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CDSS Meeting Minutes Apr-15-2010

Present: Kenya - Lagat, Kipsang    US - Ribeka, Were

Communication & Record Keeping

We need to record items on the wiki - including all reports, meeting minutes etc.
[ ] Lagat needs to get a Wiki ID

Updates on Version 3.5

- There is a growing difference between pre-generated summaries and those from list in outreach.  Means there is something missing in the query for batch printing.  Win coded the query to only use return dates only for encounter form types that are used in the summary, but this should be extended to all obs for return date, regardless of encounter type - i.e. simply look at the obs with RETURN DATE.

[ ] Lagat to send Win to list of differences between batch list and Outreach-generated list

[ ] Win to look into the code and make the changes

- There are still some clinical summaries not being picked up by the data assistant.  We had a strategy where the data-entry clerk has to go to each room and collect all form (both encounter forms and clinical summaries).   The idea by Lagat to have one of the CDSS DAs do this job would not work, because this responsibility is one for all AMPATH DA's.  Lelei and Lagat should work on ensuring that 100% of summaries and encounters forms are collected.  There also needs to be an oversight mechanism to ensure that this actually gets done, and what action will happen if a DA does not do it - right in Lelei's alley.  Kipsang to talk to clinicians to ensure that they give in all summaries and encounter forms.  Until we have reliable collection of encounter forms and summaries, DAs will have to go to the rooms.

[ ] Lelei and Lagat to work on coming up with a method that includes the AMPATH DAs, with a good mechanism to oversee that things actually get done

- Printing of summaries for patients who show up unscheduled - nurses are doing it 100% of the time as per Lagat and Kipsang.  On occasion, they have had to use the standalone machine when the Module computers were down, and this has worked well.

[ ] Lagat to talk to nurses re: any time delays with realtime summary generation and printing, and any issues they might have.

Updates on 2nd standalone machine

- Installed OpenMRS on Tuesday morning (Augustine).  They were having some problems downloading batched summaries into this new machine.  Not sure what the problem is and this has not been communicated to us.  At this point, this is the biggest rate-limiting step for us.  IT with guidance from James need to lead this process.  We all agreed that Lagat should not be installing OpenMRS etc.  This is an IT responsibility.

[ ] Martin to talk to James to see how to improve efficiency of setting up a standalone machine

[ ] Win and James to discuss why uploads are not working

Implementations

Module 1, 2 and 3 - using v3.5 with batch printing. Updates for these are in rest of the summary

Burnt Forest - we should be getting ready to install the stand alone machine on this

Other sites - need to discuss these in the next meeting

Quality Issues

- We need one person who does data quality (Sheila) to be at these meetings

- There were a lot of problems with patient staging initially- where clinicians lower the staging.  Kipsang has been seeing the respective clinicians who make mistakes and has been talking to them. 

[ ] Lagat and Kipsang to document (1) % of summaries with WHO reminder  (2) Breakdown of providers who make the errors - should be done every month.  The key is to see if we are maning any progress.

- Isoniazid was not appearing, Win made an error and put TB treatment instead of TB prophylaxis meds.  This has already been changed.  We decided that when there are any changing that actually affect the actually summary, Lagat would re-generate summaries in real time, and upload them to the standalone machine.

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