Lessons learned from implementing the HIV infant tracking system (HITSystem): A web-based intervention to improve early infant diagnosis in Kenya

Objectives: Guided by the RE-AIM model, we describe preliminary data and lessons learned from multiple serial implementations of an eHealth intervention to improve early infant diagnosis (EID) of HIV in Kenya. Methods: We describe the reach, effectiveness, adoption, implementation and maintenance of the HIT System, an eHealth intervention that links key stakeholders to improve retention and outcomes in EID. Our target community includes mother-infant pairs utilizing EID services and government health care providers and lab personnel. We also explore our own role as program and research personnel supporting the dissemination and scale up of the HITSystem in Kenya. Results: Key findings illustrate the importance of continual adaptation of the HITSystem interface to accommodate varied stakeholders' workflows in different settings. Surprisingly, technology capacity and internet connectivity posed minimal short-term challenges. Early and sustained ownership of the HIT System among stakeholders proved critical to reach, effectiveness and successful adoption, implementation and maintenance. Conclusions: Preliminary data support the ability of the HITSystem to improve EID outcomes in Kenya. Strong and sustained collaborations with stakeholders improve the quality and reach of eHealth public health interventions. (C) 2015 Elsevier Inc. All rights reserved.