scholarly journals Implementation of Electronic Medical Records for Service Delivery in Selected State Hospitals in Southwest Nigeria

2021 ◽  
Vol 5 (2) ◽  
pp. 75-94
Author(s):  
Stephen Adekunle Ajayi ◽  
Peter Wamae ◽  
Daniel Wambiri Muthee

Electronic Medical Records (EMR) is an important communications channel relating to patient health conditions. Unfortunately, many hospitals in Africa, including Nigeria, have not implemented EMR. The few Hospitals that have some level of EMR continues are still struggling with the use of paper and hybrid medical records, which has led to inadequate medical follow-up, medical error, and long waiting time for patients. A sample size of three hundred and ninety-seven (397) was determined using krejcie and morgan models, comprising of strategic managers, and the operational staff drawn from a population of 2889 in the selected hospitals. At the hospital level, purposive sampling was applied in picking strategic managers, while stratified random sampling was method was used to select operational health workers. Questionnaires were used for data collection. The study adopted a descriptive statistical analysis method to describe the existing medical records systems. The finding indicated that the systems in the hospitals are mainly paper-based. The hospitals are also using hybrid system with a few treatment areas having fully electronic medical records systems. In the area where EMR has been implemented, the finding indicates poor penetration of the EMR system, limited modules, staff readiness and poor performance in the treatment area, among others. The study concluded that hospitals that have implemented, EMR is not serving the classical purpose of medical record of supporting treatment and follow up. The study recommended that the selected hospitals should ensure there is the availability of fund, staff training, and technical infrastructures like electronic record managers, ICT support staff, and computer compatible medical devices, among others.

2021 ◽  
Vol 5 (3) ◽  
pp. 1-17
Author(s):  
Stephen Adekunle Ajayi ◽  
Peter Wamae ◽  
Daniel Wambiri Muthee

Electronic Medical Records (EMR) is an important communications channel relating to patient health conditions. Unfortunately, many hospitals in Africa, including Nigeria, have not implemented EMR. The few Hospitals that have some level of EMR continues are still struggling with the use of paper and hybrid medical records, which has led to inadequate medical follow-up, medical error, and long waiting time for patients. A sample size of three hundred and ninety-seven (397) was determined using krejcie and morgan models, comprising of strategic managers, and the operational staff drawn from a population of 2889 in the selected hospitals. At the hospital level, purposive sampling was applied in picking strategic managers, while stratified random sampling was method was used to select operational health workers. Questionnaires were used for data collection. The study adopted a descriptive statistical analysis method to describe the existing medical records systems. The finding indicated that the systems in the hospitals are mainly paper-based. The hospitals are also using hybrid system with a few treatment areas having fully electronic medical records systems. In the area where EMR has been implemented, the finding indicates poor penetration of the EMR system, limited modules, staff readiness and poor performance in the treatment area, among others. The study concluded that hospitals that have implemented, EMR is not serving the classical purpose of medical record of supporting treatment and follow up. The study recommended that the selected hospitals should ensure there is the availability of fund, staff training, and technical infrastructures like electronic record managers, ICT support staff, and computer compatible medical devices, among others.


2020 ◽  
Vol 7 (4) ◽  
pp. 326-334
Author(s):  
Salim M. Omambia ◽  
Grace Mbunga

