3.4. The benefits of Electronic Health Record and problems
associated with their implementation.
Electronic Health Record (EHR), «has the aimof providing
comprehensive, cross-institutional, longitudinal records of patients health and
healthcare data», it provides the following benefits: cost reduction
explained by future increases in revenue and cost savings, reducing errors in
pharmacy, laboratory and in medication order as well as in finance and
accounting. The improvement of coordination can be also cited as a benefit
since it improve organizational coordination within the health care facility
and between health care providers like health insurance.(Kimble, 2014)
But the organizational coordination can result to the cross
border interoperability problem between stakeholder information systems.
Instead of all these benefits a lot of EHR implementation program failed, the
EHR-IMPLEMENT program under the auspices of a European Union initiative can be
cited as an example of the large EHR implementation failure. In the study
conducted by Chris Kindle in 2014, to underlying problems that prevent EHR
systems from delivering its benefits, mains causes of failure has been
identified using the ethnographic studies of EHR systems to assess the waythat
such systems are used within the clinical setting .The problems ofpaper
persistence information exchange between services and organizations after the
introduction of the automation, the breakdown of coordination and communication
across the professional boundary in health care, and limited share of knowledge
between medical professional group since the documentation of patient actions
and treatment is managed separately by each specialty services within the
hospital are the main causes of the failure apart of those who are related to
all information system. (Kimble, 2014)
3.5. The mobile Health (mHealth)
The widespread availability of mobile communication, along
with its ease of use and relatively low cost make the mobile technology an
improvement tools in health data management.(Siedner et al., 2012) According to
the International Telecommunication Union, mobile phone subscriptions in
developing country have increased over 4-fold globally to nearly 1213 to 5,400
million subscriptions during the period 2005-2014. The most substantial
increases in cell phone access have occurred in sub-Saharan Africa.(ITU,
2014)
3.5.1. Cell phone
text messages for communication of lab results in Uganda
A study conducted in Uganda in 2012 by Mark J Siedner and
Others, to assess the acceptability for SMS to improve communication of
laboratory results with HIV-infected patients, the cell phone use practices and
literacy among them, and the issues about privacy and confidentiality of
receiving private health related information by Short Message Service on their
cell phone. The interview techniques to assess their understanding of the
subject as defined in the study objectives.(Siedner et al., 2012)
The researcher's team finds that a significant proportion of
patients preferred the SMS notification of laboratory results to the existing
system of learning laboratory results at the next clinic visit. Participants
also cited secondary benefits like improvement of relationship with clinic
staff and providers, and decreased of transportation costs when using SMS to
communicate laboratory result information, even thoughaconcern has been raised
about the confidentiality. According to the privacy and confidentiality
issuean interest of using Personal Identification Number (PIN) code activation
and deletion of SMS message after reading has been recognized to be efficient.
As such, it is important that patients understand and accept these risks prior
to receivingsensitive SMS information. (Siedner et al., 2012)
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