Mensah Nathan K, Boadu Richard O, Adzakpah Godwin, Lasim Obed U, Amuakwa Ruth D, Taylor-Abdulai Hannah B, Chatio Samuel T
Department of Health Information Management, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana.
Department of Physician Assistant Studies, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana.
Health Inf Manag. 2023 Sep;52(3):204-211. doi: 10.1177/18333583221096899. Epub 2022 May 15.
Electronic health records (EHRs) are useful tools in healthcare settings but implementation in low and middle-income countries (LMIC) face challenges.
To explore post-implementation challenges affecting the deployment of EHRs and their use in selected health facilities in Ghana.
Using a qualitative research approach, 21 in-depth interviews were conducted with health workers in two hospitals in the study area in Ghana, in February and June 2020. Purposive sampling was used to select participants. All interviews were audio recorded, transcribed, and coded into themes using QSR Nvivo12 software to aid thematic analyses.
Post-implementation challenges were grouped into lack of technological, logistical and managerial support, and inadequate training. Inadequate equipment was the most reported post-implementation challenge that affected EHR use. Unreliable Internet and network connectivity was a source of frustration, which caused staff to develop negative attitudes towards use of the system. Lack of funding stalled implementation of the system and limited its use to critical care units only. It was also the reason replacement of equipment delayed.
While EHR post-implementation challenges facing health facilities are surmountable, managerial support, backed with the requisite logistical and technical support is needed. It is not enough to rely on funding; health institutions should prioritise emerging EHR post-implementation challenges in their operating budgets.
A national framework is needed to guide effective and sustainable EHR implementation across the country.
电子健康记录（EHRs）在医疗环境中是有用的工具，但在低收入和中等收入国家（LMIC）实施面临挑战。
探讨影响加纳选定医疗机构电子健康记录部署及其使用的实施后挑战。
采用定性研究方法，于2020年2月和6月对加纳研究区域内两家医院的医护人员进行了21次深入访谈。采用目的抽样法选择参与者。所有访谈均进行了录音、转录，并使用QSR Nvivo12软件编码成主题，以辅助主题分析。
实施后挑战分为缺乏技术、后勤和管理支持以及培训不足。设备不足是影响电子健康记录使用的最常被报告的实施后挑战。不可靠的互联网和网络连接令人沮丧，导致工作人员对使用该系统产生负面态度。资金短缺阻碍了系统的实施，并将其使用限制在重症监护病房。这也是设备更换延迟的原因。
虽然医疗机构面临的电子健康记录实施后挑战是可以克服的，但需要管理支持以及必要的后勤和技术支持。仅依靠资金是不够的；卫生机构应在其运营预算中优先考虑新出现的电子健康记录实施后挑战。
需要一个国家框架来指导全国有效和可持续的电子健康记录实施。
