See the published version of this preprint at BMC Pregnancy and Childbirth.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
Research Article
Deepak Bhatt
Jhpiego-An Affiliate of Johns Hopkins University, New Delhi 110020
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Computerized clinical decision support (CDSS) –digital information systems designed to improve clinical decision making by providers – are a promising tool for improving quality of care. This study aims to understand the uptake of ASMAN application (defined as completeness of electronic case sheets), the role of CDSS in improving adherence to key clinical practices and delivery outcomes.
Methods: We have conducted secondary analysis of program data (government data) collected from 81 public facilities across four districts each in two sates of Madhya Pradesh and Rajasthan. The data collected between August –October 2017 (baseline) and the data collected between December 2019 – March 2020 was analysed (latest).
Results: The completeness of electronic case sheets was low at postpartum period (40.5%), and in facilities with more than 300 deliveries a month (20.9%). In multivariate logistic regression analysis, the introduction of technology yielded to significant improvement in adherence to key clinical practices. We have observed reduction in fresh still births rates and asphyxia, but these results were not statistically significant in interrupted time series analysis. However, our analysis showed that identification of maternal complications has increased over the period of program implementation and at the same time referral outs decreased.
Conclusions: Our study indicates CDSS has a potential to improve quality of intrapartum care and delivery outcome. Future studies with rigorous study design is required to understand the impact of technology in improving quality of maternity care.
Keywords
Intrapartum care, Postpartum care, maternal health, New-born health, CDSS, mHealth, health information technology, Quality improvement
Figure 1
Figure 2
Figure 3
Figure 4
Loading...
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Pregnancy and Childbirth.
Version 1
Posted 14 Dec, 2020
No community comments so far
Editorial decision: Major revision
On 05 Feb, 2021
Reviews received
Received 21 Jan, 2021
Reviewers agreed
On 20 Jan, 2021
Reviewers agreed
On 11 Jan, 2021
Reviewers invited
Invitations sent on 18 Dec, 2020
Editor assigned
On 18 Dec, 2020
Editor invited
On 10 Dec, 2020
Submission checks complete
On 10 Dec, 2020
First submitted
On 13 Nov, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Maternal & Fetal Medicine
Learn more about our company.
A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Pregnancy and Childbirth.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Deepak Bhatt
Jhpiego-An Affiliate of Johns Hopkins University, New Delhi 110020
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Pregnancy and Childbirth.
Version 1
Posted 14 Dec, 2020
No community comments so far
Editorial decision: Major revision
On 05 Feb, 2021
Reviews received
Received 21 Jan, 2021
Reviewers agreed
On 20 Jan, 2021
Reviewers agreed
On 11 Jan, 2021
Reviewers invited
Invitations sent on 18 Dec, 2020
Editor assigned
On 18 Dec, 2020
Editor invited
On 10 Dec, 2020
Submission checks complete
On 10 Dec, 2020
First submitted
On 13 Nov, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Maternal & Fetal Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Pregnancy and Childbirth.
Background: Computerized clinical decision support (CDSS) –digital information systems designed to improve clinical decision making by providers – are a promising tool for improving quality of care. This study aims to understand the uptake of ASMAN application (defined as completeness of electronic case sheets), the role of CDSS in improving adherence to key clinical practices and delivery outcomes.
Methods: We have conducted secondary analysis of program data (government data) collected from 81 public facilities across four districts each in two sates of Madhya Pradesh and Rajasthan. The data collected between August –October 2017 (baseline) and the data collected between December 2019 – March 2020 was analysed (latest).
Results: The completeness of electronic case sheets was low at postpartum period (40.5%), and in facilities with more than 300 deliveries a month (20.9%). In multivariate logistic regression analysis, the introduction of technology yielded to significant improvement in adherence to key clinical practices. We have observed reduction in fresh still births rates and asphyxia, but these results were not statistically significant in interrupted time series analysis. However, our analysis showed that identification of maternal complications has increased over the period of program implementation and at the same time referral outs decreased.
Conclusions: Our study indicates CDSS has a potential to improve quality of intrapartum care and delivery outcome. Future studies with rigorous study design is required to understand the impact of technology in improving quality of maternity care.
Figure 1
Figure 2
Figure 3
Figure 4
Loading...