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How do you scale up (even a small system)?

Posted by jblaya on April 3, 2008

Over the past 3 years, we have implemented a tuberculosis (TB) laboratory information system to connect the laboratories and health centers in the Peruvian public health system. This laboratory information system, named “e-Chasqui” after the ancient Inca messengers, permits entry of all TB results at regional and national laboratories and immediate viewing of those results by clinical staff. In addition, the system includes applications to assess quality control, generate aggregate reports, notify health centers of new results or contaminated samples, and track enrolled patients and the status of pending laboratory tests. In 2005, we started the pilot with two laboratories and 12 health centers. It took about a year of working with the labs and the health centers to both get the system exactly right and for them to realize the benefits of it. I say that because since 2006 the use of the system by the health centers has exploded, increasing over 3 fold over the past year and a half. At the request of public health officials we have now expanded the use of this system to a total of four laboratories and 42 health centers that cover over three million people in Lima. But there are still about another 70 health centers that we’ve been asked to train in the next 3 months in one of the health districts and another 60 or so in the second health district. So how am I and the e-Chasqui data administrator going to be able to do all of the activities required for the randomized controlled trial we are performing, continue to support the current health institutions and the overarching study that we are a part of, and at the same time triple the number of users of the system? Well, we’ll know the answer in a few months…

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