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1835 North Meridian Street
Indianapolis, Indiana 46202
Contact: Melissa Brown
Phone: (317) 931-3055
Key words: prenatal care; computerized
records
The purpose of this study was to determine
whether or not the use of a computerized
reporting system for a two-person prenatal
care coordination team would increase
the quality and quantity of data collected,
and thereby allow for a better coordination
of care.
METHODS
The Homeless Initiative Program (HIP)
created a computerized records system
to allow for greater ease in maintaining
encounter information, especially that
related to pre- and postnatal information.
Typically, information was put into
the database via a laptop computer.
The database was constructed in Microsoft
Access. Three main categories of information
were kept on clients: 1) profile (e.g.,
gender, age, race/ethnicity); 2) pregnancy
(e.g., estimated date of delivery, date
prenatal care initiated); and 3) encounter
(e.g., current address, Medicaid status).
In the design of the system, simplicity
and flexibility were emphasized to help
maximize the effectiveness of the data
entry process. Referrals to the HIP
Prenatal Care Coordination Team (PCCT)
were made from the HIP Medical Team,
social service agencies, womens shelters,
the county health department and other
organizations. Clients of the HIP/PCCT
were typically seen five to seven times
before the birth, beginning early in
the second trimester. From birth through
the infants first year of age, clients
were seen at least on a quarterly basis,
but many of them on a weekly basis.
Program staff were required to make
certain that all client information
was entered into the system within one
week of the clients visit. Several attempts
(e.g., identifying other HIP clients
who were not PCCT clients and other
similar populations at other locations)
were made to identify a comparison group
to allow for a more complete evaluation
of the HIP/PCCT and its effect on clients,
but all attempts were unsuccessful.
Using the computer made it possible to
obtain the following information: 36 records
were available for HIP/PCCT clients in
1997. Regarding these 36 pregnancies,
gestation ranged from 33 to 43 weeks;
birth weights ranged from 3 pounds and
4 ounces to 8 pounds and 8 ounces; 8 infants
required hospitalization (primarily because
they were premature); and 2 were stillborn
due to complications related to their
umbilical cords.
No single person was available to complete
all the data entry work on a regular basis.
To allow for the maximum amount of benefits
from the use of the computer, it is perhaps
best to have one individual who is able
to devote much, if not all, of his or
her time to this process. In addition,
no matter how much data is input into
the system, it will not benefit the clients
unless regular data analyses and checks
are run on it. Although the information
obtained from this study was somewhat
limited, it has encouraged HIP staff to
think more about data issues and, more
importantly, how collecting the right
data and analyzing it can help ensure
that the best possible and most appropriate
care can be given to clients.
Computerized records have the potential
to allow for more complete and consistent
data collection that can ultimately lead
to better service provision for clients.
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