scholarly journals Implementing an Open Source Electronic Health Record System in Kenyan Health Care Facilities: Case Study (Preprint)

2017 ◽  
Author(s):  
Naomi Muinga ◽  
Steve Magare ◽  
Jonathan Monda ◽  
Onesmus Kamau ◽  
Stuart Houston ◽  
...  
Keyword(s):  
Health Care ◽  
Electronic Health Record ◽  
Open Source ◽  
Health Information ◽  
Health Care Facilities ◽  
Health Record ◽  
Record System ◽  
Care Facilities ◽  
Electronic Health

BACKGROUND The Kenyan government, working with international partners and local organizations, has developed an eHealth strategy, specified standards, and guidelines for electronic health record adoption in public hospitals and implemented two major health information technology projects: District Health Information Software Version 2, for collating national health care indicators and a rollout of the KenyaEMR and International Quality Care Health Management Information Systems, for managing 600 HIV clinics across the country. Following these projects, a modified version of the Open Medical Record System electronic health record was specified and developed to fulfill the clinical and administrative requirements of health care facilities operated by devolved counties in Kenya and to automate the process of collating health care indicators and entering them into the District Health Information Software Version 2 system. OBJECTIVE We aimed to present a descriptive case study of the implementation of an open source electronic health record system in public health care facilities in Kenya. METHODS We conducted a landscape review of existing literature concerning eHealth policies and electronic health record development in Kenya. Following initial discussions with the Ministry of Health, the World Health Organization, and implementing partners, we conducted a series of visits to implementing sites to conduct semistructured individual interviews and group discussions with stakeholders to produce a historical case study of the implementation. RESULTS This case study describes how consultants based in Kenya, working with developers in India and project stakeholders, implemented the new system into several public hospitals in a county in rural Kenya. The implementation process included upgrading the hospital information technology infrastructure, training users, and attempting to garner administrative and clinical buy-in for adoption of the system. The initial deployment was ultimately scaled back due to a complex mix of sociotechnical and administrative issues. Learning from these early challenges, the system is now being redesigned and prepared for deployment in 6 new counties across Kenya. CONCLUSIONS Implementing electronic health record systems is a challenging process in high-income settings. In low-income settings, such as Kenya, open source software may offer some respite from the high costs of software licensing, but the familiar challenges of clinical and administration buy-in, the need to adequately train users, and the need for the provision of ongoing technical support are common across the North-South divide. Strategies such as creating local support teams, using local development resources, ensuring end user buy-in, and rolling out in smaller facilities before larger hospitals are being incorporated into the project. These are positive developments to help maintain momentum as the project continues. Further integration with existing open source communities could help ongoing development and implementations of the project. We hope this case study will provide some lessons and guidance for other challenging implementations of electronic health record systems as they continue across Africa.

scholarly journals Implementing an Open Source Electronic Health Record System in Kenyan Health Care Facilities: Case Study

2018 ◽  
Vol 6 (2) ◽  
pp. e22 ◽  
Author(s):  
Naomi Muinga ◽  
Steve Magare ◽  
Jonathan Monda ◽  
Onesmus Kamau ◽  
Stuart Houston ◽  
...  
Keyword(s):  
Health Care ◽  
Electronic Health Record ◽  
Open Source ◽  
Health Care Facilities ◽  
Electronic Health Record System ◽  
Health Record ◽  
Record System ◽  
Care Facilities ◽  
Electronic Health

scholarly journals A Development of Medical Records Management System to Health Care Decision Makers using Cloud Technologies

2020 ◽  
Vol 9 (4) ◽  
pp. 1320-1323
Keyword(s):  
Health Care ◽  
Electronic Health Record ◽  
Health Care Facilities ◽  
Health Record ◽  
Record System ◽  
Cloud Data ◽  
Model Complex ◽  
Electronic Health ◽  
Clinical Records ◽  
Cloud Servers

Electronic Health Record systems continue to be incorporated into health care facilities to reduce the problems and limits of paper-based methodology but their deployment has been slow due to high investment and storage costs. The Enterprise Electronic Cloud-based Health Record System is planned, created and checked for recording, recovering, chronicling and surveying patients and other clinical records. Cloud Data fills in as a coordinates information bank over every single authoritative emergency clinic, middleware gives a typical stage to all electronic health record frameworks between remote medical clinics while a security approval server gives access to approves clients and denies unapproved clients access to records or assets in the system. In this model, complex mixes are redistributed to open cloud servers, leaving nearly the whole intricate of private key generator, sender and beneficiary. In addition, PKG communication costs with users have been optimized. In addition, we are building a comprehensive library called libabe compatible with mobile devices, and the access control mechanism is distributed in a logical environment, including public cloud servers, a laptop and an inexpensive mobile device with interactive resources.

