Evaluation of the Effect of Electronic Medical Record (EMR) on Workflow in Outpatient Department Comparative Study
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Date
2009-06
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Addis Abeba University
Abstract
Background: Uncertainty in clinical decision making is due to lack of
complete, accurate and well documented patient data. Electronic Medical
Record (EMR) is expected to improve the delivery of health care services
and facilitate informed decision.
Objective: - the objective of this study is to determine the effect of EMR
on workflow in outpatient department there by assessing its effect on
waiting time, patient satisfaction, physician-patient relationship and
confidentiality and compare it with the manual system.
Method: - comparative cross sectional study design was employed using
both quantitative and qualitative approaches. The study was conducted
in two private hospitals found in Addis Ababa namely Myungsung
Christian Medical (MCM) center and Bethel Teaching General Hospital
(BTGH). The calculated sample size for quantitative study was 768 (384
from each hospital) patients who were selected by systematic random
sampling technique from OPD of each hospital. Qualitative data was
generated from purposively selected physicians and front line workers
(nurse, druggist, data clerks, etc) who have been working at OPD. The
data was collected using structured questionnaire and semi-structured
interview guide for the quantitative and qualitative methods respectively
and analyzed using frequencies, percentages, mean, median, crude and
adjusted odds ratio, P value of 0.05 was taken as a level of statistical
significance.
Result: The two hospitals were found to be comparable in almost all
socio-demographic characteristics with the exception of age and religion.
The mean waiting time for registration, service payment, searching MR
etc in MCM were significantly lower than the time in BTGH. In addition,
the overall mean satisfactions score of MCM 4.42 with SD=0.5 is
relatively higher than that of BTGH (mean score 3.8 and SD=0.8).
Regarding determinants of patient satisfaction, the presence of EMR, having knowledge about EMR, patient type and place of residence were
found to have significant association with high level of satisfaction. In
addition, waiting time has also association with level of satisfaction as
the waiting time increases the level of satisfaction decreases.
Conclusion and Recommendation: Electronic patient record handling
significantly reduced the patient waiting time and increased patient
satisfaction. Thus, promotion of the implementation of EMR both at
private and government health institutions will lead to significant change
in quality of care.
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Keywords
Medical Record,Workflow