Adoption of electronic health record systems to enhance the quality of healthcare in low-income countries: a systematic review

Woldemariam, Misganaw Tadesse; Jimma, Worku

doi:10.1136/bmjhci-2022-100704

Cited by 16 publications

(6 citation statements)

References 46 publications

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“…Our findings revealed that clinicians reported high satisfaction with digital hospitals and positively viewed data accessibility in quantitative measures; however, our qualitative evidence synthesis revealed themes of frustration with slow digital workflows and inconsistent data discoverability. Evidence of EMR adoption in low-income countries also highlights clinician perception of the EMR as a key facilitator and interoperability and clinician burnout as barriers, similar to our findings on the impact of EMR on workload and burnout symptoms [107].…”

Section: Principal Findings and Comparison With Prior Worksupporting

confidence: 86%

The Impact of Digital Hospitals on Patient and Clinician Experience: Systematic Review and Qualitative Evidence Synthesis

Canfell,

Woods,

Meshkat

et al. 2024

J Med Internet Res

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Background The digital transformation of health care is advancing rapidly. A well-accepted framework for health care improvement is the Quadruple Aim: improved clinician experience, improved patient experience, improved population health, and reduced health care costs. Hospitals are attempting to improve care by using digital technologies, but the effectiveness of these technologies is often only measured against cost and quality indicators, and less is known about the clinician and patient experience. Objective This study aims to conduct a systematic review and qualitative evidence synthesis to assess the clinician and patient experience of digital hospitals. Methods The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and ENTREQ (Enhancing the Transparency in Reporting the Synthesis of Qualitative Research) guidelines were followed. The PubMed, Embase, Scopus, CINAHL, and PsycINFO databases were searched from January 2010 to June 2022. Studies that explored multidisciplinary clinician or adult inpatient experiences of digital hospitals (with a full electronic medical record) were included. Study quality was assessed using the Mixed Methods Appraisal Tool. Data synthesis was performed narratively for quantitative studies. Qualitative evidence synthesis was performed via (1) automated machine learning text analytics using Leximancer (Leximancer Pty Ltd) and (2) researcher-led inductive synthesis to generate themes. Results A total of 61 studies (n=39, 64% quantitative; n=15, 25% qualitative; and n=7, 11% mixed methods) were included. Most studies (55/61, 90%) investigated clinician experiences, whereas few (10/61, 16%) investigated patient experiences. The study populations ranged from 8 to 3610 clinicians, 11 to 34,425 patients, and 5 to 2836 hospitals. Quantitative outcomes indicated that clinicians had a positive overall satisfaction (17/24, 71% of the studies) with digital hospitals, and most studies (11/19, 58%) reported a positive sentiment toward usability. Data accessibility was reported positively, whereas adaptation, clinician-patient interaction, and workload burnout were reported negatively. The effects of digital hospitals on patient safety and clinicians’ ability to deliver patient care were mixed. The qualitative evidence synthesis of clinician experience studies (18/61, 30%) generated 7 themes: inefficient digital documentation, inconsistent data quality, disruptions to conventional health care relationships, acceptance, safety versus risk, reliance on hybrid (digital and paper) workflows, and patient data privacy. There was weak evidence of a positive association between digital hospitals and patient satisfaction scores. Conclusions Clinicians’ experience of digital hospitals appears positive according to high-level indicators (eg, overall satisfaction and data accessibility), but the qualitative evidence synthesis revealed substantive tensions. There is insufficient evidence to draw a definitive conclusion on the patient experience within digital hospitals, but indications appear positive or agnostic. Future research must prioritize equitable investigation and definition of the digital clinician and patient experience to achieve the Quadruple Aim of health care.

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Section: Principal Findings and Comparison With Prior Worksupporting

confidence: 86%

The Impact of Digital Hospitals on Patient and Clinician Experience: Systematic Review and Qualitative Evidence Synthesis

Canfell,

Woods,

Meshkat

et al. 2024

J Med Internet Res

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“…For example, to address interoperability challenges, these countries should prioritize solutions that promote seamless integration of healthcare activities and departments. This involves providing comprehensive training programs and ongoing support to facilitate the transition from paper-based to electronic systems [5]. Another critical aspect that needs to be addressed during the successful implementation of EMRs is technological limitations.…”

Section: Interventions To Effective Emr Implementation In the Develop...mentioning

confidence: 99%

“…Therefore, only electronic records or software compatible with existing technology infrastructure should be selected. Later on, with the passing years, increased communication between healthcare providers and IT project managers will help healthcare authorities overcome organizational barriers, and software with even the latest and more advanced features will be successfully implemented [5]. Developing countries must also prioritize confidentiality, integrity, access control, and audit trail mechanisms to safeguard electronic records effectively, for which they can seek guidance and support from experienced nations to design foolproof data preservation protocols.…”

