Use of electronic medical records in emergency care at Komfo Anokye Teaching Hospital in Kumasi, Ghana

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JUNE, 2016.
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Abstract
Background: The use of paper for record keeping (manual system) has been the order of the day in almost all the health care facilities of resource poor setting countries such as Ghana. This system has presented numerous challenges. The use of Electronic Medical Records (EMR) however seeks to address many of such challenges if not all. Main objective: The main objective of the study was to evaluate the use of EMR in Komfo Anokye Teaching Hospital‟s (KATH) Emergency Department (ED). The outcome of the study was intended to provide lesson learning to improve the existing system at ED of KATH and other health facilities with intention of setting up EMR system. Method: The study was a non-interventional, descriptive cross-sectional study that employed the qualitative approach of research. The study population was twenty four involving four core implementers and twenty end users of KATH ED EMR. Semi-structured interview guides were used to collect data from the respondents. The interviews were manually recorded and analyzed thematically facilitated by manual analysis. Results: The KATH ED EMR project had no funding and it has been piloted for three years. The ED staff doubled up as the EMR personnel. An open source EMR was freely downloaded and customized to meet the needs of the ED. The EMR database was composed of bio-data of patients which was accessible to end users with user identification and password. The facilitators for utilizing the system included the desire to improve emergency medicine practice through data persistency; availability of some logistics such as computers, scanners, printers, office space, open source EMR, local area network and external storage devices; involvement of ED‟s internal management committee; motivation; previous knowledge in information technology; capacity building and training. The project had constraints of funding, inadequate computers and xii accessories, full time information technology experts, automatic data and power backups, data entry and limited office space. It was observed that with the provision of adequate human and financial resources the challenges of the project will be overcome and the adoption of the EMR improved. Conclusions and recommendation: The KATH ED EMR was hybrid and the end users were basically nurses and medical record staff. The staffs were motivated in using the EMR. However, the implementation was confronted with logistics and human resource constraints. Therefore, financial support from KATH management towards the clinical EMR at the ED will be an enormous contribution for successful implementation of the ED‟s EMR
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A thesis submitted to the Department of Health Policy, Management and Economics, College of Health Science, School of Public Health, in partial fulfillment of the requirements for the degree of Master of Public Health in Health Services Planning and Management.
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