Standards and Guidelines for Electronic Medical Record Systems in ...

o Height
o Blood pressure
o BMI
Where applicable, EMR systems should have listed data in lookups to reduce data entry time
and limit errors. Lists should be defined and changed by the authorized users.
Intra-field validation should be implemented where there is a logical or causal relationship. For
example:
1. The system should not allow for selection of pregnancy tests when the client is male.
2. The system should allow for collection of PMTCT data for a pregnant woman and keep these
elements invisible for a non-pregnant woman.
Second order validation
Second order validation is the historical comparison for the same data element so that an alert is
prompted if an indicator increases or decreases abruptly.
· All data should be validated for trends and change, for example:
o Weight shall be validated for sudden increases and decreases.
o Laboratory tests such as CD4 counts and CD% shall be validated for sudden change
in trends.
Third order validation
Third order validation assesses data elements for consistency within a specific form or set of
indicators. For example:
· Number of women receiving PMTCT services checked against the number of pregnant
women treated for a given time period.
· Number of clients receiving cotrimoxazole therapy checked against the number of clients
enrolled for care.
· The number of clients tested for HIV checked against the number counseled for HIV testing.
Fourth order validation
Standards and Guidelines for Electronic Medical Records Systems in Kenya 37