Implementation and evaluation of Stanford Health Care store-and-forward teledermatology consultation workflow built within an existing electronic health record system

2018 ◽  
Vol 26 (3) ◽  
pp. 125-131 ◽  
Author(s):  
Grace E Kim ◽  
Olga K Afanasiev ◽  
Chris O’Dell ◽  
Christopher Sharp ◽  
Justin M Ko
Keyword(s):  
Health Care ◽  
Electronic Health Record ◽  
Primary Care Physicians ◽  
Health Record ◽  
Record System ◽  
Privacy Concerns ◽  
Successful Model ◽  
Dermatology Clinic ◽  
Electronic Health ◽  
Store And Forward

Introduction Teledermatology services that function separately from patients’ primary electronic health record (EHR) can lead to fragmented care, poor provider communication, privacy concerns and billing challenges. This study addresses these challenges by developing PhotoCareMD, a store-and-forward (SAF) teledermatology consultation workflow built entirely within an existing Epic-based EHR. Methods Thirty-six primary care physicians (PCPs) from eight outpatient clinics submitted 215 electronic consults (eConsults) for 211 patients to a Stanford Health Care dermatologist via PhotoCareMD. Comparisons were made with in-person referrals for this same dermatologist prior to initiation of PhotoCareMD. Results Compared to traditional in-person dermatology clinic visits, eConsults decreased the time to diagnosis and treatment from 23 days to 16 hours. The majority (73%) of eConsults were resolved electronically. In-person referrals from PhotoCareMD (27%) had a 50% lower cancellation rate compared with traditional referrals (11% versus 22%). The average in-person visit and documentation was 25 minutes compared with 8 minutes for an eConsult. PhotoCareMD saved 13 additional clinic hours to be made available to the dermatologist over the course of the pilot. At four patients per hour, this opens 52 dermatology clinic slots. Over 96% of patients had a favourable experience and 95% felt this service saved them time. Among PCPs, 100% would recommend PhotoCareMD to their colleagues and 95% said PhotoCareMD was a helpful educational tool. Discussion An internal SAF teledermatology workflow can be effectively implemented to increase access to and quality of dermatologic care. Our workflow can serve as a successful model for other hospitals and specialties.

scholarly journals How well is the electronic health record supporting the clinical tasks of hospital physicians? A survey of physicians at three Norwegian hospitals

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Thomas Roger Schopf ◽  
Bente Nedrebø ◽  
Karl Ove Hufthammer ◽  
Inderjit Kaur Daphu ◽  
Hallvard Lærum
Keyword(s):  
Health Care ◽  
Electronic Health Record ◽  
Electronic Health Record System ◽  
System Stability ◽  
Medical Decision ◽  
Health Record ◽  
Clinical Workflow ◽  
Online Questionnaire ◽  
Record System ◽  
Electronic Health

Abstract Background The electronic health record is expected to improve the quality and efficiency of health care. Many novel functionalities have been introduced in order to improve medical decision making and communication between health care personnel. There is however limited evidence on whether these new functionalities are useful. The aim of our study was to investigate how well the electronic health record system supports physicians in performing basic clinical tasks. Methods Physicians of three prominent Norwegian hospitals participated in the survey. They were asked, in an online questionnaire, how well the hospital’s electronic health record system DIPS supported 49 clinical tasks as well as how satisfied they were with the system in general, including the technical performance. Two hundred and eight of 402 physicians (52%) submitted a completely answered questionnaire. Results Seventy-two percent of the physicians had their work interrupted or delayed because the electronic health record hangs or crashes at least once a week, while 22% had experienced this problem daily. Fifty-three percent of the physicians indicated that the electronic health record is cumbersome to use and adds to their workload. The majority of physicians were satisfied with managing tests, e.g., requesting laboratory tests, reading test results and managing radiological investigations and electrocardiograms. Physicians were less satisfied with managing referrals. There was high satisfaction with some of the decision support functionalities available for prescribing drugs. This includes drug interaction alerts and drug allergy warnings, which are displayed automatically. However, physicians were less satisfied with other aspects of prescribing drugs, including getting an overview of the ongoing drug therapy. Conclusions In the survey physicians asked for improvements of certain electronic health record functionalities like medication, clinical workflow support including planning and better overviews. In addition, there is apparently a need to focus on system stability, number of logins, reliability and better instructions on available electronic health record features. Considerable development is needed in current electronic health record systems to improve usefulness and satisfaction.

