Collecting and analyzing data is key to encouraging data-driven decision making. Our health informatics team works to increase data-driven decision-making across IMB through synergy between Health Information Systems (HIS) and Monitoring and Evaluation (M&E). We create software solutions and collect routine data for many IMB initiatives, ranging from mentorship and pediatrics to transport and procurement. Each of these systems enables efficiency and continuous improvement. 

MONITORING AND EVALUATION

In M&E we support organizational knowledge management by identifying programmatic priorities, collecting and analyzing indicators that monitor these priorities, and reviewing the metrics needed to inform the improvement, development and expansion of programmatic activities. The team also works to ensure the availability of quality strategic information with the aim of data sharing with our government partners, data use for collaborative decision-making, as well as donor reporting and external communications. We help the organization in strategic planning, we collect routine data for new initiatives, and we generate analysis aimed at improving the services programs provide.

For example, the mentorship program uses checklists to both ensure the quality of their coaching visit and help focus resources where they can be best used. That information is then analyzed and shared with the IMB clinical programs and health system leaders to inform interventions.

ELECTRONIC MEDICAL RECORDS

In HIS we provide business analysis for new software solutions and provide software support for the OpenMRS-based Electronic Medical Records System (EMR). PIH co-developed OpenMRS, an electronic medical records system platform for developing countries, now used in many countries around the world. When IMB was mandated to model a transformation of HIV care in Rwanda, real-time data were needed to show how the model of care worked, how it could be expanded, and how it could be further improved. In 2008 Rwinkwavu became the second implementation site of EMR in Africa. Over the years, information from EMR has been used for clinical decision-making, M&E, policy advocacy, and as a central data source for numerous research studies including the National HIV Research Writing Group.

As IMB model of care was expanded throughout Rwanda, record-keeping in OpenMRS-based EMR expanded with it. The government of Rwanda launched EMR in 2009 and partnered with IMB to train more than 30 local software developers in OpenMRS and Java development—many of whom went on to further develop EMR content for Rwanda Ministry of Health. Today we are building on this HIV-specific work by enabling other IMB clinical programs to have information needed for helping patients, having a strong understanding of how we can improve, and disseminating data on program expansion and research. IMB now uses EMR for also capturing oncology, non-communicable diseases, and the pediatric development clinic care. Just like with HIV care, the system provides clinicians users with information about the patients they can expect on a given day and the most important facts before the patient even arrives. For when we need to follow up on certain types of patients such as those who are due for more intensive tests like HIV Viral Load or those who have missed visits to their heart failure clinic, EMR allows clinicians to catch patients who might otherwise fall through the cracks. 

Through EMR and M&E analysis of routine data, the informatics team generates a depth of information that is used to understand how our care works and to inform decisions on improving the lives of the people and patients we serve. Informatics data are also used in extensive pre-planned research and allows for numerous operational research projects disseminating IMB programs’ outcomes and lessons learned.