Transcript IMPACT OF ELECTRONIC HEALTH RECORDS IN A HOSPITAL …

IMPACT OF ELECTRONIC
HEALTH RECORDS IN A
HOSPITAL SET UP IN KENYA
By Judy A. Ouma
Introduction

An electronic health record (EHR) (also electronic patient
record (EPR) or computerized patient record) is an
evolving concept defined as a systematic collection of
electronic health information about individual patients or
populations.

It is a record in digital format that is capable of being
shared across different health care settings, by being
embedded
in
network-connected
enterprise-wide
information systems.

Such records may include a whole range of data in
comprehensive or summary form, including demographics,
medical
history,
medication
and
allergies, immunization status, laboratory test results,
radiology images, vital signs, personal stats like age and
weight, and billing information.
Statement of the problem

Most public hospitals in Kenya maintain manual health
records. Data is entered manually and bound to human
error.

There are cases of files being misplaced or lost
altogether. Some patients may not remember their
patient numbers and therefore tracing their files is an
uphill task.

There are cases of multiple entries of case files for
patients when files cannot be found.Tracing files is time
consuming and leads to loses in working man hours.

Shortage of staff is also a major problem in Kenya.This
implies care givers become more of administrative staff
and offer less in health provision.

Reduced budgetary allocation to the Ministries by the
Central government
Literature Review

The EHR, allows physicians and staff members to
document interactions with patients, view medical
histories and insurance information, make referrals,
order laboratory tests and view test results, send
electronic prescription requests to pharmacies
(reducing the risk that hard-to-read handwriting will
lead to medical errors) and flag potentially harmful
drug interactions.

It also provides physicians with "decision support"
tools, such as clinical guidelines and checks for drug
interactions; and generates printed post-visit
summaries for patients, among other benefits. 2
Literature Review
cont..

A study was done to evaluate the interest
taken by the health care providers in the
electronic medical file and its use within
the quality improvement process by
Boyer L et al 7

It showed that sixty-seven percent of staff
interviewed had a favorable opinion of the
electronic medical file.
Literature Review
cont.

A study was done by Gill J M et al on the
‘Impact of EHR-based clinical decision
support on adherence to guidelines for
patients on nonsteroidal anti-inflammatory
drugs (NSAIDs): a randomized controlled
trial’6

It concluded that there was only a small
impact of EHR-based clinical decision
support for high-risk patients on NSAIDs in
primary care
Methodology

The Ministry of Medical Services has begun
the process of computerizing high volume
hospitals. These hospitals will be evaluated to
see the impact of introducing EHRs. Data will
be collected from these hospitals and
evaluated.
Results of interventions
Increased availability of data that can be used for
policy planning.
 Reduced cases of lost or missing files.
 Time taken to locate a file is much shorter now.
 Improved revenue generation and collection
 The uptake by clinicians is rather slow since they
have not attended many training sessions. Time
to learn the system is also limited due to the
current workload.
 Patient waiting time is reduced.

References
1.
2.
3.
4.
5.
6.
7.
8.
http://en.wikipedia.org/wiki/Electronic_health_record
http://www.pamf.org/ehr/benefits/
http://www.aameda.org/MemberServices/Exec/Articles/spg04/Gu
rley%20article.pdf
Arizona Republic: “Electronic Health Records: About $500 Million
at stake in digital move.” Ken Alltucker. March 20, 2011Sfgs
Hoffman S, Podgurski, A (Fall 2008). "Finding a Cure; The Case for
Regulation and Oversight of Electronic Health Record
Systems" (PDF). Harvard Journal of Law & Technology 22 (1): 10
http://www.ncbi.nlm.nih.gov/pubmed/21242557
http://www.ncbi.nlm.nih.gov/pubmed/19853719
RWIF,GWUMC, and IHP Staff: "Health Information Technology in
the United States: The Information Base for Progress", Robert
Wood Johnson Foundation, George Washington University
Medical Center, and Institute for Health Policy, 200