Open Access Research article

An evaluation of a tailored intervention on village doctors use of electronic health records

Peiyuan He1, Zhaokang Yuan1*, Yong Liu1, Guoqing Li1, Huanhuan Lv1, Ji Yu2 and Mark F Harris3

Author Affiliations

1 School of Public Health, Nanchang University, 461 Baiyi Road, Nanchang, Jiangxi 330006, China

2 Rural Health Office of Jiangxi Provincial Health Bureau, 1 South 1st Road in Courtyard of Jiangxi Provincial government, Nanchang, Jiangxi 330000, China

3 Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW 2052, Australia

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BMC Health Services Research 2014, 14:217  doi:10.1186/1472-6963-14-217

Published: 14 May 2014

Abstract

Background

To describe and evaluate the effectiveness of tailored intervention on village doctor’s use of electronic health records (EHR) in rural community health services in less developed areas.

Methods

Ten townships were selected. In each township, two similar health service station (CHSS) were chosen. One was randomly as allocated to the intervention group, the other to the control group. Over six monthly visits, a structured on-site intervention including education, supervision and technical support was provided to village doctors in the intervention group tailored to their needs. The Control group received no visits. A sample of 20 families from each CHSS was randomly chosen. An online evaluation of each family’s EHR was conducted by the investigators at baseline and at the end of the 6 month intervention.

Results

In the intervention group, the proportion of households with complete records increased: basic personal information from 2.6% to 32.5%, (Z = -15.099, P = 0.000) and health education records from 0.3% to 1.6% (Z = -4.459, P = 0.000). Similarly at baseline none of the 80 elders had her records. This increased in the intervention group to 16.4% recorded in part and 37.0% in full (Z = -7.480, P = 0.000). The proportion of complete health management records for children aged 1 to 2 years and 3 to 6 years increased from 28.6% and 33.3% to 66.7% and 74.2% respectively (the difference of children group 3 to 6 years of age was statistically significant, Z = -3.860, p = 0.000). The proportion of complete basic clinic records in the intervention group increased from 7.6% to 13.9% (Z = -3.252, P = 0.001). There were no significant differences in the control group.

Conclusions

The pilot study showed that a on-site education, supervision and technical support tailored to their needs was associated with improvements in village doctors use of EHR. This model is worthy of implementation in other rural areas.

Keywords:
EHR; Village doctors; Pilot study; Personalized intervention; Rural areas