Comparative analysis of HIV data completeness in Haiti’s iSanté Plus Electronic Medical Record system across children, adolescents and adults: a cross-sectional evaluation of 2016–2022 data

Objective To evaluate and compare documentation completeness of HIV-related data by age group (children, adolescents and adults) in Haiti’s Electronic Medical Record (EMR) system.Design Cross-sectional evaluation.Setting EMR data for 36 965 enrolment visits, and 123 608 return visits from 58 facilit...

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Main Authors: James P Hughes, Stephen Gloyd, Bradley Wagenaar, Nancy Puttkammer, Beryne Odeny, Jean Guy Honoré, Jean Gabriel Balan, Kemar Célestin, Marinho Elisma, Kesner Francois
Format: Article
Language:English
Published: BMJ Publishing Group 2025-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/7/e087654.full
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author James P Hughes
Stephen Gloyd
Bradley Wagenaar
Nancy Puttkammer
Beryne Odeny
Jean Guy Honoré
Jean Gabriel Balan
Kemar Célestin
Marinho Elisma
Kesner Francois
author_facet James P Hughes
Stephen Gloyd
Bradley Wagenaar
Nancy Puttkammer
Beryne Odeny
Jean Guy Honoré
Jean Gabriel Balan
Kemar Célestin
Marinho Elisma
Kesner Francois
author_sort James P Hughes
collection DOAJ
description Objective To evaluate and compare documentation completeness of HIV-related data by age group (children, adolescents and adults) in Haiti’s Electronic Medical Record (EMR) system.Design Cross-sectional evaluation.Setting EMR data for 36 965 enrolment visits, and 123 608 return visits from 58 facilities in Haiti (from 2016 to 2022).Participants Children, adolescents and adults accessing HIV care and treatment services in Haiti.Main exposure measure Health facility attendance for HIV-related healthcare.Main outcome measure Level of data completeness, as a measure of data quality. We developed Composite Completeness Scores (CCS scores) to measure data completeness. Lower scores meant lower completeness. Generalised linear models were used to investigate factors associated with completeness.Results At the enrolment visit, most patients were adults (81.6%) and female (56.7%). Most facilities were health centres (75.9%). The overall average enrolment visit CCS score was 54.0%. At enrolment, being a child (CCS score difference=−7.08, 95% CI: −11.31 to −2.86) and a more recent year of enrolment (−6.01, 95% CI: −11.69 to −0.33) were significantly associated with lower completeness scores than being an adult and having an earlier year of enrolment, respectively. The overall average return visit CCS score was 49.6%. At the return visit, children (−6.76, 95% CI: −10.07 to −3.45) had significantly lower average completeness scores than adults. For first viral load documentation, children had lower odds of completeness compared with adults (adjusted OR=0.21, 95% CI: 0.16 to 0.28). Sex, year of enrolment, facility ownership (public, private, mixed), total patient volume and duration of EMR use were not significantly associated with completeness of documentation at the enrolment and return visits.Conclusions We observed disparities in electronic data completeness by age group, which may be indicative of digital health disparities. Documentation was particularly poor among children and declined over time for enrolment visits. Further research is needed to understand and address these documentation gaps.
