April 21, 2011

1. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ Using electronic TB case management systems at RKM Chest Clinic DOT Centers(This Study is supported by grant from State TB office of Delhi) April 21, 2011

2. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ Outline • Background • Quarter 1 Observations • Quarter 2 Observations • TBTMS New Features • TBTMS Requested features (being developed) • Status and Plans

3. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ Background

4. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ RKM Chest Clinic Visit Timeline

5. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ Pilot Study Overview • One year durationof all new patientsstarting treatment at the Ramakrishna Mission Chest Clinic, Karol Bagh and all its DOT centers under Ramakrishna Mission Chest Clinic, Karol Bagh District, New Delhi using TBTMS. • Status: Two quarters data entry completed and reports are available.

6. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ Three-fold Evaluation • Timelyand accurate update of electronic TB treatment records • Estimate the total cost of ownership.

7. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ Oct 1-Dec 31, 2010 Quarter Observations

8. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ Process • Data entry done by supervisor and at DOT providers using laptop with internet access card (connecting to server computer) • For tallying results • We generated TB register automatically from electronic TB cards • Compared this data with manually prepared TB register (and resolved mismatches by inspecting the manual and electronic TB cards)

9. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ Data Mismatch (between manual and electronic)

10. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ Results • The case finding report matched. • Interestingly in one mismatch case, the error was in copying information into manual TB register from TB card.

11. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ TB Patient distribution across DOT Centers

12. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ Patient Registration Activity

13. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ Data Entry Activity Distribution

14. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ Data Lag in DOT Schedule Updates

15. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ Data Lag In DOT Schedule Updates

16. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ Jan 1 to March 31, 2011 Observations

17. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ Process • Starting tallying case finding report at end of each month • Number of mismatches were fewer and were resolved by comparing relevant electronic and manual TB cards. • Planning to provide embedded hyperlinks in case finding report to get the patient TB records corresponding to the category.

18. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ Quarterly reports with hyperlinks 8/11 101/11 153/11 201/11 123/11 … … … … … 5

19. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ TB Patients Gender and Category wise distribution

20. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ Test Distribution by DMCs

21. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ DOT Schedule Update Lag

22. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ DOT Schedule Update Distribution

23. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ TBTMS New Features

24. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ DOT Schedule Update Simplified • Earlier: Click each TB card and tick • New: Open daily report for dosage taken (tick in the list); TB card automatically updated. • All updates for scheduled patients done in a single page • Only for unscheduled patients, go to TB card.

25. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ Alerts for Events • Treatment starts without assigning treatment category • [An alert ‘Mention Category’ is generated prompting user to enter]

26. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ Reports and Charts • Sputum Conversion report • Treatement Outcome Pie Chart • Gender-wise Bar Chart • By Disease Category Pie Chart

27. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ TBTMS New Features (being developed)

28. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ Recording Enhancements • Add more validations to prevent incorrect data entry • New patient can not be category 2 • For Old Patients previous ATT must be specified • Extra Pulmonary patient must specify site • [Please give us any further such validations so we can minimize incorrect data entry] • For pediatric TB cases, automatically generate dosage regimen based on weight

29. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ Recording Enhancements • Treatment Status of positive diagnosed patients should be selectable from list of values (instead of free text) • Recording PHI detail when registering general patients

30. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ TBTMS Features (being developed) • Daily report of scheduled patient dosage taken status (add number of doses taken out of scheduled number of doses) • Monthly report for lab register • PHI report • MDR suspect report • [All reports are auto-generated from the electronic TB card data]

31. Sarada Research Labs (http://www.saradaresearchlabs.org)‏ Status and Plans