Delphi Survey for determining minimum functional requirements for a digital client record system for service delivery and accountability
In February 2019, WHO convened a technical working group on Digital Client Records for Service Delivery and accountability to gain consensus on their definition, minimum requirements, variable capabilities and goals across health programme areas. However, in the meeting, participants identified a diversity of terms that had variable meanings and reflected a state of ambiguity in the broader community. The group then concluded that it is better to focus on what the core/minimum functionality of a Digital Client Record comprises of, in addition to ensuring consistency of allied terms and definitions.

The purpose of this Delphi survey is to gain consensus on the minimum functions comprising "digital client records for service delivery and accountability."

A digital client record is a persistent record of an encounter at the point of care/service delivery between a health service provider and individuals (clients, patients) that is recorded in a digital format, either directly by the provider, or captured after first being recorded on paper. A digital client record will include all the information required for detailing health status and provided health interventions, and data necessary for assembling a programme register.

Digital client records' primary, target end-users are health service providers operating at the primary care level in and out of formal health facilities (e.g. nurse/midwives, primary care physicians, and community health workers). However, digital client records can also be used by any and all cadres of health service providers inclusive of those operating at secondary and tertiary health facilities. Participants at the 2019 WHO meeting identified the following attributes of digital client record systems:

The GOALS and PRINCIPLES of a digital client record, at a minimum, are:
- improving the quality of service delivery at the point of care;
- improving the continuity of preventive and curative person-centric care;
- reducing the burden of data entry, data aggregation, and indicator reporting for health service providers;
- increasing population coverage of health interventions through timely and accurate data availability and use by service providers and health systems managers; and
- subsequently increasing the level of accountability at all levels of the health system from the health provider to decision-makers including national-level ministry of health.

The purpose of this survey is to gain your input into the functional requirements you believe are necessary at a minimum in order for a digital client record to achieve the goals and principles outlined above.

For this survey, please indicate whether you think our initial list of CORE FUNCTIONS are "NEED to have" or alternatively, are "NICE to have".

In the survey, each function references the "WHO Classification of Digital Health Interventions v1.0” (https://tinyurl.com/WHOclassifications) for clarity. In the linked document, for your convenience, you can find illustrative examples of software products for each intervention type (i.e., functionality), to facilitate your consideration of required functionality for digital client record systems.

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