Barriers to the Adoption of Electronic Medical Record System in Ethiopia: A Systematic Review (Preprint)

2021 ◽  
Author(s):  
Delelegn Emwodew ◽  
Binyam Tariku ◽  
Abel Desalegn ◽  
Endris Seid
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Computer Literacy ◽  
Technical Assistance ◽  
Resistance To Change ◽  
Current Evidence ◽  
Future Research ◽  
System Quality ◽  
National Implementation ◽  
Emr Adoption

BACKGROUND Electronic Medical Records (EMRs) have been an important tool in improving patient safety, improving the quality of health care, and increasing health efficiency. Various countries have gone through the local application of EMRs to various health care organizations in national implementation and integration of EMRs. Ethiopia lags far behind in this regard, as only a few hospitals have implemented EMR. OBJECTIVE This study aimed to identify barriers to the adoption of EMRs in Ethiopia through systematic literature reviews. METHODS We searched for relevant articles using three search engines (PubMed, Semantic Scholar, and Google Scholar). The search method focuses on peer-reviewed, empirical studies conducted in Ethiopia. The final set that met the inclusion criteria was nine studies. The authors extracted, analysed, and summarized empirical results related to EMR barriers in these studies. RESULTS This systematic review identified the following 19 barriers to EMR adoption: lack of EMR training, lack of access to computers, lack of computer literacy, lack of knowledge of EMR, lack of technical assistance, lack of EMR manual, negative attitude with EMR, limited internet access, lack of management support, electric power interruption, lack of perceived system quality, lack of perceived information quality, user resistance to change, the complexity of the system, performance expectancy, effort expectancy, social influence, lack of IT qualification, and lack of confidence with computer typing ability. CONCLUSIONS The most common barriers identified in the literature are: lack of EMR training, limited computer access, lack of computer literacy, lack of EMR knowledge, lack of technical support, and absence of an EMR manual. These six barriers alone contain 56.8% of the barriers reported in the literature. As this study summarizes the available evidence regarding barriers to the adoption of EMR in Ethiopia, future research will build on the current evidence and will focus on building an appropriate framework for EMR adoption in Ethiopia.

scholarly journals Analysis of Facilitators and Barriers to the Delivery of Routine Care during the COVID-19 Global Pandemic: A Systematic Review

Healthcare ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 528
Author(s):  
Cristian Lieneck ◽  
Brooke Herzog ◽  
Raven Krips
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Services ◽  
Care Delivery ◽  
Routine Care ◽  
Future Research ◽  
Healthcare Organizations ◽  
Care Services ◽  
Global Pandemic ◽  
Facilitators And Barriers

The delivery of routine health care during the COVID-19 global pandemic continues to be challenged as public health guidelines and other local/regional/state and other policies are enforced to help prevent the spread of the virus. The objective of this systematic review is to identify the facilitators and barriers affecting the delivery of routine health care services during the pandemic to provide a framework for future research. In total, 32 articles were identified for common themes surrounding facilitators of routine care during COVID-19. Identified constructed in the literature include enhanced education initiatives for parents/patients regarding routine vaccinations, an importance of routine vaccinations as compared to the risk of COVID-19 infection, an enhanced use of telehealth resources (including diagnostic imagery) and identified patient throughput/PPE initiatives. Reviewers identified the following barriers to the delivery of routine care: conservation of medical providers and PPE for non-routine (acute) care delivery needs, specific routine care services incongruent the telehealth care delivery methods, and job-loss/food insecurity. Review results can assist healthcare organizations with process-related challenges related to current and/or future delivery of routine care and support future research initiatives as the global pandemic continues.

scholarly journals A systematic review of interventions to improve acute hospital care for people with dementia

2021 ◽  
Author(s):  
Melanie Karrer ◽  
Angela Schnelli ◽  
Adelheid Zeller ◽  
Hanna Mayer
Keyword(s):  
Systematic Review ◽  
Hospital Care ◽  
Current Evidence ◽  
Future Research ◽  
Acute Hospital Care ◽  
Hand Search ◽  
People With Dementia ◽  
Acute Hospitals ◽  
Delirium Management ◽  
Study Designs