Section: Interventions To Effective Emr Implementation In the Develop...mentioning

confidence: 99%

Empowering Patients Through Digital Health Literacy and Access to Electronic Medical Records (EMRs) in the Developing World

Sham,

Shiwlani,

Kirshan Kumar

et al. 2024

Cureus

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This editorial discusses the transformative potential of digital health literacy and the critical role of electronic medical records (EMRs) in promoting patient empowerment in the healthcare landscape of developing countries. It examines the impact of digital media in healthcare, noting its ability to both democratize access to information and services and pose risks of misinformation among populations with limited health literacy. The discussion includes an overview of key literacy components critical for effectively navigating the digital healthcare ecosystem. Our article highlights the critical role of EMR in facilitating a patient-centered care (PCC) model, with a special emphasis on making EMR systems accessible and user-friendly for vulnerable groups in developing countries. The core aim of our study is twofold: First, it sheds light on the significant challenges -be they technical, financial, or infrastructural -that obstruct the adoption of sophisticated EMR systems in these areas. Second, it explores the essential aspect of digital health literacy, advocating for its improvement as a vital step toward enabling patients to effectively engage with their medical records. By addressing these key issues, our study seeks to illustrate how enhancing digital health literacy, alongside increasing the accessibility of EMR systems, can empower patients in the developing world to actively participate in their healthcare processes. This dual focus aims to contribute to the broader discourse on improving healthcare outcomes through more inclusive and patient-centered approaches, particularly in settings that are currently underserved by modern healthcare technologies. In conclusion, the editorial advocates for a concerted effort toward creating a more inclusive and empowered healthcare paradigm. It suggests integrating PCC principles, tailoring EMR systems to diverse needs, and enhancing digital health literacy as strategies to harness digital health innovations for better healthcare outcomes and equity. It emphasizes the importance of ongoing investment in education, technology, and policy to fully leverage digital health solutions in the developing world.

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“…Studies have shown that EHR systems can improve patient care, increase patient participation, improve care coordination, and enhance patient safety (Eduhealthsystem, 2022;Woldemariam & Jimma, 2023). However, the implementation of EHR systems in low-middle income countries (LMICS) has been challenging due to poor infrastructure, lack of management commitment, standards, interoperability, support, experience, and poor EHR systems (Woldemariam & Jimma, 2023;Bisrat et al, 2021;Silwamba, 2019).…”

Section: Statement Of the Problemmentioning

confidence: 99%

A Study of the Effect of Health Records Digitalization on Healthcare Facility Operational Efficiency

Ng’andu,

Haabazoka

2024

OJBM

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Historically, public health spending has consistently accounted for a substantial portion of government expenditure. In line with the 2022 national budget allocation analysis conducted by the Policy Monitoring and Research Centre, it was revealed that over 13 billion kwacha had been allocated to health services. As society continued to age and exerted a growing strain on healthcare systems, healthcare stakeholders actively sought solutions to address pressing concerns, including cost management, data quality, and overall efficiency. The study hypothesized that digitizing medical health records would improve overall health care facility operational efficiency by improving access to patient information, streamlining workflows, reducing documentation errors, and improving communication among healthcare stakeholders. Furthermore, the study aimed to identify potential implementation challenges and barriers, providing valuable insights for healthcare institutions looking to adopt or optimize their EHR systems. The research design used a survey-based approach with a sample size of 150 respondents from ten public health care facilities in Lusaka using an EHR such as SmartCare or paper-based records. The respondents included healthcare professionals, health facility administrators, and data entry clerk personnel. The primary data collection instrument used was a structured questionnaire that targeted key facility operational efficiency indicators such as time efficiency, workflow optimization, documentation accuracy, information accessibility and cost efficiency. The collected data was analyzed using SPSS and Microsoft Excel software. Descriptive statistics were used to summarize and interpret survey responses, while inferential statistics were used to establish relationships and correlations between variables. The study's findings were presented in tables, graphs, and charts, allowing for a thorough understanding of the findings. The results collected and analyzed highlight the significance of addressing these issues to guarantee the success-

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Adoption of electronic health record systems to enhance the quality of healthcare in low-income countries: a systematic review

Cited by 16 publications

References 46 publications

The Impact of Digital Hospitals on Patient and Clinician Experience: Systematic Review and Qualitative Evidence Synthesis

The Impact of Digital Hospitals on Patient and Clinician Experience: Systematic Review and Qualitative Evidence Synthesis

Empowering Patients Through Digital Health Literacy and Access to Electronic Medical Records (EMRs) in the Developing World

A Study of the Effect of Health Records Digitalization on Healthcare Facility Operational Efficiency

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