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OpenMRS Academy

LEVEL 1: OpenMRS Fundamentals

Module 1: Introduction to Health IT and EMRs

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Learning objectives

Define the concepts of: Health IT, Health Information System (HIS) and Electronic Medical Record Systems (EMR);
Explain the role and the advantages of EMRs for a health system;
Describe the barriers of EMR implementation in developing countries.

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What is Health IT?

Health information technology (Health IT) is the use of computer hardware, software, or infrastructure to record, store, protect, and retrieve clinical, administrative, or financial information.
Health IT supports the management and secure exchange of health information between the different actors within the MoH, including consumers, policymakers, and healthcare providers.

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Health Information System vs Electronic Medical Record

A Health Information System (HIS) is a set of components that act in an integrated manner through mechanisms for the collection, processing, analysis and transmission of the necessary and timely information for the implementation of decision-making processes in the Health System * .

*Source: WHO

The EMR system is an electronic version of the paper forms defined by the MoH, and which are usually used in healthcare facilities by healthcare providers.
The EMR system records all the data that is collected through the forms and then managed and consulted by doctors or authorized health professionals.

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HEALTH IT ADVANTAGES

The use of Health IT through electronic medical records helps:
Increase productivity in health care and treatment;
Speed up transactions between patients and healthcare providers;
Improve healthcare quality;
Increase healthcare accuracy;
Prevent medical errors;
Improve administrative and processes;
Decrease paperwork and bureaucratic processes.

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What is an EMR?

An Electronic Medical Record (EMR) is a computerized version of the information typically found in a paper-based form of a healthcare provider (hospital, clinic, health centre, etc.).

The EMR records data that is managed and consulted by authorized clinicians or healthcare professionals. �

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Comparing EMR with other HIS tool

�

	Tool	Why	Applied for	Where	Who	How
Electronic Medical Records		Tracks patient clinical encounters during their health care journey	Improving patient information flow and reporting	Hospital, Clinic, Health Center	Doctors, Nurses, Laboratory, Pharmacy personnel, clinical Supervisors	Integrated modules: registration, clinical, lab, pharmacy, radiology etc.
Data collection tools		Collect, disseminate and analyze data for health programs	Household surveys, epidemiology	Health facilities, community outreach and surveys	Community health worker programs, program managers	Surveys, case management
Data collection tools		Collect, disseminate and analyze data for health programs	Health programs monitoring	From facility to district level aggregated data	Data officers, Program managers	Surveys, case management

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Advantages of EMR systems

Provides comprehensive information used to provide patient care, in a simpler and faster way;
Clinical information is maintained safely

During a natural disaster or any other hazardous event that may destroy paper-based forms with patient’s clinical data;
Electronic communication is done safely between healthcare professionals and patients;

Instant access to patient information; �

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Advantages of EMRs

Computerized administration processes, such as appointment scheduling and payments;
It allows to reduce diagnostic errors due to lack of information;
It allows to reduce the waiting time of patients in the HF;
It allows to standardize the processes or procedures;
Increases productivity in healthcare and treatment;�

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Advantages of EMRs

Possibility of making patient data available to other health professionals for follow-up in case of emergency or transfers;
It allows the administrator to obtain billing data;
The doctor can observe the evolution of the treatments effectiveness;
The nurse can report an adverse reaction;
An investigator can analyze the effectiveness of drugs in patients with co-morbidities.
If each of these professionals works alone with their data, each one will have an incomplete view of the patient's condition (USA. NIH, 2006).

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Barriers and Disadvantages of EMR implementation in developing countries

Insufficiency of skilled human resources for development, implementation, use, maintenance and support of the EMR;
Limited internet connectivity;
Costly infrastructure required for implementation in low resource settings (Servers, computers, power backup systems for constant electricity supply, network devices, etc.);

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Barriers and Disadvantages of EMR implementation in developing countries

High level of effort for training, organizational capabilities and change management required;
Privacy and security concerns;
Temporary loss of productivity in the clinic during the adoption phase of the EMR;
Changes in workflow. �

Change management and social barriers: Resistance to change at HF (fear of the unknown), introduction to new electronic tools is seen as more work for health staff, replaces manual work.

HF want to be convinced that the system works before it’s implemented.

Morning lectures at the health facility helped inform the patients and the staff that there was a new change coming to improve the situation and make the clinicians work more efficient and reduce waiting time.

Many times the systems are imported without being contextualized, or translations which puts the implementation at risk

A lot of the systems are accompanied by predefined projects that are not necessarily in alignment with objectives and interests of the government. Therefore, there needs to

be coordination.

There is usually times where health staff resist to move away from paper to electronic, so at times both are used at the same time.

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Thank you!