Abstract The aim of this study was to provide an overview of interventions targeting hospital care of patients with dementia. We conducted a systematic review, including interventional study designs. We searched five electronic databases, conducted a hand search and performed citation tracking. To assess risk of bias, we used Cochrane Collaboration’s tool, ROBANS and AMSTAR. We narratively summarized the outcomes.The findings of twenty studies indicated a broad range of interventions and outcomes. We categorised the interventions into eight intervention types. Educational programmes were the most reported intervention type and resulted in improved staff outcomes. Family-/person-centred care programmes, use of specially trained nurses and delirium management programmes were effective in improving patient-related outcomes. However, current evidence is insufficient to declare which interventions are effective in improving dementia care in acute hospitals. Future research should focus on relevant patient and family caregiver outcomes and must to consider the complexity of the interventions. Trial registration: PROSPERO: CRD42018111032.

scholarly journals Current Evidence for Continuous Vital Signs Monitoring by Wearable Wireless Devices in Hospitalized Adults: Systematic Review

10.2196/18636 ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. e18636 ◽  
Author(s):  
Jobbe P L Leenen ◽  
Crista Leerentveld ◽  
Joris D van Dijk ◽  
Henderik L van Westreenen ◽  
Lisette Schoonhoven ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Clinical Outcomes ◽  
Health Care Professionals ◽  
Continuous Monitoring ◽  
Vital Signs ◽  
Current Evidence ◽  
Cochrane Central Register ◽  
Wireless Devices

Background Continuous monitoring of vital signs by using wearable wireless devices may allow for timely detection of clinical deterioration in patients in general wards in comparison to detection by standard intermittent vital signs measurements. A large number of studies on many different wearable devices have been reported in recent years, but a systematic review is not yet available to date. Objective The aim of this study was to provide a systematic review for health care professionals regarding the current evidence about the validation, feasibility, clinical outcomes, and costs of wearable wireless devices for continuous monitoring of vital signs. Methods A systematic and comprehensive search was performed using PubMed/MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials from January 2009 to September 2019 for studies that evaluated wearable wireless devices for continuous monitoring of vital signs in adults. Outcomes were structured by validation, feasibility, clinical outcomes, and costs. Risk of bias was determined by using the Mixed Methods Appraisal Tool, quality assessment of diagnostic accuracy studies 2nd edition, or quality of health economic studies tool. Results In this review, 27 studies evaluating 13 different wearable wireless devices were included. These studies predominantly evaluated the validation or the feasibility outcomes of these devices. Only a few studies reported the clinical outcomes with these devices and they did not report a significantly better clinical outcome than the standard tools used for measuring vital signs. Cost outcomes were not reported in any study. The quality of the included studies was predominantly rated as low or moderate. Conclusions Wearable wireless continuous monitoring devices are mostly still in the clinical validation and feasibility testing phases. To date, there are no high quality large well-controlled studies of wearable wireless devices available that show a significant clinical benefit or cost-effectiveness. Such studies are needed to help health care professionals and administrators in their decision making regarding implementation of these devices on a large scale in clinical practice or in-home monitoring.

scholarly journals A systematic review of mHealth interventions for HIV prevention and treatment among gay, bisexual, and other men who have sex with men

2020 ◽  
Vol 10 (5) ◽  
pp. 1211-1220
Author(s):  
Kimberly M Nelson ◽  
Nicholas S Perry ◽  
Keith J Horvath ◽  
Laramie R Smith
Keyword(s):  
Systematic Review ◽  
Hiv Prevention ◽  
Text Messaging ◽  
Controlled Trial ◽  
The United States ◽  
Current Evidence ◽  
Future Research ◽  
Targeted Prevention ◽  
Prevention And Treatment ◽  
Sex With Men

