Electronic health record system in the public health care sector of South Africa: A systematic literature review

Background: South Africa is planning to implement the National Health Insurance (NHI) scheme in the near future. The NHI is intended to improve the accessibility of quality health care services for all South African citizens. For the NHI to achieve this objective, an electronic health record (EHR) system to register and track patients who visit different health care providers will have to be developed. Aim: To identify critical success factors for the implementation of EHRs in South Africa’s public health care sector. Setting: This study reviewed studies on EHR implementation in African countries published between 2006 and 2017. Methods: The study made use of a systematic literature review to identify barriers to the implementation of EHRs in the public health care sector. Results: Fifteen articles were included in the study. The study identified technical, social and environmental barriers to the implementation of EHRs. The barriers could further be broken down into lack of supporting infrastructure; user training and commitment; political influence or strategy; legislation and regulations; and the lack of a framework for implementation and management of EHRs. The study suggests six main recommendations for the successful implementation of EHRs in South Africa’s public health care sector. Conclusion: The study recommended investing in alternative infrastructure facilities, incentivising the health informatics field to attract and retain information and communication technology professionals and to encourage the participation of all stakeholders in the development process to develop context-relevant e-health implementation strategies, legislation and frameworks. Government should also allocate separate budgets for e-health projects

Implementação do Registo Eletrónico de Saúde em África - uma Análise SWOT

A inovação tecnológica em saúde está a revolucionar significativamente a forma como os cuidados de saúde estão a ser prevenidos, diagnosticados e tratados. Apesar dos muitos benefícios destacados, a implementação de EHR requer um grande investimento, não só em recursos tecnológicos, mas também em recursos humanos qualificados. O objetivo principal do estudo é conhecer as forças, oportunidades, fraquezas e ameaças dos registos eletrónicos em saúde nos países africanos. A metodologia baseou-se na realização de uma revisão sistemática para análise SWOT. Com base nos resultados obtidos, o ponto forte com maior relevância esta relacionado com acesso oportuno e rápido das informações. Já a fraqueza mais evidente é a queda da corrente elétrica seguida da fraca conexão a internet. Ter experiência prévia em EHR é a oportunidade identificada com maior relevância na utilização destes sistemas. Por último, a maior ameaça evidenciada é a inexistência de conhecimento prévio em EHR e em informática. Os sistemas implementados na África. os resultados mostram que o sistema EHR Open source como o mais implementado na África em 83,3% em (10/12) artigos que caracterizaram os tipos de sistemas implementados.Technological innovation in healthcare is significantly revolutionising the way healthcare is being prevented, diagnosed and treated. Despite the many benefits highlighted, EHR implementation requires a major investment, not only in technological resources, but also in qualified human resources. The main objective of the study is to know the strengths, opportunities, weaknesses and threats of electronic health records in African countries. The methodology was based on conducting a systematic review for SWOT analysis. Based on the results obtained, the strong point with the greatest relevance is related to timely and rapid access to information. The most obvious weakness is the power outage followed by poor internet connection. Having previous EHR experience is the most relevant opportunity identified when using these systems. Finally, the greatest threat evidenced is the lack of prior knowledge in EHR and computer science. The systems implemented in África. the results show that the Open source EHR system as the most implemented in África in 83.3% in (10/12)c articles that characterized the types of systems implemented

Synchronization of patient data among health facilities through electronic medical records system: a case study of Kabgayi District Hospital

Background: The use of modern technology in healthcare system aims to increase the reliability, accessibility and productivity of delivered services. In most developing countries, particularly in sub-Saharan Africa, Electronic Medical Records (EMRs) has been dominated by paper-based system. In Rwanda, EMRs started in 2011 with a baseline of 8% and reached 50% in 2017 within 516 health facilities, but patient data synchronization among health facilities is still a problem. The aim of this research was to identify factors hindering EMRs implementation and propose applied solutions.Methods: A cross-sectional descriptive study design with qualitative and quantitative approach was used. A purposive method to select the research participants among the target population was also used.Results: It was found that, despite the improvement of hospitals’ management and healthcare efficiency via EMRs system, factors affecting synchronization of patients’ data among health facilities still persist. The study also revealed the need for the interoperability in the integration of EMRs system among health facilities.Conclusion: The OpenMRS EMR-based data synchronization can reduce gaps in HIV care. It avoids a duplication of patient identification number (PID) at the same health facility for more than one visit and missing data among health facilities. As part of implementable solutions for effective service delivery, cloud-based server and patient identification were suggested as solutions for much more success in Open MRS EMRs system.Keywords: Electronic Medical Record, Data synchronization, Cloud computing technolog

