ArticleGlobal health action2015
Impact of an electronic clinical decision support system on workflow in antenatal care: the QUALMAT eCDSS in rural health care facilities in Ghana and Tanzania.
Article in Global health action, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
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Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The impact of eHealth use on general practice workload in the pre-COVID-19 era: a systematic review.BMC health services research · 2024Pooled it
- Trial
- Integrated Digital Decision-Making Systems in Maternal Nursing and Maternity Care: A Scoping Review.Journal of multidisciplinary healthcare · 2026Review
- A Novel Approach to Assessing the Potential of Electronic Decision Support Systems to Improve the Quality of Antenatal Care in Nepal.Global health, science and practice · 2025Article
- Workload in antenatal care before and after implementation of an electronic decision support system: an observed time-motion study of healthcare providers in Nepal.BMC medical informatics and decision making · 2025Observational
- Experiences, challenges and lessons while implementing a clinical decision support system in Botswana.Oxford open digital health · 2025Article
- Clinical decision support systems for maternity care: a systematic review and meta-analysis.EClinicalMedicine · 2024Article
- Use of Antivibration Technology to Reduce Demands for In-Home Nursing Care and Support in Rural Settings for Persons with Essential Tremors: A Qualitative Study.International journal of environmental research and public health · 2024Article
- Article
- Towards an explainable clinical decision support system for large-for-gestational-age births.PloS one · 2023Article
- Effects of computerized decision support on maternal and neonatal health-worker performance in the context of combined implementation with performance-based incentivisation in Upper East Region, Ghana: a qualitative study of professional perspectives.BMC health services research · 2022Article
- eRegTime-Time Spent on Health Information Management in Primary Health Care Clinics Using a Digital Health Registry Versus Paper-Based Documentation: Cluster-Randomized Controlled Trial.JMIR formative research · 2022Article
- The Development of an Electronic Clinical Decision and Support System to Improve the Quality of Antenatal Care in Rural Tanzania: Lessons Learned Using Intervention Mapping.Frontiers in public health · 2021Article
- Article
- "Assessment of the social influence and facilitating conditions that support nurses' adoption of hospital electronic information management systems (HEIMS) in Ghana using the unified theory of acceptance and use of technology (UTAUT) model".BMC medical informatics and decision making · 2019Article
- eRegTime, Efficiency of Health Information Management Using an Electronic Registry for Maternal and Child Health: Protocol for a Time-Motion Study in a Cluster Randomized Trial.JMIR research protocols · 2019Article
- The Usability of Electronic Medical Record Systems Implemented in Sub-Saharan Africa: A Literature Review of the Evidence.JMIR human factors · 2019Review
- Mobile health and the performance of maternal health care workers in low- and middle-income countries: A realist review.International journal of care coordination · 2018Article
- Pregnant women's experiences with an integrated diagnostic and decision support device for antenatal care in Ghana.BMC pregnancy and childbirth · 2018Article
- Integration of maternal postpartum services in maternal and child health services in Kaya health district (Burkina Faso): an intervention time trend analysis.BMC health services research · 2018Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe implementation of new technology can interrupt established workflows in health care settings. The Quality of Maternal Care (QUALMAT) project has introduced an electronic clinical decision support system (eCDSS) for antenatal care (ANC) and delivery in rural primary health care facilities in Africa.
objectiveThis study was carried out to investigate the influence of the QUALMAT eCDSS on the workflow of health care workers in rural primary health care facilities in Ghana and Tanzania.
designA direct observation, time-and-motion study on ANC processes was conducted using a structured data sheet with predefined major task categories. The duration and sequence of tasks performed during ANC visits were observed, and changes after the implementation of the eCDSS were analyzed.
resultsIn 24 QUALMAT study sites, 214 observations of ANC visits (144 in Ghana, 70 in Tanzania) were carried out at baseline and 148 observations (104 in Ghana, 44 in Tanzania) after the software was implemented in 12 of those sites. The median time spent combined for all centers in both countries to provide ANC at baseline was 6.5 min [interquartile range (IQR) =4.0-10.6]. Although the time spent on ANC increased in Tanzania and Ghana after the eCDSS implementation as compared to baseline, overall there was no significant increase in time used for ANC activities (0.51 min, p=0.06 in Ghana; and 0.54 min, p=0.26 in Tanzania) as compared to the control sites without the eCDSS. The percentage of medical history taking in women who had subsequent examinations increased after eCDSS implementation from 58.2% (39/67) to 95.3% (61/64) p<0.001 in Ghana but not in Tanzania [from 65.4% (17/26) to 71.4% (15/21) p=0.70].
conclusionsThe QUALMAT eCDSS does not increase the time needed for ANC but partly streamlined workflow at sites in Ghana, showing the potential of such a system to influence quality of care positively.
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