Implementation of electronic medical records requires more than new software: Lessons on integrating and managing health technologies from Mbarara, Uganda

Madore, Amy; Rosenberg, Julie; Muyindike, Winnie; Bangsberg, David R.; Bwana, Mwebesa; Martin, Jeffrey N.; Kanyesigye, Michael; Weintraub, Rebecca

doi:10.1016/j.hjdsi.2015.08.006

Cited by 12 publications

(10 citation statements)

References 5 publications

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“…In the early 2000s, the United States’ President’s Emergency Plan for AIDS Relief (PEPFAR) and non‐profit organizations increased their financial commitment to addressing this problem by subsidizing the high cost of ART drugs. By 2009, approximately 5 million people in more than 100 countries had received the lifesaving drugs, and patients could expect to live an additional 40 years (Madore et al, ).…”

Section: Resultsmentioning

confidence: 99%

“…Data management was an unintended challenge. ‘Paper files overwhelmed administrative staff and clinicians… It became harder to create progress reports… (and) if anyone wanted to use clinic data for research, it was tedious and – in large‐scale HIV treatment programs – nearly impossible to select participants systematically’ (Madore et al, ). The existing software available to record and track this data, like the ART drugs themselves, was prohibitively expensive for users in developing countries.…”

Section: Resultsmentioning

confidence: 99%

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Write Code, Save Lives: How a Community Uses Open Innovation to Address a Societal Challenge

et al. 2018

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This study explores how a community uses open innovation over time to tackle a global societal challenge. Relying on inductive analyses of qualitative and archival data, we conduct an in-depth case study of OpenMRS, an open-source software community providing affordable medical record-keeping software in developing nations. We develop a process model that describes how inbound, outbound, and coupled open innovation influenced the community through four discrete phases of community development. We explain how the founders' vision led to the creation of the community, and how increasing community participation and community governance facilitated its growth. Interestingly, we found that economic opportunities made possible by open innovation may paradoxically create challenges to community sustainability. Ultimately, this study expands our understanding of open innovation communities in different settings, and their role in addressing societal challenges.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Write Code, Save Lives: How a Community Uses Open Innovation to Address a Societal Challenge

et al. 2018

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“…Various researchers have argued that EHRS implementation is very complicated due to the shortage of experience in implementation and the associated issues [7][8][9][10][11]. Although, the barriers to EHRS implementation have been described, many of them remain unresolved [12].…”

Section: Introductionmentioning

confidence: 99%

Exploring Facilitators to the Implementation of Electronic Health Records in Saudi Arabia

Alzghaibi

Hutchings

2022

Preprint

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The introduction of IT was one of the key priorities for policy-makers in healthcare organisations over the last two decades, due to the potential benefits of this technology to improve healthcare services and quality. However, about 50% of those projects failed to achieve their intended aims. This was as a result of several factors, and included the cost of these projects. The Saudi MoH was planning on implementing EHRS in around 2200 PHCs nationwide. It was acknowledged that this project may face hurdles, which might result in the failure of the project, if implementation facilitators were not first determined. According the Saudi MoH, previous EHRS implementation in the PHCs failed as a consequence of several barriers, such as poor infrastructure, lack of connectivity and lack of interoperability. However, the facilitators to the successful EHRS implementation in the Saudi PHCs not understood. Objective:To determine the facilitators that enhance the success of the implementation of the EHRS in the PHCs in SA.Method:A mixed methods approach was used with both qualitative and quantitative methods (Qualitative using semi-structured interviews and quantitative with a closed survey). The purpose of the utilization of exploratory mixed-methods was to identify a wide range of facilitators that may influence EHRS implementation. The data were obtained from two different perspectives (PHCs practitioners and project team members), 351 practitioners from 21 PHCs participated in the online based, while 14 key informants at the Saudi MoH who were directly involved in the EHRS implementation in the PHCs agreed to be interviewed face to face.Results:The findings from both studies revealed several facilitators. Among these facilitators, financial resources were found to be the most influential factor which assisted in overcoming some barriers such as software selection. The size of the PHCs was the second facilitator to successful implementation. This was despite the scale of the project. The perceived usefulness was another facilitator identified in both the interviews and survey. More than 90% of the participants thought that the EHRS was useful and could contribute to improving the quality of healthcare services. While high level of satisfaction was expressed toward the EHRS usability and efficiency, low levels of satisfaction were recorded toward organisational factors such as user-involvement, training and support. Hence, the system usability and efficiency were documented to be other facilitators of successful EHRS implementation in the Saudi PHCs Conclusion: The findings of the present study suggest that sufficient financial support is essential to enhance the success of the EHRS implementation, despite the scale of the project. Also, effective leadership and project management were found core factors to overcome many obstacles and thus ensure the success of large-scale projects

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“…Two additional barriers—organizational and change—should be paid special attention, the authors argue, as they mediate the effects of the others and thereby most directly influence a project’s success [9]. There is indeed a growing literature on EMR implementation as a complex change project [10-13] targeting factors related to cost, time, technical issues, or resistance (fear of change, doubt the investment of resources will be worth it, and so on) [11,12,14-17] . EMR adoption and use operates in a complex adaptive system, highly sensitive to shifting politics and public policy.…”

Section: Introductionmentioning

confidence: 99%

Progress in the Enhanced Use of Electronic Medical Records: Data From the Ontario Experience

Jones¹,

Koziel²,

Larsen³

et al. 2017

JMIR Med Inform

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BackgroundThis paper describes a change management strategy, including a self-assessment survey tool and electronic medical record (EMR) maturity model (EMM), developed to support the adoption and implementation of EMRs among community-based physicians in the province of Ontario, Canada.ObjectiveThe aim of our study was to present an analysis of progress in EMR use in the province of Ontario based on data from surveys completed by over 4000 EMR users.MethodsThe EMM and the EMR progress report (EPR) survey tool clarify levels of capability and expected benefits of improved use. Maturity is assessed on a 6-point scale (0-5) for 25 functions, across 7 functional areas, ranging from basic to more advanced. A total of 4214 clinicians completed EPR surveys between April 2013 and March 2016. Univariate and multivariate descriptive statistics were calculated to describe the survey results.ResultsPhysicians reported continual improvement over years of use, perceiving that the longer they used their EMR, the better patient care they provided. Those with at least two years of experience reported the greatest progress.ConclusionsFrom our analyses at this stage we identified: (1) a direct correlation between years of EMR use and EMR maturity as measured in our model, (2) a similar positive correlation between years of EMR use and the perception that these systems improve clinical care in at least four patient-centered areas, and (3) evidence of ongoing improvement even in advanced years of use. Future analyses will be supplemented by qualitative and quantitative data collected from field staff engagements as part of the new EMR practice enhancement program (EPEP).

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Implementation of electronic medical records requires more than new software: Lessons on integrating and managing health technologies from Mbarara, Uganda

Cited by 12 publications

References 5 publications

Write Code, Save Lives: How a Community Uses Open Innovation to Address a Societal Challenge

Write Code, Save Lives: How a Community Uses Open Innovation to Address a Societal Challenge

Exploring Facilitators to the Implementation of Electronic Health Records in Saudi Arabia

Progress in the Enhanced Use of Electronic Medical Records: Data From the Ontario Experience

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