Development and User Testing of a Dynamic Tool for Rheumatic Heart Disease Management

Author:

de Loizaga Sarah R.12,Pulle Jafesi3,Rwebembera Joselyn3,Abrams Jessica45,Atala Jenifer3,Chesnut Emily6,Danforth Kristen7,Fall Ndate1,Felicelli Nicholas6,Lapthorn Karen6,Longenecker Chris T.7,Minja Neema W.3,Moore Ryan A.12,Morrison Riley6,Mwangi Jeremiah8,Nakagaayi Doreen3,Nakitto Miriam3,Sable Craig9,Sanyahumbi Amy10,Sarnacki Rachel9,Thembo Jenipher3,Vincente Sophie La8,Watkins David7,Zühlke Liesl1112,Okello Emmy3,Beaton Andrea12,Dexheimer Judith W.213

Affiliation:

1. The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States

2. Department of Pediatrics, University of Cincinnati School of Medicine, Cincinnati, Ohio, United States

3. Uganda Heart Institute, Mulago Hospital, Kampala, Uganda

4. Division of Paediatric Cardiology, Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa

5. Reach, Cape Town, South Africa

6. Department of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States

7. Department of Global Health & Division of Cardiology, University of Washington, Seattle, Washington, United States

8. Reach, Geneva, Switzerland

9. Department of Cardiology, Children's National Medical Center, Washington, District of Columbia, United States

10. Division of Pediatric Cardiology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, United States

11. Division of Cardiology and Paediatric Cardiology, Department of Medicine/Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa

12. South African Medical Research Council, Cape Town, South Africa

13. Division of Emergency Medicine and Department of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States

Abstract

Abstract Objective Most rheumatic heart disease (RHD) registries are static and centralized, collecting epidemiological and clinical data without providing tools to improve care. We developed a dynamic cloud-based RHD case management application with the goal of improving care for patients with RHD in Uganda. Methods The Active Community Case Management Tool (ACT) was designed to improve community-based case management for chronic disease, with RHD as the first test case. Global and local partner consultation informed selection of critical data fields and prioritization of application functionality. Multiple stages of review and revision culminated in user testing of the application at the Uganda Heart Institute. Results Global and local partners provided feedback of the application via survey and interview. The application was well received, and top considerations included avenues to import existing patient data, considering a minimum data entry form, and performing a situation assessment to tailor ACT to the health system setup for each new country. Test users completed a postuse survey. Responses were favorable regarding ease of use, desire to use the application in regular practice, and ability of the application to improve RHD care in Uganda. Concerns included appropriate technical skills and supports and potential disruption of workflow. Conclusion Creating the ACT application was a dynamic process, incorporating iterative feedback from local and global partners. Results of the user testing will help refine and optimize the application. The ACT application showed potential for utility and integration into existing care models in Uganda.

Funder

American Heart Association Strategically Focused Research Network

Publisher

Georg Thieme Verlag KG

Subject

Health Information Management,Computer Science Applications,Health Informatics

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