Impact of Electronic Medical Records on Patient Waiting Time in Health Care Delivery System in Federal Medical Center Asaba, Delta State
Chapter One
OBJECTIVE OF THE STUDY
Broad Objective: To determine the impact of Electronic medical record on healthcare delivery system in relation to patient waiting time.
Specific objectives of the study:
- To evaluate the utilization of EMR system in Federal Medical Center Asaba
- To determine level of understanding of the EMR by hospital staff in Federal Medical Center Asaba
- To determine the if EMRE reduces patient waiting time in Federal Medical Center Asaba
CHAPTER TWO
LITERATURE REVIEW
REVIEW OF RELATED LITERATURE
Electronic medical records is defined as an electronic records of health related information on an individual that can be created gathered, managed and consulted by authorized clinicians and staff within one health care organisation. Despite the great emphasis of utilization of electronic medical records system nowadays, the first EMR was actually developed in 1972 by the Regenstre if institution. It was welcomed as a major advancement in health care and medical practice.
But according to the Electronic Medical Records standards and guidelines (ESG) EMR system must address some functional areas like to record and provide demographic and clinical health information. EMR should provide a clinical decision support. EMR staff should be able to electronically enters instructions for the care and treatment of patients would be able to provide health information and report. EMR system is to support security and confidentiality. This is to ensure that the privacy of patient data is maintained. EMR should be able to facilitate exchange of electronic information that co-exists with other system in the health care setting.
The impact of EMR system on health care have help in reducing challenges facing health care today thereby decreasing preventable errors, improving communication among health care providers and facilities also controlling cost of medical care.
Patient waiting time is the amount of time for patient seeking health care before being attended for consultation and treatment. According to Wikipedia the term medical records and medical chart are used interchangeably to describe the systematic documentation of a single patient’s medical history and care across time within one particular health care provider.
A medical record includes variety of types of notes entered over time by health care professionals recording observation and administration of drugs. The patients’ waiting time and the consultation time are very important parts of patients’ experience that could be impacted by the introduction of EMR systems. Many studies have shown that physicians are concerned about the amount of time needed for data entry, and the physicians have stated that the data entry time could be better used to provide direct patient care (Hsu, et al, 2005). The distribution of patients’ time during visits to Federal Medical Center (FMC) center is a strong predictor of patient satisfaction and, thus, utilization. Studies have found that patients prefer to spend less time waiting for doctors, registering, or at the pharmacy and would prefer to have more time with physicians (Xie, 2017).
The vast majority of prior studies that investigated the impact of EMR on time can be categorized into two general classes of studies: efficiency studies and time and motion studies. Efficiency studies tend to focus on the number of patients who can be seen in a given period, whereas the majority of the EMR-related time and motion studies investigate the duration of a single task performed by health care providers (Holman, 2016). Most patient-centered studies focused on the patient-physician interaction and the amount of time physicians allocate to patients. These studies examined the consultation time by comparing the time physicians allocate to EMR or electronic data entry with the amount of time physicians need for completing conventional paper-based documentation. Studies reported conflicting results regarding EMR’s effects on consultation time. In addition, one study also reported that more variation was attributed to the facility location than the system being implemented (Joukes et al 2018).
The results of these studies provided details about patients’ experience and the amount of time spent at the doctor’s office but did not provide information about the time spent before or after a physician visit. Examples of time spent before and after a physician visit include the time spent in the waiting room before seeing a physician. To determine the impact of EMR on patients, it is important to investigate the impact of EMR from a patient’s perspective. The amount of time spent in a waiting area is strongly associated with patients’ satisfaction and willingness to revisit (Deveugele et al, 2002). Similarly, other tasks that do not involve interactions with a physician impact patients’ satisfaction. These tasks could include registration and pharmacy services, which can add to the total duration of patients’ visit.
The duration of users’ experience with EMR can contribute to the duration of tasks at EMR-based facilities. Studies have indicated that user familiarity with a system is related to the amount of time per task. Some studies have highlighted reduced productivity in hospitals shortly after EMR implementation. The reduced productivity often improves as users become more familiar with the new system and develop the necessary skills to use the system efficiently. In some cases, the longer amount of time needed to perform tasks may continue, which can be explained by an EMR system having more functions and being more complicated than a comparable paper-based system (Poissant, 2005). The additional functions and features could result in a longer amount of time needed to complete tasks.
The aim of this study was to investigate the time patients spend at the various departments in FMC centers. The study focused on the following: time at registration, time spent in the waiting room, consultation time, and the time spent at the pharmacy. We hypothesized that the time patients spend at EMR-based and paper-based FMC centers is different. Furthermore, we hypothesized that the time patients spend at the EMR-based FMC centers will decrease with time after implementation.
CHAPTER THREE
INTRODUCTION
This chapter deals with the methodology employed to gather or obtain information or data for the study. It covers different subheadings i.e. Research design, population of the study, instruments for data analysis.
RESEARCH DESIGN
The research design adopted for this research work was descriptive study design. The research design was adopted by the researcher to enable data to be collected, described and analysed from health workers.
DESCRIPTION OF THE RESEARCH POPULATION
The hospital, Federal Medical Center (FMC) Asaba was established on the 12th August, 1998 as a consequence of the federal government of Nigeria policy to setup a Federal Medical Center in states where a federal hospital is non-existed.
It took its current site from central hospital. These was from the colonial cottage hospital of the mid-western region, with its foundation stone was laid by the then western region commissioner for health; Mr. J Adigun in march 1962 with thirty bed complement. It was at the creation of Delta State in 1991 that the cottage was rechristened and upgraded. AS at 5th January 2020, Adebayo Folorunsho Francis the federal medical center, Ebute-metta Lagos introduce electronic medical records. The type of electronic medical records used is Rapid Medchart,
STUDY POPULATION
This research work was carried out at Federal Medical Center, Asaba, Delta State. The population of this study was One Hundred (100) comprises the staff of health records department (16), Physicians (21), Nurses (43), Laboratory workers (11) and Pharmacy (9) as relevant to the research study.
CHAPTER FOUR
DATA PRESENTATION, ANALYSIS AND DISCUSSION OF FINDINGS
INTRODUCTION
This chapter deals with data presentation, analysis and discussion of findings.
Data collected for this research work are in line with the problems and objectives of the study. The presentation, will be followed by analysis of data using frequency, percentages.
CHAPTER FIVE
SUMMARY, CONCLUSION AND RECOMMENDATION
SUMMARY
In this study, simple percentage was used to analyse the value of the responses of respondents. The value of response to the questions was analysed and used to draw findings of the study.
The number of responses agreeing to the statement of the study is considered as positive response and the number of responses disagreeing to the statement of the study is considered negative response.
However, the analysis was based on these responses and the highest value between the positive and negative response was chosen to draw conclusion on the study and the lower value was rejected. Table 6, 7, 8, 9 response.
CONCLUSION
Conclusively, through the impact of electronic medical records on patients waiting time in health care delivery system in Federal Medical Center, Asaba. Delta state has increase productivity in health care delivery, better communication among health care providers bringing about better clinical decision making and providers satisfaction. Despite these great effects, there are some short comings that challenge the adoption and utilization of EMR systems like systems downtime funding, lack of computer proficiency and insecurity. For the full effect of these systems, to be felt in FMC, there is need for these short comings to be dealt with and eliminated
RECOMMENDATION
The following recommendations were made base on the findings
- The government needs to increase the amount of funding to FMC for the running and adoption of EMR systems.
- The government also needs to spread the use of EMR systems to the other level of hospitals. For ease of sharing information among hospitals.
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