Evaluating Electronic Health Record Systems in Ghana: the case of Effia Nkwanta Regional Hospital

Abstract

The adoption and promotion of Information and Communication Technology (ICT), including Electronic Health Records (EHR) system, in healthcare delivery is growing rapidly in most developing countries including Ghana. Notwithstanding this tremendous growth in the implementation of ICTs in healthcare delivery, most of these projects have been recorded to have survived partially or fully at the pilot phase or have been repealed at the full implementation phase (Adjorlolo & Ellingsen, 2013), hence the need for system evaluation to assuage some of the challenges faced by most system implementation. The current study evaluates the implemented EHR at Effia Nkwanta Regional Hospital (ENRH) by assessing the preparations made prior to the systems introduction as well as the factors that impede or promote the systems usability and satisfaction among the users of the system. The study also examined the impact of the EHR to healthcare delivery by identifying the benefits and challenges of the implemented system. With an interpretive case study research approach, data was gathered from the users of the system and the system administrators using in-depth semi-structured interviews, open-ended questionnaires, observations and focused group discussions. Results indicate sufficient preparations made by the hospital prior to the systems introduction through thorough understudying of other implemented systems in other hospitals, the establishment of an Information Technology (IT) department, provision of infrastructure and network connections, and the training of staff. In spite of these, the study revealed some drawbacks in the preparations to include; inadequate computers, inadequate training and the non-involvement of users in the design and configuration of the system. Majority of the users recorded their satisfaction with the system although the attitudes of some users were perceived to be underserved. Benefits realised from the implemented EHR included; reduced errors and missing files, reduced work task, reduced expenditure on paper logistics and the retrieval of absconded bills. Challenges to the implemented system were recorded to include; poor network connections, illegible handwriting of some doctors, unstable power supply and increased work task. The study also revealed that inadequate funds which hinders EHR implementation in most developing countries was not a major challenge to the systems implementation as adequate budgetary allocations as well as payment plans were initiated with the vendors to reduce this challenge. The findings from the study were discussed and the necessary recommendations made towards the sustainability of the implemented EHR. Keywords: Electronic Health Records, Information Infrastructure, Usability, Users satisfaction, initial assessment