Electronic Medical Records is the use of information and communication technology (ICT) for health care systems. Although Electronic Health Records has been discoverable for decades, hospitals, doctors and other caregivers have been slow to adopt them. Inadequate use of technology leads to a decrease of provision of service quality. Embracing modern technology is one among very many ways of improving efficiency and reducing costs within healthcare organizations. EMR helps to get rid of missing records, duplication of records, minimize the cost of services, saves time and enhances co-ordination between healthcare providers. Objective: The broad objectives of the study was to practises towards implementation of Electronic Medical Record systems at Moi Level 5Hospital Taita Taveta County. Methods: This study used descriptive study design. The study population that was used are all health workers that are privy to information that was influencing implementation of EMR. The researcher applied census sampling method where the entire health workers were questioned. A questionnaire was used to collect data. The researcher pre-tested the data collection tool to check on the validity and reliability of the results. The pre-tested data was arranged systematically according to the codes of the questionnaires to facilitate analysis. The researcher used a number of software packages to facilitate data analysis. The software packages include Microsoft word and Microsoft Excels for calculation practices. Also researcher made use of calculator in the study. Results and Discussion:Results show that at Moi hospital 85.25% of the respondents had not received any form of training and only 14.71% had received training, out of the 68 respondents, 86.76% had not received further follow up after the training, and 13.24% received follow up after the training.           It was concluded that practices towards EMR implementation were found to influence and correlated to the adoption of EMR. Most healthcare workers reported that they had neither received any form of training nor any further follow-up.  The findings indicated a significant positive relationship thus attributing to the low implementation of EMR. It was recommended that including ICT in the curriculum of medical courses as this will give them ownership and confidence to use the technology once they join the practicing field and this will assist in the adoption of EMR by the physicians. After the first formal training of the healthcare practitioners a very good follow-up mentorship should follow to provide the necessary technical support and this will help the healthcare providers to get sufficient experience to be comfortable in the use the EMR system. Conclusions: Organizational factors were an important contributor to implementation of EMR system. The results indicated a significant relationship between the factors and adoption of EMR and this meant that adoption of EMR was affected by organizational factors, practices towards EMR implementation were found to influence and correlated to the adoption of EMR. Most healthcare workers reported that they had neither received any form of training nor any further follow-up.  The findings indicated a significant positive relationship thus attributing to the low implementation of EMR. Also, the findings indicated a moderate positive significant relationship between technical factors and adoption of EMR and this meant that adoption of EMR was affected by technical factors. Recommendation:  Including ICT in the curriculum of medical courses as this will give them ownership and confidence to use the technology once they join the practicing field and this will assist in the adoption of EMR by the physicians. After the first formal training of the healthcare practitioners a very good follow-up mentorship should follow to provide the necessary technical support and this will help the healthcare providers to get sufficient experience to be comfortable in the use the EMR system. The ministries of health to consider having sufficient health care providers to meet the need of the ever increasing number


2012 ◽  
Vol 52 (188) ◽  
Author(s):  
A Watkinson-Powell ◽  
A Lee

Introduction: Electronic medical records systems may improve the efficiency and quality of health services in developing countries. However the supporting evidence is limited as there are a number of barriers to their implementation, including lack of infrastructure, resources and skills. The objective of this study was to evaluate the introduction and assess the potential benefits of an Electronic Medical Records System in Rural at an NGO-supported health post in rural Nepal. Methods: Original research in the form of a case report was carried out using participant observation of health clinics, semi-structured interviews with health workers and recording of time spent on clinic activities at the pilot and a control site. Results: This evaluation found that the Electronic Medical Records System was well used and easy to learn. Health workers thought it improved continuity of care and found decision-support tools useful. Monthly report creation was faster but the system was difficult to integrate with government services, which limited the reduction in paperwork. Other problems identified included minor software issues, a lack of back-up, continuity of power supply and inadequate technical support. There was no significant impact on consultation length or time spent interacting with patients. Conclusions: The introduction of the Electronic Medical Records System was largely successful. With adequate technical support and training, Electronic Medical Records System could provide a relatively low-cost means of improving patient care and health worker efficiency in developing countries. However they must be designed to fit their intended environment. Keywords: computerized; electronic health records; medical records; medical records systems..


2018 ◽  
Vol 35 (4) ◽  
pp. 189-197 ◽  
Author(s):  
Kian Karimi ◽  
Chester F. Griffiths ◽  
Alex Reivitis ◽  
Austin Davis-Hunter ◽  
Elizabeth Zhang ◽  
...  

