ASSESSMENT OF INFORMATION TECHNOLOGY LITERACY SKILLS AND TRAINING NEEDS OF HEALTH RECORDS MANAGEMENT PROFESSIONAL IN FEDERAL MEDICAL CENTER OWO
There is a lack of effective health information management systems in Nigeria due to the prevalence of cumbersome paper-based and disjointed health data management systems. This can make informed healthcare decision making difﬁcult. This study examined the information technology (IT) skills, utilisation and training needs of Nigerian health information management professionals. We deployed a cross-sectional structured questionnaire to determine the IT skills and training needs of health information management professionals who have leadership roles in the nation’s healthcare information systems (n=374). It was found that ownership of a computer, level of education and age were associated with knowledge and perception of IT. The vast majority of participants (98.8%) acknowledged the importance and relevance of IT in healthcare information systems and many expressed a desire for further IT training, especially in statistical analysis. Despite this, few (8.1 %) worked in settings where such systems operate and there exists an IT skill gap among these professionals which is not compatible with their roles in healthcare information systems.To rectify this anomaly they require continuing professional development education, especially in the areas of health IT. Government intervention in the provision of IT infrastructure in order to put into practice a computerised healthcare information system would therefore be a worthwhile undertaking.
Objectives of the Study
- To determine the IT knowledge of health information management professionals in the health facilities.
- To determine the utilization and perception of health information management professionals in the health facilities towards electronic health records.
To determine the training needs of health information management professionals on electronic health records management in the health facilities
REVIEW OF RELATED LITERATURE
2.1 : Introduction
This chapter reviews various works that have been undertaken in the field of factors influencing the implementation of an EHR management system. The chapter considers both theoretical and empirical evidence that has already been done in the area to serve as a guide to compare and contrast the findings of this work. The review in this chapter relates to variables under study, such as the ICT infrastructure, access to quality of internet, available software, the financial implications, level of ICT knowledge, health care practitioners’ perception, subjective norms, social factors, and power supply in the implementation of an EHR management system.
2.2 : Electronic Health Records Systems
Health Information Technology (HIT) consists of different technologies that transmit and manage health information for consumers, providers, insurers, and other groups interested in health and health care. In this study, the emphasis is on storing and processing data about patients. Even if these technologies contain many types of systems, these systems are familiar to physicians, such as the computerized storage and reporting of laboratory results, which permit clinicians to share information about patients across institutional and geographic boundaries. Many HIT types are essential, but EHR, personal health records (PHR), and clinical data exchanges (CDE) deserve specific consideration for their potential significance for health care services. The EHR is a technology that has the most critical effect on the daily work of physicians and other health care providers. According to the Institute of Medicine, EHR is a system that can do many functions electronically (Blumenthal & Tavenner, 2010).
2.2.1 : Electronic Health Records
Electronic Health Record is extensively used in many countries, with variations in definitions and the extent of coverage. It is broadly accepted as a longitudinal health record with entries by healthcare practitioners in multiple sites where care is provided in today’s environment. The USA definition for EHR currently includes all information in a traditional health record, including a patient’s health profile and behavioural and environmental information. The content of the EHR management system also provides for the measurement of time, which permits for the addition of data across several occurrences and benefactors, and ultimately evolves into a lifetime record (Amatayaku & Mon, 2004).
2.2.2 : Electronic Health Records Management Systems Benefits
Some health care providers discussed the high costs of preliminary capital investment for applying EHR in organizations. However, considering the benefits of implementing an EHR management system that can offset expenses involved in repairs, regular training of staff, and system upgrading, it is worthwhile to invest in it. EHR management systems provide many benefits to the government and health care providers as a whole. It can be accessed from multiple locations and units within the enterprise. Therefore, the time of accessing the patient’s medical record is reduced; hence, productivity will increase, and the quality of care will improve. At the same time, it will allow applying the best clinical practices, especially in decision making.
EHR also gives advantages to clinical procedures like better chart access, improvement of clinical decision making, disease management, documentation enhancement, and increasing the free time spent with patients, which improves the perception of care and quality of work life. For example, the preliminary test results of the decision support system (DSS) in drug management and disease management emphasized clinical processes. Moreover, specific advantages for physicians are:
- Information, such as medical and family history, clinical history, vital signs, the visit duration, complaints, and recent lab test results are organized in proper format and easily retrieved,
- The system prompts the physician to ask the right questions, reviews medications updates information, and checks to see whether screening and monitoring tests are completed on schedule,
- Prescriptions and patient education materials can be printed with the click of a button (Andrews, 2003).
