Association between Human Resource Factors and Utilization of IQCare System for Clinical Decision Support in HIV Care Clinics in Nakuru County, Kenya

Abstract

Electronic medical records (EMR) are computerized medical information systems that are used to collect, store, and display patient information. EMR systems can strengthen pathways of care and close gaps in patient tracking, care, and management of chronic diseases such as HIV&AIDS. Conventionally, health care workers (HCWs) face difficulties in locating, sorting, and identifying key information in paper records. To counter these challenges, in the year 2010 the Ministry of Health in Kenya approved the use of two EMR platforms, namely the International Quality Care (IQCare) system and the KenyaEMR. These systems were initially set to support HIV&AIDS clinical decision making. In 2014, Nakuru County was among the first counties to roll out the utilization of IQCare system for clinical decision support (CDS). In its implementation, appropriate support was provided, which included human resource and ICT infrastructure. Despite the substantial investment in IQCare in Nakuru County, its utilization for CDS remained low. As such, this study investigated the influence of human resource factors on the utilization of IQCare for CDS in the provision of HIV&AIDS care services in health facilities in Nakuru County. This cross-sectional study was conducted in 13 health facilities where IQCare had been deployed since January 2014 and enrolled 81 HCWs. Data was collected using questionnaires and focus group discussions. The results from the study revealed a significant association between human resource factors and utilization of IQCare for CDS. Specifically, IQCare training (p=0.023) and mentorship support (p=0.049) were significantly associated with use of IQCare for CDS. These results showed that staff training on IQCare and mentorship support are drivers to utilization of IQCare for CDS in Nakuru County. The study recommends that decision-makers at facility, county and national level should invest in HCWs training and mentorship support to guarantee optimal utilization of IQCare systems for CDS.