The microcannula technique has become an increasingly popular method for injecting cosmetic fillers. Previous studies have illustrated that the microcannula technique allows filler to be injected with less pain, swelling, and essentially no bruising. This study is a retrospective clinical series examining 247 patients who have undergone dermal filler injections using the microcannula technique from 2011 to 2016 with a single injector, Kian Karimi. The purpose of this study is to assess the frequency of adverse events associated with injections such as bruising and swelling. All 666 recorded patient visits from 2011 to 2016 were analyzed using electronic medical records based on the criteria that the patients had cosmetic filler using the microcannula technique by the surgeon investigator. Of the 666 filler treatments using the microcannula technique, 3 treatments (0.5%) produced adverse events on the day of service, and 32 treatments (4.8%) produced adverse events at 2-week follow-up. In total, 5.4% of treatments produced adverse events. At the 2-week follow-up, 5.7% of treatments using the 25-gauge microcannula produced adverse events ( P = .830); 3.9% of treatments using the 27-gauge microcannula produced adverse events ( P = .612]). Only 3 patients were treated with the 30-gauge microcannula, and 1 patient reported adverse events on the day of service. None of the treatments using the 30-gauge microcannula produced adverse events at the 2-week follow-up ( P = .160). The data support that the microcannula technique is a safe and effective alternative to hypodermic needles for the injection of dermal filler to minimize common adverse events.


2021 ◽  
Vol 9 (10) ◽  
pp. 232596712110354
Author(s):  
Judson L. Penton ◽  
Travis R. Flick ◽  
Felix H. Savoie ◽  
Wendell M. Heard ◽  
William F. Sherman

Background: When compared with fluid arthroscopy, carbon dioxide (CO2) insufflation offers an increased scope of view and a more natural-appearing joint cavity, and it eliminates floating debris that may obscure the surgeon’s view. Despite the advantages of CO2 insufflation during knee arthroscopy and no reported cases of air emboli, the technique is not widely used because of concerns of hematogenous gas leakage and a lack of case series demonstrating safety. Purpose/Hypothesis: To investigate the safety profile of CO2 insufflation during arthroscopic osteochondral allograft transplantation of the knee and report the midterm clinical outcomes using this technique. We hypothesized that patients undergoing CO2 insufflation of the knee joint would have minimal systemic complications, allowing arthroscopic cartilage work in a dry field. Study Design: Case series; level of evidence, 4. Methods: A retrospective chart review was performed of electronic medical records for patients who underwent arthroscopic osteochondral allograft transplantation of the knee with the use of CO2 insufflation. Included were patients aged 18 to 65 years who underwent knee arthroscopy with CO2 insufflation from January 1, 2015, to January 1, 2021, and who had a minimum follow-up of 24 months. All procedures were performed by a single, fellowship-trained and board-certified sports medicine surgeon. The patients’ electronic medical records were reviewed in their entirety for relevant demographic and clinical outcomes. Results: We evaluated 27 patients (14 women and 13 men) with a mean age of 38 and a mean follow-up of 39.2 months. CO2 insufflation was used in 100% of cases during the placement of the osteochondral allograft. None of the patients sustained any systemic complications, including signs or symptoms of gas embolism or persistent subcutaneous emphysema. Conclusion: The results of this case series suggest CO2 insufflation during knee arthroscopy can be performed safely with minimal systemic complications and provide an alternative environment for treating osteochondral defects requiring a dry field in the knee.


2012 ◽  
Vol 1 (3) ◽  
pp. 13-19
Author(s):  
Ángel Igualada Menor ◽  
Teresa Pereyra Caramé

The right implementation and design of Electronic Medical Records Systems present an opportunity of improvement, since they provide the owners of personal data, who are under treatment in medical care activities, with the exercise of control over them; avoidance of any change; loss or non-authorised access, as well as availability safeguarding, and use in activities that are not strictly within welfare.


2019 ◽  
Vol 19 (3) ◽  
pp. 453-464 ◽  
Author(s):  
Elisabeth B. Powelson ◽  
Brianna Mills ◽  
William Henderson-Drager ◽  
Millie Boyd ◽  
Monica S. Vavilala ◽  
...  

