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Lusaka, Zambia October 5, 2007 Xenophon M. Santas Global AIDS Division, CDC-Atlanta

Strategies for Building National-Scale Longitudinal Patient Monitoring Systems for HIV Treatment and Care in PEPFAR Countries Wrap-up and Next Steps. Lusaka, Zambia October 5, 2007 Xenophon M. Santas Global AIDS Division, CDC-Atlanta xsantas@cdc.gov.

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Lusaka, Zambia October 5, 2007 Xenophon M. Santas Global AIDS Division, CDC-Atlanta

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  1. Strategies for Building National-Scale Longitudinal Patient Monitoring Systems for HIV Treatment and Care in PEPFAR CountriesWrap-up and Next Steps Lusaka, Zambia October 5, 2007 Xenophon M. Santas Global AIDS Division, CDC-Atlanta xsantas@cdc.gov

  2. Synergy, enthusiasm generated just by getting folks together

  3. Strategic vision for HMIS • Review and assess existing systems, especially facility, patient-level systems • HMIS/SI addendum for the PEPFAR 5-year strategy

  4. Identifying/attracting new HMIS staff • Within USG • Within host governments

  5. Challenges of Scale-up • Implementation planning • E-readiness • Training • Hardware needs • Hardware Maintenance • Connectivity • Technical support for technology • Service level support • Well-structured, accountable contracts • “If you don’t know how to write a system, you don’t know how to buy one.”

  6. Data system architecture • Delineate system component • Manage change

  7. Human capacity development • Immediate term • Long-range planning • Incorporating HMIS into existing curricula • Fellowships • Academia • Staff turnover • Bi-directional technical assistance • 1-2 month assignments for field staff at headquarters

  8. Data quality improvement

  9. Paper versus electronic systems • Hybrid systems

  10. Building a single national monitoring system for HIV care, treatment, and prevention activities (the Third One) • Standards for data content • Standard core data sets • Standard definitions for data elements • Operational definitions • Standards for data transmission • HL7 messaging • Inclusive, collaborative process for planning and harmonizing systems

  11. Building the Third One • Aiming for convergence • Fewer systems make harmonization easier • Innovation must not be hampered • Collective efforts can help build support at higher levels • Challenges of legacy systems

  12. National IDs/Unique IDs

  13. Free and open source software

  14. Confidentiality and Security of HIV information

  15. Aggregate versus patient-level data for monitoring activities • How far up the reporting chain should patient-level information be transmitted? • How do we link patient-level systems to aggregated data system

  16. Legal framework for health information systems • Privacy/confidentiality • Recognition of electronic records as legal documents

  17. Allure of technology • Patients perceptions that adoption of technology correlates with quality of clinical care

  18. Evaluation of information systems • Challenge of evaluation framework/design • Identifying appropriate measures • “Evaluation can be more challenging than the system itself.”

  19. We need your feedback • Evaluation forms • Comments on the workshop materials

  20. Thanks! • MACRO International • Meeting organization and logistics • Graphics and workshop material • Bibliography • Implementation plan template • Session speakers, facilitators, rapartuers • CDC-Zambia • SmartCare sites • Workshop participants

  21. Deeds not words

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