1. Evaluating a scalable model for implementing electronic health records in resource-limited settings.
- Author
-
Were MC, Emenyonu N, Achieng M, Shen C, Ssali J, Masaba JP, and Tierney WM
- Subjects
- Ambulatory Care Information Systems economics, Community Participation, Consumer Behavior, Cost Control, Electronic Health Records economics, HIV Infections, Health Plan Implementation economics, Health Planning Technical Assistance, Humans, Models, Organizational, Time and Motion Studies, Uganda, Ambulatory Care Information Systems organization & administration, Developing Countries, Electronic Health Records organization & administration, Health Plan Implementation organization & administration, Outcome Assessment, Health Care
- Abstract
Current models for implementing electronic health records (EHRs) in resource-limited settings may not be scalable because they fail to address human-resource and cost constraints. This paper describes an implementation model which relies on shared responsibility between local sites and an external three-pronged support infrastructure consisting of: (1) a national technical expertise center, (2) an implementer's community, and (3) a developer's community. This model was used to implement an open-source EHR in three Ugandan HIV-clinics. Pre-post time-motion study at one site revealed that Primary Care Providers spent a third less time in direct and indirect care of patients (p<0.001) and 40% more time on personal activities (p=0.09) after EHRs implementation. Time spent by previously enrolled patients with non-clinician staff fell by half (p=0.004) and with pharmacy by 63% (p<0.001). Surveyed providers were highly satisfied with the EHRs and its support infrastructure. This model offers a viable approach for broadly implementing EHRs in resource-limited settings.
- Published
- 2010
- Full Text
- View/download PDF