Implementation of Electronic Medical Records for Service Delivery in Selected Southwest Nigeria State University Teaching Hospitals
Ajayi, Stephen Adekunle
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Electronic Medical Records (EMR) is an essential communications channel relating to patient health conditions. Unfortunately, many hospitals in Africa, including Nigeria, have not implemented EMR. The few hospitals with some level of EMR are still struggling with the use of paper and hybrid medical records, which has led to poor medical follow-up, medical error and long waiting times for patients. The study is anchored on five main objectives: determining the existing types of EMRS, level of readiness, usefulness, and the relationship between user readiness EMR usefulness, among others. A sample size of three hundred and forty-one (341) was determined using krejcie and morgan models, comprising strategic managers and the operational staff drawn from a population of 2889 in the selected hospitals. Weighted sampling was used to determine the respondent to pick from each hospital. The study chooses 108 from LAUTECH, UNIMEDTH 79; EKSTH 104 and LSUTH 106. The purposive sampling technique was applied at the hospital level in selecting strategic managers, while operational health workers were determined using a stratified random sampling technique. Questionnaires were used for data collection. A pilot study was conducted at Olabisi Onobanjo University teaching hospital Ogun state Nigeria, where 45 questionnaires were administered to strategic healthcare managers (20) and operational healthcare workers (25) in a similar secondary healthcare hospital to determine the instrument's validity. This study adopted the Cronbach alpha reliability procedure. The result indicates the reliability of .789 for operational healthcare staff and .878 for strategic managers, respectively. The study used a descriptive statistical analysis technique to describe the present medical record systems in the hospitals under study. The data from the quantitative method was presented in tables and figures. The finding indicated that the systems in the hospitals are mainly paper-based. The hospitals also use a hybrid system with a few treatment areas having fully electronic medical records systems. The findings indicated that management readiness, which covers financial (ability to provide funds for implementation) and political readiness (wiliness of the strategic managers and government to implement EMR), was very low. In the area of readiness, which covers the availability of electronic record managers, ICT support staff, computer compatible medical devices, among others, was low. In the area where EMR has been implemented, the finding indicates poor penetration of the EMR system in treatment areas, limited modules and poor staff readiness. The study concluded that hospitals in Nigeria are not taking an adequate preparatory step in implementing EMR. In hospitals that have implemented, EMR is not serving the classical purpose of the medical record of supporting treatment and follow up. Before embarking on the implementation of EMR, the study recommended that the selected hospitals ensure the availability of funds by liaising with international donors and prioritising their budget on the implementation of EMR. There should be staff training on how to troubleshoot and operate the EMR system and its usefulness, and technical infrastructures like electronic record managers, ICT support staff, and computer compatible medical devices, among others.