Abstract The use of mobile health (mHealth) technologies addressing HIV disparities among gay, bisexual, and other men who have sex with men (GBMSM) has increased. A systematic review of mHealth interventions for HIV prevention and treatment among GBMSM was conducted to summarize the current evidence and provide recommendations for future research. PRISMA guidelines were followed (PROSPERO ID: 148452). Studies identified via PubMed, PsychInfo, or Embase were included that (i) were in English, (ii) were published in a peer-reviewed journal prior to July 1, 2019, (iii) presented primary results, (iv) included only GBMSM, and (v) reported the results of an mHealth intervention (e.g., text message, phone/mobile application [app]) to improve HIV prevention or treatment outcomes. Of 1,636 identified abstracts, 16 published studies met inclusion criteria. Eleven studies were conducted in the United States. One study was a fully powered randomized controlled trial (RCT), seven were single-arm pilots with pre–post assessments, four were pilot RCTs, and four tested public health campaigns with post-assessments. Seven developed study-specific apps, five used text messaging, and four used existing social networking apps. Most (81%) targeted prevention outcomes. Nine cited a specific behavioral theory. All studies found that a mHealth approach was feasible and acceptable. All interventions provided evidence of preliminary efficacy or promising trends on primary outcomes. Although mHealth interventions for HIV prevention and treatment appear feasible and acceptable, most published studies are small pilot trials. Additional research assessing the efficacy and mechanisms of mHealth interventions is needed.

scholarly journals Is Non-Chlamydial Non-Gonococcal Urethritis Associated with Significant Clinical Complications in Men? A Systematic Review

2020 ◽  
Vol 14 (1) ◽  
pp. 1-13 ◽  
Author(s):  
Cassandra E.L. Fairhead ◽  
Alexander Hampson ◽  
Louis Dwyer-Hemmings ◽  
Nikhil Vasdev
Keyword(s):  
Systematic Review ◽  
Reactive Arthritis ◽  
Case Reports ◽  
Case Series ◽  
Current Evidence ◽  
Future Research ◽  
Qualitative Synthesis ◽  
Cross Sectional ◽  
Gonococcal Urethritis ◽  
Clinical Complications

Background: It is estimated that between 50 and 89% of non-gonococcal urethritis is not caused by Chlamydia trachomatis. Associations between non-chlamydial non-gonococcal urethritis (NCNGU) with balanoposthitis, epididymo-orchitis and reactive arthritis have been suggested, but evidence to support these often-theoretical relationships is sparse and further investigation is called for. Concerns over increasing antimicrobial resistance has rendered the need for clarity over this question ever more pressing in recent years. A review of the current evidence on the complications of NCNGU in men is therefore urgently warranted. Objective: This systematic review summarizes and evaluates the available evidence that NCNGU, whether symptomatic or asymptomatic, causes the significant complications that are already well-recognized to be associated with non-gonococcal urethritis. These significant complications are epididymo-orchitis, balanoposthitis, and sexually-acquired reactive arthritis (Reiter's syndrome) including arthritis or conjunctivitis. Summary: We conducted a systematic review and qualitative synthesis using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis framework. Five databases (PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, and British Nursing Index) were searched. We included studies that measured clinical outcome after diagnosis of NCNGU in men. Bias was assessed using variations of the Newcastle-Ottawa scale. Data were extracted and entered into a pre-written data abstraction proforma. Seven peer-review studies were included. This included 2 retrospective cohort studies, 1 case series, 2 case reports and 2 cross-sectional studies. The studies described and analyzed 3 types of complication: balanitis, posthitis and/or meatitis; reactive arthritis and/or conjunctivitis; and epididymitis. All studies reported one or more complications. Key Messages: This review identifies an important avenue for future research: while the available evidence suggests that NCNGU has the potential to cause significant complications in men, with the strongest evidence existing for balanitis, posthitis and/or meatitis, the nature and significance of these relationships is far from clear. The findings of this review suggest that prospective, adequately powered research into whether there is a causal link between NCNGU and significant clinical complications in men would be highly worthwhile. The findings of this review raise important questions about the utility of the term NCNGU in research and clinical practice.