scholarly journals Functionalities of free and open electronic health record systems

2010 ◽  
Vol 26 (4) ◽  
pp. 382-389 ◽  
Author(s):  
Alejandro Enrique Flores Zuniga ◽  
Khin Than Win ◽  
Willy Susilo
Keyword(s):  
Electronic Health Record ◽  
Open Source ◽  
Security Requirements ◽  
Health Record ◽  
Reference Architecture ◽  
Functional Requirements ◽  
Privacy And Security ◽  
Record System ◽  
Iso Standards ◽  
Electronic Health

Objectives: The aim of this study was to examine open-source electronic health record (EHR) software to determine their level of functionalities according to the International Organization for Standardization (ISO) standards.Methods: ISO standards were used as a guideline to determine and describe the reference architecture and functionalities of a standard electronic health record system as well the environmental context for which the software has been built. Twelve open-source EHR systems were selected and evaluated according to two-dimensional criteria based on ISO/TS 18308:2004 functional requirements and ISO/TR 20514:2005 context of the EHR system.Results: Open EHR software programs mostly fulfill structural, procedural, evolutional, and medicolegal requirements at the minimal and full functionality levels. Communication, privacy, and security requirements are accomplished in less than 23 percent of the cases, mainly at minimal functional level. Ethical, cultural, and consumer requirements still need to be fulfilled by free and open-source EHR applications.Conclusions: Most analyzed systems had several functional limitations. Nevertheless, especially for clinicians and decision makers in developing countries, open-source EHR systems are an option. The limited functionalities are likely to become requirements for further releases of open-source EHR systems.

scholarly journals Electronic Health Record System Implementation in a Health Informatics Program: A Case Study

2017 ◽  
Vol 2017 (2) ◽  
pp. 121-137
Author(s):  
Kalyani Ankem ◽  
◽  
Vishal Uppala ◽  
Alka Dhawan ◽  
◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Health Informatics ◽  
Electronic Health Record System ◽  
Health Record ◽  
System Implementation ◽  
Record System ◽  
Electronic Health

scholarly journals Evaluation of the electronic health record system in maternal and child health centers of Marie Stopes International Ethiopia

2019 ◽  
Vol 3 ◽  
pp. 1655
Author(s):  
Tizita Gizaw ◽  
Mengistu Bogale ◽  
Tilahun Alemayehu
Keyword(s):  
Child Health ◽  
Electronic Health Record ◽  
Health Information ◽  
Maternal And Child Health ◽  
Care Delivery ◽  
Health Record ◽  
Record System ◽  
Cross Sectional ◽  
Electronic Health ◽  
And Child Health

Background: The Health Information Management Systems Society (HIMSS) defines an Electronic Health Record (EHR) as a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting”. EHR systems improve quality and adaptability of care, contributing to patient safety. The system is also efficient and provides real-time administration to patients. Driven by the need to facilitate clinical and administrative process, and to reduce medical errors, Marie Stopes international Ethiopia (MSIE) implemented EHR system in its maternal and child health (MCH) centers. This study sought to evaluate the EHR system in six departments (inpatient, outpatient, pharmacy, laboratory, reception cashiers and MCH managers) of these MCH centers in terms of ease of performing tasks and satisfaction with the system. Methods: A cross-sectional method with formative evaluation was used to address the objective. A sample size of 54 were used for the investigation. The participants were from six departments (inpatient, outpatient, pharmacy, laboratory, reception cashiers and MCH managers) within three MCH centers. Data was collected using structured, self-administered questionnaires and interviews and analyzed using SPSS 20. Results: In total, 83% of respondents found that performing tasks using EHR made tasks easier; the lowest score was from Pharmacy department (48%). The overall satisfaction with EHR was 87%. The lowest score is from the indicator “the system meets my needs” (80%). Conclusions: Staffs in all department reported the EHR system as “very good” for both ease of performing their daily tasks and satisfaction with the system. In addition, the study revealed that ease of performing tasks and satisfaction with the system were varied by department and specific task within the department. It is essential to know the needs and requirements of each department before implementation of the system and user feedback for long lasting uptake and impact.

Electronic Health Record System Risk Assessment: A Case Study from the MINET

2004 ◽  
Vol 33 (2) ◽  
pp. 43-48 ◽  
Author(s):  
Khin Than Win ◽  
Hai Phung ◽  
Lis Young ◽  
Mai Tran ◽  
Carole Alcock ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Electronic Health Record ◽  
Electronic Health Record System ◽  
Health Record ◽  
Record System ◽  
System Risk ◽  
Electronic Health
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