UNDERSTANDING THE PRESENT TO PREPARE FOR THE FUTURE: A REVIEW OF HEALTH INFORMATION SYSTEMS RESEARCH IN NIGERIA (7)

Health Information Systems (HIS) present many opportunities to address health challenges in developing countries such as Nigeria. However, in order to leverage the potential of HIS, the opportunities and challenges facing implementation must be explored and understood. This paper conducts an archival analysis of the existing literature on HIS in Nigeria published in premier Information Systems (IS) and Health Informatics outlets; in an effort to provide a comprehensive picture of existing literature by identifying trends, discussing findings, and proposing new research opportunities. The 18 articles meeting the inclusion criteria are reviewed. Current trends are discussed using the framework developed by McLeon et al. (2013) for understanding the factors influencing health IS implementation in developing countries. At present, several challenges face IS implementation in Nigeria such as the lack of policy guidance, resistance among end users, and cultural barriers. In addition, existing studies are limited in scope, theory, and level of analysis applied. The paper contributes to the literature by investigating the status quo, presenting new areas ripe for future investigation including the organisational, financial, and technological issues at play, and illuminating important issues which can guide pilot testing and implementation of new health IS initiatives in Nigeria

Trends, Findings, and Opportunities: An Archival Review of Health Information Systems Research in Nigeria

Low and middle income countries continue to struggle with limited availability of healthcare capability and resources. Recently, a variety of health information systems (HIS) projects have been piloted in an attempt to overcome these challenges by improving the quality of data to support the delivery of healthcare services from the community to hospital settings. Indeed, existing literature considers a breath of pilot HIS studies that have been undertaken in African countries. This study focuses on HIS interventions in the West African country of Nigeria. This paper conducts an archival analysis of existing literature on HIS in Nigeria published in premier Information Systems (IS) and Health Informatics outlets. This analysis provides a comprehensive picture of existing literature by identifying trends, discussing findings, and proposing new research opportunities. The 18 articles meeting the inclusion criteria are reviewed. Using a framework developed by Leon, Schneider, and Daviaud (2012), we consider current trends to elucidate the factors influencing health IS implementation in developing countries. Several challenges face IS implementation in Nigeria such as the lack of policy guidance, resistance among end users, and cultural barriers. Existing studies are limited in scope, theory, and level of analysis applied. The paper contributes to the literature by providing practical recommendations to better navigate future HIS implementations in developing countries, while also identifying avenues through which IS researchers can advance the HIS literature in an empirical, theoretical, and practical sense

Critical success factors for the implementation of an electronic health record system in the public health care sector of South Africa

South Africa intends to implement a National Health Insurance for its citizens, however, for this to be possible there is a need for registering and tracking all the patients who visit health care institutions. The use of EHRs was identified as the most suitable towards accomplishing the above-mentioned tasks. This study investigated other African countries’ EHR implementation efforts in order to identify the critical success factors for the implementation of EHR in South Africa’s public health system. The study conducted a structured literature review of articles written about EHR implementation in African countries and found that issues such as the high costs of implementation; resistance by health workers; a lack of suitable infrastructure; a lack of skills; political influence and poor government commitment were some of the challenges to the implementation of EHRs in African countries. The study then identified 6 critical factors that could address these challenges and ensure that EHR implementation is successful. Identified factors included Incentivising the health informatics career field to attract and retain ICT professionals; Encouraging participation of all stakeholders in the development process of EHR systems; Investigating and investing in alternative infrastructural facilities; Allocating separate budgets for E-health projects; Developing context relevant E-health implementation strategies and frameworks; and finally, Develop and implement Legislation specific to EHR implementation and continued use. Recommendations were also made on each factor regarding how it could be accomplished