Abstract Background and aims Chronic pain after traumatic injury and surgery is highly prevalent, and associated with substantial psychosocial co-morbidities and prolonged opioid use. It is currently unclear whether predicting chronic post-injury pain is possible. If so, it is unclear if predicting chronic post-injury pain requires a comprehensive set of variables or can be achieved only with data available from the electronic medical records. In this prospective study, we examined models to predict pain at the site of injury 3–6 months after hospital discharge among adult patients after major traumatic injury requiring surgery. Two models were developed: one with a comprehensive set of predictors and one based only on variables available in the electronic medical records. Methods We examined pre-injury and post-injury clinical variables, and clinical management of pain. Patients were interviewed to assess chronic pain, defined as the presence of pain at the site of injury. Prediction models were developed using forward stepwise regression, using follow-up surveys at 3–6 months. Potential predictors identified a priori were: age; sex; presence of pre-existing chronic pain; intensity of post-operative pain at 6 h; in-hospital opioid consumption; injury severity score (ISS); location of trauma, defined as body region; use of regional analgesia intra- and/or post-operatively; pre-trauma PROMIS Depression, Physical Function, and Anxiety scores; in-hospital Widespread Pain Index and Symptom Severity Score; and number of post-operative non-opioid medications. After the final model was developed, a reduced model, based only on variables available in the electronic medical record was run to understand the “value add” of variables taken from study-specific instruments. Results Of 173 patients who completed the baseline interview, 112 completed the follow-up within 3–6 months. The prevalence of chronic pain was 66%. Opioid use increased from 16% pre-injury to 28% at 3–6 months. The final model included six variables, from an initial set of 24 potential predictors. The apparent area under the ROC curve (AUROC) of 0.78 for predicting pain 3–6 months was optimism-corrected to 0.73. The reduced final model, using only data available from the electronic health records, included post-surgical pain score at 6 h, presence of a head injury, use of regional analgesia, and the number of post-operative non-opioid medications used for pain relief. This reduced model had an apparent AUROC of 0.76, optimism-corrected to 0.72. Conclusions Pain 3–6 months after trauma and surgery is highly prevalent and associated with an increase in opioid use. Chronic pain at the site of injury at 3–6 months after trauma and surgery may be predicted during hospitalization by using routinely collected clinical data. Implications If our model is validated in other populations, it would provide a tool that can be easily implemented by any provider with access to medical records. Patients at risk of developing chronic pain could be selected for studies on preventive strategies, thereby concentrating the interventions to patients who are most likely to transition to chronic pain.


2016 ◽  
Vol 9 (2) ◽  
pp. 196-199 ◽  
Author(s):  
Amy Deipolyi ◽  
Alexander Bailin ◽  
Joshua A Hirsch ◽  
T Gregory Walker ◽  
Rahmi Oklu

ObjectiveTo describe findings and outcomes of 331 bilateral inferior petrosal sinus sampling (BIPSS) procedures performed in 327 patients evaluated for Cushing disease (CD).Materials and methodsThe radiology department's electronic database was searched to identify all BIPSS procedures (1990–2013). Electronic medical records were used to identify demographics, laboratory, procedural, surgical and pathologic findings.ResultsA total of 331 BIPSS procedures were performed in 327 patients (254 F, 73 M), mean age 41 (range 7–81) years. The overall technical success rate was 88% for bilateral cannulation, though nearly two-thirds of the technical failures had unilateral sampling that diagnosed CD. Of the 331 BIPSS procedures, 40 were performed without, and 291 with stimulation by Acthrel or desmopressin. Sensitivity was 89–94% for unstimulated BIPSS, 96% for stimulated BIPSS, and 77% for MRI. BIPSS lateralization was accurate in about half of patients, compared with 75% accuracy for MRI. Mean inferior petrosal sinus (IPS):peripheral adrenocorticotropic hormone ratio was 17.3 (SE 1.8) at baseline, and 99.2 (SE 14.8) at 3 min, with decreasing values over time. All patients with follow-up after surgical resection for centralizing BIPSS were reported to be cured, with cortisol levels significantly decreased from 19 to 4 μg/dL (p<0.0001). Complications from BIPSS were rare, including groin hematoma (2.5%), but no thromboembolic complications were seen.ConclusionsBIPSS remains the ‘gold standard’ for diagnosing CD. Stimulation with Acthrel or desmopressin is key to increasing specificity. When only one IPS can be successfully cannulated, results may still be diagnostic. BIPSS findings cannot be used to accurately lateralize lesions within the pituitary.


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