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Evolution of a Training Program in Use of Electronic Medical Records: Towards Efficiency and Quality Scale-Up “Doing More with Less”

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Evolution of a Training Program in Use of Electronic Medical Records: Towards Efficiency and Quality Scale-Up “Doing more with less”
Introduction
International Training and Education Center for Health (I-TECH) is a global network that supports the development of a skilled health work force to provide effective prevention, care, and treatment of infectious disease in the developing world
I-TECH provides technical assistance to the Kenyan Ministry of Health for implementation of an open-source electronic medical record (EMR) system, called KenyaEMR (hosted on Open MRS platform) within 315 public health facilities in four regions of Kenya. Before implementation, I-TECH carried out a training needs assessment among personnel in 23 facilities. Distinct training needs for health managers and front-line health care workers identified

Method
I-TECH implemented three different strategies in delivering KenyaEMR trainings to users
Trainings were delivered by three different groups (training institutions, centrally located facilitators, county facilitators)
Training locations transitioned from off-site (hotel-based) trainings to on-site (facility-based) trainings in a bid to train more health care workers (HCW)
Length and content of trainings was adjusted in response to curriculum evaluation and strategy changes to incorporate mentorship sessions

Strategy #1 • Five-day off site user training • Delivered by facilitators from training institutions

Strategy #2 • Three-day off site user training • Delivered by master facilitators

Strategy #3 • Four-day on-site end-user + mentor training • Delivered by MOH county-level facilitators • 1-2 Champion Mentors per site cascade training to other HCW

Results
January-March 2013: Strategy 1
Cost per participant $2,345
121 managers attended Health Manager Orientations
67 HCW attended KenyaEMR User Training

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