The Personal and Professional Consequences of Physician Burnout: A Systematic Review of the Literature

2019 ◽  
Vol 77 (5) ◽  
pp. 371-386 ◽  
Author(s):  
Eric S. Williams ◽  
Cheryl Rathert ◽  
Sandra C. Buttigieg
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Well Being ◽  
Empirical Literature ◽  
Future Research ◽  
Conservation Of Resources ◽  
Physician Burnout ◽  
Health Physician ◽  
Reducing Costs ◽  
Dynamic Loss

The well-being of the health care workforce has emerged as both a major concern and as a component of the “quadruple aim” to enable the “triple aim” of improving patient experiences, reducing costs, and improving population health. Physician burnout is problematic given its effects on physicians, patients, health care organizations, and society. Using conservation of resources theory as a frame, we conducted a systematic review of the empirical literature on the relationship of physician burnout with physician personal and professional outcomes that includes 43 articles. Nine outcomes were organized into three categories illustrating burnout as a dynamic loss spiral rather than a static end-state. Findings show that emotional exhaustion had the greatest impact with the outcomes explored, while depersonalization and lack of professional accomplishment manifested fewer associations. The results suggest that burnout is a complex, dynamic phenomenon, which unfolds over time. Future research and implications of these results are discussed.

scholarly journals Patient and public perspectives on cell and gene therapies: a systematic review

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Olalekan Lee Aiyegbusi ◽  
Karen Macpherson ◽  
Lauren Elston ◽  
Susan Myles ◽  
Jennifer Washington ◽  
...  
Keyword(s):  
Systematic Review ◽  
Information Needs ◽  
Current Evidence ◽  
Future Research ◽  
Sources Of Information ◽  
Social Challenges ◽  
Research Education ◽  
Gene Therapies ◽  
Education And Awareness ◽  
Cell And Gene Therapy

AbstractCell and gene therapies offer opportunities for treating disease with potential to restore function, and cure disease. However, they are not without risk and pose complex logistical, economic, ethical and social challenges for health systems. Here we report our systematic review of the current evidence on patient and public knowledge and perspectives of cell and gene therapies, to inform future research, education and awareness raising activities. We screened 10,735 titles and abstracts, and evaluated the full texts of 151 publications. The final selection was 35 publications. Four themes were generated from the narrative synthesis of the study findings namely: (1) Knowledge and understanding of cell and gene therapies, (2) Acceptance of cell and gene therapies (3) Understanding of risk and benefits of therapy, and (4) Information needs and current sources of information. As potential funders or future recipients, it is important that the public and patients are aware of these therapies, understand the issues involved, and can contribute to the debate. This review highlights the need for appropriate patient and public education on the various aspects of cell and gene therapies. High quality studies exploring patient and public opinions and experiences of cell and gene therapy are required. Patient and public perceptions of these therapies, alongside evidence of clinical and cost-effectiveness, will be central to their uptake and use.

scholarly journals A Systematic Review and Meta-Analysis of Buyang Huanwu Decoction in Animal Model of Focal Cerebral Ischemia

2013 ◽  
Vol 2013 ◽  
pp. 1-13 ◽  
Author(s):  
Rui-li Wei ◽  
Hai-juan Teng ◽  
Bo Yin ◽  
Yang Xu ◽  
Yue Du ◽  
...  
Keyword(s):  
Systematic Review ◽  
Focal Cerebral Ischemia ◽  
Meta Analysis ◽  
Cell Types ◽  
Experimental Stroke ◽  
Current Evidence ◽  
Future Research ◽  
Neuroprotective Effects ◽  
Buyang Huanwu Decoction ◽  
Therapy Strategy

Buyang Huanwu Decoction (BHD) is a well-known Chinese herbal prescription for ischemic stroke. The objective of this systematic review and meta-analysis is to provide the current evidence for neuroprotective effects of BHD and its possible mechanisms in animal models of focal ischemia. A systematic literature search, through October 2012, was performed using six databases. The outcome measures assessed were infarct size and/or neurological score. Fifty-six studies with 1270 animals that met the inclusion criteria were identified. The median score for methodological quality was 3 with a range of 2 to 6. Compared with vehicle or no treatment controls, BHD gave a 37% improvement in outcome for all doses ranging from 1.0 g/kg to 60 g/kg at each time point that BHD was administered (P<0.01). Efficacy was higher in mouse models that utilized suture occlusion and temporary ischemia. The neuroprotective effects of BHD are involved in multiple mechanisms and act upon multiple cell types. In conclusion, BHD possesses substantial neuroprotective effects in experimental stroke probably as a result of the multitarget therapy strategy typically utilized in traditional Chinese medicine. Future research should examine the presence of possible experimental bias and an in-depth study of herbal compound preparations.

