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满意还是不满意?加纳电子健康记录系统的实施:卫生领导人的观点。

Satisfied or not satisfied? Electronic health records system implementation in Ghana: Health leaders' perspective.

机构信息

Public Health Nursing Department, School of Nursing and Midwifery, University of Ghana, Legon, Ghana.

Department of Public Admin and Health Services Management, University of Ghana Business School, Legon, Ghana.

出版信息

BMC Med Inform Decis Mak. 2022 Sep 22;22(1):249. doi: 10.1186/s12911-022-01998-0.

Abstract

BACKGROUND

Electronic Health Records (EHR) has been espoused to be an innovation from the paper-based system, with benefits such as fast access to patient information thereby facilitating healthcare provider communication, healthcare continuity and improved quality of care. However, it is the extent of the quality of the electronic health records that determines the access to these stated benefits. The quality of health care records indirectly contributes to patient safety because inaccurate patient data can lead to improper diagnosis and consequently wrong treatment of patients. Most hospitals in Ghana, have recently transitioned into the EHR system, hence, there is a need to assess its accuracy, impact on workflow, staff training on usage, support from the EHR team, and the overall satisfaction of the EHR system. As health leaders are at the frontline of its implementation, their views on the challenges and successes of the EHR system are imperative.

METHOD

This qualitative study sought to explore the views of the health leaders on the implemented electronic health records system in nine (9) hospitals within three (3) regions in Ghana. Following ethical approval, GHS-ERC:007/04/21, focus group discussions were conducted with a minimum of 10 hospital leaders in each facility. These included quasi, government and private hospitals. Data was collected between September and November 2021.

RESULTS

The study found poor quality of records, lack of involvement of frontline clinicians in the development of the EHR system, inadequate training of staff and limited workstations as some of the challenges associated with the use of EHR in hospitals. Health leaders were generally not satisfied with the EHR system.

CONCLUSION

It is recommended that addressing inputs from end-users as well as circulating more computers will motivate EHR usage and acceptance. Provision of additional workstations for the various units and involvement of staff in the system development would be most prudent to enable health workers to accept the EHR system in improving the quality of care.

摘要

背景

电子健康记录 (EHR) 被认为是从纸质系统发展而来的一项创新,其优点包括快速获取患者信息,从而促进医疗服务提供者之间的沟通、医疗连续性和提高护理质量。然而,电子健康记录的质量在很大程度上决定了这些益处的实现程度。医疗记录的质量间接有助于患者安全,因为不准确的患者数据可能导致诊断不当,从而错误地治疗患者。加纳的大多数医院最近已经过渡到 EHR 系统,因此需要评估其准确性、对工作流程的影响、员工使用培训、EHR 团队的支持以及 EHR 系统的整体满意度。由于卫生领导人处于其实施的前线,因此了解他们对 EHR 系统的挑战和成功的看法至关重要。

方法

这项定性研究旨在探讨卫生领导人对加纳三个地区的九家医院实施的电子健康记录系统的看法。在获得 GHS-ERC:007/04/21 的伦理批准后,我们在每个机构都进行了至少 10 名医院领导人的焦点小组讨论。这些医院包括准政府和私营医院。数据收集于 2021 年 9 月至 11 月之间。

结果

研究发现,医院在使用 EHR 方面面临一些挑战,包括记录质量差、缺乏一线临床医生参与 EHR 系统的开发、员工培训不足以及工作站有限。卫生领导人对 EHR 系统普遍不满意。

结论

建议解决最终用户的投入问题,并增加更多的计算机,以提高 EHR 的使用和接受度。为各个单位提供额外的工作站,并让员工参与系统开发,将是最明智的做法,使卫生工作者能够接受 EHR 系统,从而提高护理质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/32cf/9494885/85c66f978b6b/12911_2022_1998_Fig1_HTML.jpg

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