A Micro-analysis Approach in Understanding Electronic Medical Record Usage in Rural Communities: Comparison of Frequency of Use on Performance Before and During the COVID-19 Pandemic

Abstract

In strengthening eHealth in the Philippines to support the universal health care (UHC) law, the scaling up and full adoption of electronic medical record (EMR) systems was strategically scheduled and supposedly completed in 2020. The Covid-19 pandemic, however, delayed these strengthening efforts. We wanted to assess the status of EMR adoption in primary clinics of rural health units (RHUs) and understand the frequency of use, particularly during the pandemic. Through analyses of EMR usage logs from selected RHUs in 2020, we estimated frequency of EMR usage based on duration of use and tested if this was influenced by the performing RHU and pandemic event. We also determined the most frequent EMR activities through process maps and tested if there were differences in the conduct of these activities before and during the pandemic. Results showed that EMR use during work hours was significantly dependent on the performing RHU (p<0.001). High-performing RHUs used EMRs more than 3 hours/day while low-performing RHUs used the systems for less. The pandemic either significantly decreased or increased EMR use during work hours by around 5 hours/day in some RHUs (p<0.01). Process maps revealed that there were additional activities performed by RHUs during the pandemic. Except for Update Patient Profile and Add Patient EMR features, significant differences (p<0.01) were observed in accessing frequently used features before and during the pandemic. The results suggest some uneven level of utilization of EMRs at the primary care level which can impact readiness to support full implementation of the UHC law. The study shows the potential of using a more granular approach in studying adoption to help improve the quality of EMR use and contribute to improving health service delivery and financing.

Technology Dependency and Impact During COVID-19: A Systematic Literature Review and Open Challenges

“…Far back in 2005, the potential of employing information communication technology (ICT) systems has been recognized by the World Health Organization (WHO), in helping to transform health delivery systems and services positively, thereby urging member states to set up long-lasting strategies for the use of ICT in the health sector [9]. Consequently, with the current pandemic in place, the role played by information technology in health systems has been accelerated.…”

“…One such study examined the adoption as well as utilization of EMR technology in rural primary care settings. Their study revealed a non-parallel level of EMR utilization at primary care levels, thus instigating the need for a more granular approach to study adoption that can help in improving EMR usage quality, thereby contributing to the improvement of health service delivery and financing [9]. Similarly, in a qualitative descriptive study on the perception of nurses concerning the critical care work system during the COVID-19 pandemic [11], it was discovered that communication between patients and families was facilitated via iPad tablets supplied by respective organizations.…”

“…Table III summarises the discussion on the first item in the taxonomy, technology type as previously discussed: The onslaught of the pandemic has exposed the gaps in technology adoption in healthcare. The lack of utilization of EMRs has [9], [10], [11], [12], [13] become apparent which may lead to data inconsistencies, providing the organizations with unreliable information in a critical setting. Mobile Technology Mobile technologies have become increasingly prevalent and of cardinal importance in the COVID-19 pandemic.…”

Exploring the Landscape of Health Information Systems in the Philippines: A Methodical Analysis of Features and Challenges

“…It encompasses all sources of health data, including those related to health facilities and communities, electronic health records for patient care, populationbased data, information about human resources, finances, supply chains, and surveillance, as well as how that information is used and disseminated. [1]. Electronic health records (EHR), electronic medical records (EMR), health information exchange (HIE), computerized physicians order entry (CPOE), hospital information systems, and telemedicine/telehealth/e-health have all developed acronyms over time to describe electronic HISs [2] [3] [4] [5] [6].…”