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Evaluating the Performance, Impact and Costs of a Large Scale eHealth System Impl

Award Number: U01GH000782
ORGANIZATION: COORDINATING OFFICE OF GLOBAL HEALTH
OPDIV: CDC
AWARD CLASS: COOPERATIVE AGREEMENT
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/30/2013
PERIOD OF PERFORMANCE END DATE: 09/29/2017

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Evaluating the Performance, Impact and Costs of a Large Scale eHealth System Impl - Project summary This application addresses the urgent need for more and better evidence on the appropriate selection, implementation and use of electronic health (eHealth) systems to support the care of HIV patients in developing countries. eHealth system including electronic medical records (EMRs) are potentially powerful instruments to strengthen health systems, to improve access to and quality of care, and reduce costs. While these technologies show great promise in countries whose health systems face severe financial, infrastructural, technical and human resource constraints, key questions remain for decision makers: (1) How can eHealth facilitate scale up of health initiatives in resource poor environments? (2) How can such systems be more effectively developed, and implemented to ensure high quality information for clinical and programmatic use? (3) Have the large investments in eHealth in resource-poor environments demonstrated clinical impacts such as improving HIV patient outcomes? (4) What are the short term and long term costs of implementing such systems and how can their sustainability be improved? While eHealth is proliferating in resource poor environments, often for HIV care supported by large investments from agencies including PEPFAR, data on their implementation, clinical impact and costs is very sparse. Countries like Rwanda and Kenya whose eHealth plans call for national rollouts of EMRs critically need evidence from rigorous, and generalizable studies. The core issue being addressed in this study is: What is the benefit of using an eHealth system to collect and manage clinical data at clinics that are often in remote sites with limited staff, and infrastructure? It builds on a critical opportunity to assess an open source EMR system, OpenMRS, that is being adapted by a technical team from the Rwandan MOH, and rolled out to several hundred clinics. With 11 sites implemented to date, this is the ideal time to perform a randomized controlled trial with 50 or more sites randomized to receive the system early or late. We will address three related questions: how to optimize systems and ensure they are stable, usable and used, what are the impacts on clinical processes and outcomes, and what are the costs of deploying and sustaining such systems? Clinical indicators will include mean CD4 count and viral load, activities such as ordering of laboratory tests, and rate of loss to follow up of pre-ART patients. The results should inform policy and care in many countries for HIV and other diseases. We will also create a training course in eHealth evaluation at the National University of Rwanda School of Public Health, training evaluators to take a lead in designing and carrying out studies.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2017 ( Subtotal = $0 )
2017	2014	UNIVERSITY OF RWANDA	GIKONDO	KIGALI				RWA	Global AIDS	000	2	10/21/2016	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2015 ( Subtotal = $495,000 )
2015	2015	NATIONAL UNIVERSITY OF RWANDA	BUTARE	BUTARE				RWA	Global AIDS	003	2	8/28/2015	SUPPLEMENT FOR EXPANSION	$495,000
2015	2015	NATIONAL UNIVERSITY OF RWANDA	BUTARE	BUTARE				RWA	Global AIDS	004	2	9/4/2015	SUPPLEMENT FOR EXPANSION	-$495,000
2015	2015	NATIONAL UNIVERSITY OF RWANDA	BUTARE	BUTARE				RWA	Global AIDS	005	2	9/8/2015	SUPPLEMENT FOR EXPANSION	$495,000
2015	2014	University of Rwanda College of Medicine and Health Sci	University Avenue	KIGALI CITY				RWA	Global AIDS	001	2	7/1/2015	NON-COMPETING CONTINUATION	$0
2015	2014	University of Rwanda College of Medicine and Health Sci	University Avenue	KIGALI CITY				RWA	Global AIDS	000	2	12/12/2014	NON-COMPETING CONTINUATION	$0
2015	2013	University of Rwanda College of Medicine and Health Sci	University Avenue	KIGALI CITY				RWA	Global AIDS	002	1	7/17/2015	NEW	$0
														Subtotal = $495,000

Issue Date FY: 2014 ( Subtotal = $5,000 )
2014	2014	National University of Rwanda	University Avenue	KIGALI CITY				RWA	Global AIDS	003	2	12/12/2014	NON-COMPETING CONTINUATION	$0
2014	2014	NATIONAL UNIVERSITY OF RWANDA	BUTARE	BUTARE				RWA	Global AIDS	002	2	8/22/2014	NON-COMPETING CONTINUATION	$5,000
2014	2013	National University of Rwanda	University Avenue	KIGALI CITY				RWA	Global AIDS	001	1	8/19/2014	NEW	$0
2014	2013	National University of Rwanda	University Avenue	KIGALI CITY				RWA	Global AIDS	000	1	1/9/2014	NEW	$0
														Subtotal = $5,000

Issue Date FY: 2013 ( Subtotal = $495,223 )
2013	2013	NATIONAL UNIVERSITY OF RWANDA	BUTARE	BUTARE				RWA	Global AIDS	000	1	8/28/2013	NEW	$495,223
														Subtotal = $495,223

Grand Total All Awards = $995,223

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Evaluating the Performance, Impact and Costs of a Large Scale eHealth System Impl

Award Number: U01GH000782

ORGANIZATION: COORDINATING OFFICE OF GLOBAL HEALTH

OPDIV: CDC

AWARD CLASS: COOPERATIVE AGREEMENT

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/30/2013

PERIOD OF PERFORMANCE END DATE: 09/29/2017

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