Perceived benefits and barriers to the use of electronic medical records at health centres level in Kigali

Abstract

Electronic Medical Records (EMRs) are widely perceived to improve care delivery that is why some professional organizations encourage widespread adoption even into primary care. According to the Millennium Development Goals (MDG) set by the United Nations, the reduction of risks to catch a disease is only possible if health services are oriented towards primary health care and prevention. However, in developing countries, the health sector faces barriers in implementation and promotion of health information technology such as EMRs. These barriers are hurdle to the widespread adoption of health technologies, and it is necessary to address these for a successful implementation. In Rwanda, primary health care services are the first point of contact for patients. The inability of health care providers to share and access health information effectively, leads to difficulties in providing consistent, efficient and coordinated patient care in health centres (HCs). The efficient use of EMRs can promote prevention and adequate management of most diseases at primary care level. The aim of the present research work was to carry out an assessment of the benefits and barriers to the use of Electronic Medical Records at Health Centres level. The purpose of the research was to show that surveying the benefits and barriers to the use of EMRs can enhance primary health care in Rwanda, where a majority of the population utilizes a mutual health insurance, which requires each individual to seek care at health centre level. The results of this research can ultimately lead to improvement in the daily health care tasks, which can enhance patient health outcome and safety. A cross-sectional design with census method was used to collect quantitative data from 52 health care providers who worked in eight selected health centres and who respondent to questionnaire. A questionnaire adapted to the study was used to collect data and the gathered quantitative data were analyzed using Statistical Package for Social Science (SPSS version 20) software and chi-square test was performed. The results indicated that the majority of users perceived several benefits, and thought that the EMRs can improve significantly the quality of care. Of 86.5% (n=45) participants agreed that the information of patient can be retrieved in a timely manner for example finding the level of CD4. The majority of users agreed that the generation of reports from EMRs was easily. Whereas, others thought that vii using of EMRs seems to be an additional since they still used papers to records patient information prior to entering it in the electronic system. The study observed that the nurses have a large gap to overcome the lack of computer skills and confidence in managing electronic system. The proportion of perception of the EMRs usage as a double work to professional has been calculated, and chi-square was statistically significant (P=0.003). In conclusion, the results of this study revealed that the users reported a full range of EMRs benefits, and they think the EMRs can improve significantly the quality of health care delivery. However the study observed that the nurses had insufficient knowledge of information technology and the resistance to change from paper based records as barriers. To overcome these challenges a long term and effective adoption of EMRs has to be reinforced by empowering the IT managers with medical knowledge, health care providers with computer skills, and providing necessary equipment at all the health institutional levels in Rwanda.