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spelling doaj-art-d6e2a87f9d2c4eb59be6e43bcc6001102025-07-15T04:55:13ZengBMJ Publishing GroupBMJ Open2044-60552025-07-0115710.1136/bmjopen-2024-087654Comparative analysis of HIV data completeness in Haiti’s iSanté Plus Electronic Medical Record system across children, adolescents and adults: a cross-sectional evaluation of 2016–2022 dataJames P Hughes0Stephen Gloyd1Bradley Wagenaar2Nancy Puttkammer3Beryne Odeny4Jean Guy Honoré5Jean Gabriel Balan6Kemar Célestin7Marinho Elisma8Kesner Francois9University of Washington, Seattle, Washington, USADepartment of Global Health, University of Washington, Seattle, Washington, USAUniversity of Washington, Seattle, Washington, USAI-TECH, Department of Global HEalth, University of Washington School of Public Health, Seattle, Washington, USADepartment of Surgery, Washington University in St Louis, St Louis, Missouri, USACentre Haïtien pour le Renforcement du Système de Santé (CHARESS), Port-au-Prince, HaitiCentre Haïtien pour le Renforcement du Système de Santé (CHARESS), Port-au-Prince, HaitiCentre Haïtien pour le Renforcement du Système de Santé (CHARESS), Port-au-Prince, HaitiCentre Haïtien pour le Renforcement du Système de Santé (CHARESS), Port-au-Prince, HaitiProgramme National de Lutte contre le VIH/SIDA (PNLS), Port-au-Prince, HaitiObjective To evaluate and compare documentation completeness of HIV-related data by age group (children, adolescents and adults) in Haiti’s Electronic Medical Record (EMR) system.Design Cross-sectional evaluation.Setting EMR data for 36 965 enrolment visits, and 123 608 return visits from 58 facilities in Haiti (from 2016 to 2022).Participants Children, adolescents and adults accessing HIV care and treatment services in Haiti.Main exposure measure Health facility attendance for HIV-related healthcare.Main outcome measure Level of data completeness, as a measure of data quality. We developed Composite Completeness Scores (CCS scores) to measure data completeness. Lower scores meant lower completeness. Generalised linear models were used to investigate factors associated with completeness.Results At the enrolment visit, most patients were adults (81.6%) and female (56.7%). Most facilities were health centres (75.9%). The overall average enrolment visit CCS score was 54.0%. At enrolment, being a child (CCS score difference=−7.08, 95% CI: −11.31 to −2.86) and a more recent year of enrolment (−6.01, 95% CI: −11.69 to −0.33) were significantly associated with lower completeness scores than being an adult and having an earlier year of enrolment, respectively. The overall average return visit CCS score was 49.6%. At the return visit, children (−6.76, 95% CI: −10.07 to −3.45) had significantly lower average completeness scores than adults. For first viral load documentation, children had lower odds of completeness compared with adults (adjusted OR=0.21, 95% CI: 0.16 to 0.28). Sex, year of enrolment, facility ownership (public, private, mixed), total patient volume and duration of EMR use were not significantly associated with completeness of documentation at the enrolment and return visits.Conclusions We observed disparities in electronic data completeness by age group, which may be indicative of digital health disparities. Documentation was particularly poor among children and declined over time for enrolment visits. Further research is needed to understand and address these documentation gaps.https://bmjopen.bmj.com/content/15/7/e087654.full
spellingShingle James P Hughes
Stephen Gloyd
Bradley Wagenaar
Nancy Puttkammer
Beryne Odeny
Jean Guy Honoré
Jean Gabriel Balan
Kemar Célestin
Marinho Elisma
Kesner Francois
Comparative analysis of HIV data completeness in Haiti’s iSanté Plus Electronic Medical Record system across children, adolescents and adults: a cross-sectional evaluation of 2016–2022 data
BMJ Open
title Comparative analysis of HIV data completeness in Haiti’s iSanté Plus Electronic Medical Record system across children, adolescents and adults: a cross-sectional evaluation of 2016–2022 data
title_full Comparative analysis of HIV data completeness in Haiti’s iSanté Plus Electronic Medical Record system across children, adolescents and adults: a cross-sectional evaluation of 2016–2022 data
title_fullStr Comparative analysis of HIV data completeness in Haiti’s iSanté Plus Electronic Medical Record system across children, adolescents and adults: a cross-sectional evaluation of 2016–2022 data
title_full_unstemmed Comparative analysis of HIV data completeness in Haiti’s iSanté Plus Electronic Medical Record system across children, adolescents and adults: a cross-sectional evaluation of 2016–2022 data
title_short Comparative analysis of HIV data completeness in Haiti’s iSanté Plus Electronic Medical Record system across children, adolescents and adults: a cross-sectional evaluation of 2016–2022 data
title_sort comparative analysis of hiv data completeness in haiti s isante plus electronic medical record system across children adolescents and adults a cross sectional evaluation of 2016 2022 data
url https://bmjopen.bmj.com/content/15/7/e087654.full
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