EHR can also empower individuals and communities by providing timely and understandable health-related information. With data available in real-time, the evidence-based would be strengthened and help decision-makers formulate effective health policies and monitor SDGs. In addition, it enables innovation through research, improves governance in the health industry, mobilizes new resources and ensures accountability in their use; strengthening national and health information systems will also require a collaborative effort (HMIS Need Assessment Report, 2003).
3.1 : Research Design
This research sought to determine and analyse the key factors influencing the implementation of an Electronic Health Record management system in Owo, Ondo state of Nigeria mission hospitals. A non-interventional (exploratory) study was conducted because the study aimed at exploring and analysing the variables under study without assigning interventions. The researcher adopted exploratory research because the main objective is to identify critical issues and variables. Consequently, the researcher employed an analytical approach to achieving the study’s objectives. The study sought to identify the key factors influencing EHR implementation and analysed their impacts to recommend effective strategies for implementing EHR management systems in mission hospitals in Owo, Ondo state of the Republic of Nigeria.
DATA ANALYSIS AND PRESENTATION OF RESULTS
4.1 : Demographic Response of the Respondents
The demographic characteristics of the respondents of the study are presented in the table below. Among the study participants, 34 (51%) and 33 (49%) were male and female. The majority of the participants were in the age groups of 26-33 and 34-41 years, with both having 22 (33%) respondents. On the contrary, 7 (11%) and 3 (5%) were found in the 18-25- and 50- 58-years groups, respectively. Also, 24 (36%) and 19 (28%) of the respondents have a Diploma and Degree as their highest level of education, respectively. Among the study participants, 38 (59%) were clinicians, whereas 21 (32%) were medical records staff.
DISCUSSION, CONCLUSION AND RECOMMENDATION
5.1.1 Technological context of an Electronic Health Records management system implementation
In this study, the technological context captured the availability of ICT infrastructure, perceived compatibility, security issues and technical know-how. Implementing an EHR management system hinges on the level of technology in the facility.
- : Availability of Information and Communications Technology
An EHR management system incorporates ICT tools, uninterrupted power supply and suitable software for operation. The study established that less than half of the study participants agree/strongly agree that their facilities have adequate computer gadgets for operation. Therefore, the availability of computer gadgets for operation in the study sites is problematic for implementing an EHR management system. Because computers and their other accessories are the major components of an EHR management system. Hence, the functionality of an EHR management system depends mainly on the availability of ICT infrastructure in these facilities.
The findings confirm Miller’s (2005) literature that for an electronic system to work efficiently, there has to be some ICT infrastructure of which the system developers give the required specifications. To him, the higher the specifications, the harder it is to find the hardware and the higher the costs of purchase (Miller, 2005). Every technological innovation has a minimum requirement that an organization must meet before functioning as expected.
126.96.36.199 : Technical Know-how
Effective implementation of an EHR management system requires active players with technological competencies and access to service providers. The technical know-how of the stakeholders of an EHR management system can be improved/built through regular training of staff on ICT, accessible technical/maintenance unit, adequate technical officers employed for operation and finally, accessible service providers and spare parts. Therefore, the study further revealed that most participants claimed that their facilities have staff with technological competencies to manage the system for daily operations.
5.2 : Conclusion
Health information professionals in Nigeria acknowl- edged the importance of IT in managing patients’ health information and were willing to improve their skills. However, the proportion of IT-skilled health information professionals working in technical and leadership roles in health information technology who currently possess these skills is not encouraging. This has created many skill gaps among these profes- sionals. Much more needs to be done with regards
to IT training and retraining in order to enhance their skills and improve healthcare data manage- ment. Furthermore, the clause on IT in the existing
curriculum used in Nigerian schools of health informa- tion should be upgraded to include specific software for health information technology. It is highly recom- mended that the respective authorities make necessary IT equipment and accessories available for the trans- formation of theory in IT training into real practice.
5.3 : Recommendation
In light of the findings and conclusions of the study, the following recommendations are made to the various participants involved in the provision of health care in Owo, Ondo state, with a solid emphasis on the Government, Christian Health Association of Nigeria, Ministry of Health and Health training institutions to ensure high commitment and innovation in the adoption of EHR.
First, medical and other health institutions should train their students to adapt to EHR usage. Training medical students to use computer-aided programs as their decision support tools can only serve to accelerate EHR adoption. In addition, it will give them the confidence to use the technology once they join the practising field.
Second, technical support should be much considered when institutions operate according to EHR systems to provide backup support.
Third, in the midst of this era of unreliable power supply, institutions must be ready to provide alternative power supply to complement their system if the unexpected happens.
Fourth, there should be governmental and institutional budgets and policies to drive the idea of the implementation of EHR in mission health facilities in Owo, Ondo state.
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Assessment of Information Technology Literacy Skills and Training Needs of Health Records Management Professional in Federal Medical Center Owo