for the service delivery area).

Definition of an Electronic Medical Record (EMR): An EMR/EPTS is a longitudinal electronic record of an individual patient's health information that can assist health professionals with decision-making and treatment. Data found in a record may include patient demographics, past medical history, vital signs, examination and progress notes, medications, allergies, immunizations, laboratory test results, other test results. It can also support the collection of data for other uses such as quality management, public health disease surveillance and reporting. < WHO: Global Observatory for eHealth > EMR can include real-time point-of-care data entry as well as retrospective data entry. An electronic medical record (EMR) is a digital version of a paper chart that contains key information in a patient’s medical history from one service delivery point or site.

Individual SDP EMR versus Integrated Health EMR: EMRs are typically for all health areas, but PEPFAR is interested in better understanding whether EMRs are available for the service delivery areas where PEPFAR focusses its work (presented in the disaggregation below). If a service delivery area is incorporated in a larger integrated health EMR, then it should be included this indicator. If two or more service areas are in an integrated EMR, both areas should be included in this indicator. A site service delivery area should be included in this indicator if the EMR is on site (Server and Computer entry screen or there is a central server at a hub facility, that includes all data from all the “spokes” for that facility’s catchment area. As long as the data for patient management and reporting comes from the EMR system as one source.

Registries: Some sites maintain types of e-Register (which might provide basic functionality like reporting, default tracing, etc), however, if they do not capture longitudinal clinical information, they should not be included in this indicator.

How to review for data quality:

If a site does not report ART (PEPFAR-supported ART site), then it should not be included as having a function-able, working ART EMR; but should be included in N/A. Number of service delivery area with an EMR should not exceed the number of service delivery areas reporting results/targets.

Reporting Level

Site level, facility only

Measurement frequency

Reported at Q4

Disaggregation

Number of PEPFARsupported facility service delivery points supported by your organization that have an electronic medical record system.

Service delivery point

HIV testing Services Care and Treatment ANC EID HIV/TB

Description of Disaggregate

See “how to collect”

Further information

MER 1.0 to 2.0 Change

This is a new indicator for MER 2.0 and is the first MER SI indicator to capture PEPFAR strategy information systems investments.

PEPFAR Support definition

As an above site indicator, the PEPFAR support categories of DSD and TA-SDI do not apply. To report results for this indicator, it is expected that PEPFAR provides support to the HIV service delivery area. PEPFAR does NOT have to have supported the development of the EMR at the site to be counted. EMRs supported by other donors or Ministries of Health should be included in this indicator. It is highly recommended that service delivery areas that have functional EMRs use these both for patient management as well as reporting.

Definition : what is a PEPFAR supported site for the purpose of this indicator:

A “PEPFAR supported site” for the purpose of this indicator should include any facility site in the PEPFAR master facility list in DATIM which also reported any programmatic target or result during the same reporting period.

Definition: PEPFAR-Supported Service Delivery Point at a site for the purpose of this indicator

A PEPFAR-supported facility-based service delivery point uses PEPFAR funds to provide HIV-related services. It offers one or more HIV-related services including but not limited to: HIV testing and counseling; prevention of mother-to-child transmission of HIV (PMTCT); anti-retroviral treatment (ART) and TB/HIV services. Examples include different HIV services within clinics, hospitals, health facilities and community-based organizations (government, private or NGO). These can also include fixed locations and/or mobile operations offering routine and/or regularly scheduled services.

PEPFAR service delivery points for EMR integration include the following:

1. HIV Testing services –includes counselling (pre-test information and post-test counselling); linkage to appropriate HIV services; and coordination with laboratory services to support quality assurance and the delivery of correct results.

2. Treatment services – this includes services where ART is initiated and monitored.

3. Antenatal/maternity services– HIV Testing and treatment in an ANC and/or maternity setting

4. EID services – HIV testing and care for infants of HIV positive women, often linked to <5 children services and/or maternity services, but can also be part of an ART clinic, but with its own EMR EID

5. TB/HIV services – includes routine screening, diagnosis, treatment, and prevention of TB among PLWHA or routine HIV testing and counseling and appropriate referral in persons with TB

If services are integrated, for example EID as part of the Treatment services, then as long as EID is captured in the treatment services EMR or a separate EMR for EID is available within these services, then this would be counted as an EID EMR as well.

DREAMS SNU Specific Guidance

None