| dc.description.abstract | The study was carried out at Ministry of Health Central Registry. The aim of the study was to enhance the automated record system of Ministry records, in order to prevent delay of Ministry records processing and management.
The researcher used a qualitative and quantitative research designs and this sought to describe the finding in details. The researcher collected data from 5 respondents. Several data collection methods where used and these include interviews, questioners and observation.
The efforts being made in the implementation of EMR in Health Facilities of Uganda is encouraging. Although there exist various challenges in the operationalization of the EMR systems, feedback from healthcare providers indicated an unstoppable will to move on with EMRs. The challenges and opportunities are summarized below. In the area of EMR implementation practices, the study noted challenges concerning the planning of activities from pre-implementation, implementation and post-implementation stages. In the planning stage, the key challenges included lack of master plan for EMR, overreliance on limited government funding and low exploration of alternative funding methods for EMR sustainability, low awareness on the existing National EMR standards, lack of information policy at the facility level, and a disconnect between initial planning by strategic managers and actual activation of the activities. Such a disconnect indicates a gap in user involvement and is likely to negatively impact on the process.
These challenges are likely to affect evaluation and monitoring of the EMR implementation process. Despite confirmation by strategic managers that users were being involved, the actual responses from EMR users indicated user involvement gaps in the EMR preparatory stages, choice of technology for medical data capture and analysis, EMR sensitization, testing and piloting. Such gaps are likely to affect EMR ownership and acceptability levels. As earlier stated, successful EMR should allow access to the patient record 24 hours a day, prevent medication error by providing decision support, support ongoing education for healthcare professionals, timely and effective care, improved hospital revenue, reduced patient-turn-around time, and sharing of information by authorized people.
This potential has not been realized in Uganda public Health Facilities. Some of the challenges contributing to 43 this include concurrent operation of manual, hybrid and electronic medical records system meaning that one has to rely on all for patient care and follow-up. Feedback from the respondents indicated no improvement in doctor patient time, nurse patient time, and patientturn- around time. Feedback from doctors and nurses indicated EMRs inability to provide information for use during their day to day operations. Lack of such information indicates a gap in the maximization of EMR systems information management opportunities in the Health Facilities. The general usability of EMR for querying, availability of system help, and it speed received low ratings from the users. However, user interface screens, and retrieval of information were acceptable by a significant number of users. Although the strategic managers had confirmed installation of clinician’s modules, the EMRs coverage of doctor’s processes, such as monitoring of vital signs, prescription, drug administration was rated low. A similar case was noted with nursing where EMR coverage of nursing processes was also rated low. Feedback from health records and information officers indicated that the EMRs do not cover records management functions such as authentic creation of medical records, electronic signatures, retention and disposal of medical records. These gaps indicate a challenge in the identification of EMR requirements in the respective hospital functional areas. 5.3 Conclusions Public Health Facilities in Uganda face many challenges that are unique to the healthcare providers working there. The importance of the existing electronic medical record systems has at least been recognized despite the challenges being encountered. The conclusion drawn according to the research findings of the study most of the respondents agreed that health facilities may need to build on the existing EMR modules which have already been shown to work, then add only relevant modules to the system depending on their priorities. The Facilities should identify the most appropriate technology for their EMR due to funding challenges or where possible explore other sources of EMR funding. | en_US |