scholarly journals Cost drivers of inpatient mental health care: a systematic review

2013 ◽  
Vol 24 (1) ◽  
pp. 78-89 ◽  
Author(s):  
J. Wolff ◽  
P. McCrone ◽  
L. Koeser ◽  
C. Normann ◽  
A. Patel
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Health Care ◽  
Mental Health Care ◽  
Hospital Costs ◽  
Patient Characteristics ◽  
Current Evidence ◽  
Related Factors ◽  
Inpatient Mental Health ◽  
Affective Symptoms

Aims.New reimbursement schemes for inpatient mental health care are imminent in the UK and Germany. The shared intention is to reflect cost differences between patients in reimbursement rates. This requires understanding of patient characteristics that influence hospital resource use. The aim of this review was to show which associations between mental health care per diem hospital costs and patient characteristics are supported by current evidence.Methods.A systematic review of the literature published between 1980 and 2012 was carried out. The search strategy included electronic databases and hand-searching. Furthermore, reference lists, citing articles and related publications were screened and experts were contacted.Results.The search found eight studies. Dispersion in per diem costs was moderate, as was the ability to explain it with patient characteristics. Six patient characteristics were identified as the most relevant variables. These were (1) age, (2) major diagnostic group, (3) risk, (4) legal problems, (5) the ability to perform activities of daily living and (6) presence of psychotic or affective symptoms. Two non-patient-related factors were identified. These were (1) day of stay and (2) treatment site.Conclusions.Idiosyncrasies of mental health care complicated the prediction of per diem hospital costs. More research is required in European settings since transferability of results is unlikely.

scholarly journals Factors associated with brain ageing - a systematic review

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jo Wrigglesworth ◽  
Phillip Ward ◽  
Ian H. Harding ◽  
Dinuli Nilaweera ◽  
Zimu Wu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Community Dwelling ◽  
Systematic Search ◽  
Current Evidence ◽  
Chronological Age ◽  
Future Research ◽  
Age Related ◽  
Brain Ageing

Abstract Background Brain age is a biomarker that predicts chronological age using neuroimaging features. Deviations of this predicted age from chronological age is considered a sign of age-related brain changes, or commonly referred to as brain ageing. The aim of this systematic review is to identify and synthesize the evidence for an association between lifestyle, health factors and diseases in adult populations, with brain ageing. Methods This systematic review was undertaken in accordance with the PRISMA guidelines. A systematic search of Embase and Medline was conducted to identify relevant articles using search terms relating to the prediction of age from neuroimaging data or brain ageing. The tables of two recent review papers on brain ageing were also examined to identify additional articles. Studies were limited to adult humans (aged 18 years and above), from clinical or general populations. Exposures and study design of all types were also considered eligible. Results A systematic search identified 52 studies, which examined brain ageing in clinical and community dwelling adults (mean age between 21 to 78 years, ~ 37% were female). Most research came from studies of individuals diagnosed with schizophrenia or Alzheimer’s disease, or healthy populations that were assessed cognitively. From these studies, psychiatric and neurologic diseases were most commonly associated with accelerated brain ageing, though not all studies drew the same conclusions. Evidence for all other exposures is nascent, and relatively inconsistent. Heterogenous methodologies, or methods of outcome ascertainment, were partly accountable. Conclusion This systematic review summarised the current evidence for an association between genetic, lifestyle, health, or diseases and brain ageing. Overall there is good evidence to suggest schizophrenia and Alzheimer’s disease are associated with accelerated brain ageing. Evidence for all other exposures was mixed or limited. This was mostly due to a lack of independent replication, and inconsistency across studies that were primarily cross sectional in nature. Future research efforts should focus on replicating current findings, using prospective datasets. Trial registration A copy of the review protocol can be accessed through PROSPERO, registration number CRD42020142817.

Sign in / Sign up

Export Citation Format

Share Document