For sometimes now, I have had the privilege of living and working in a society that has made a tremendous investment in healthcare. I have also had the opportunity to be part of another society that is yet to do much in the area of their healthcare. One significant factor differentiating these two sides of the aisle is the Electronic Health Records (EHR).
In developing countries, access to a patient’s medical records can determine if such a patient should live or die. For example, in Nigeria, many multi-drug resistant ailments (malaria and typhoid fevers) require a solid regimen of medicines. Treatment of people living with these illnesses requires physicians and other care providers in the hospitals and different healthcare settings to be able to see or access the patients’ health records,
including laboratory results. Access to patients’ records allows healthcare providers to know patients’ medical histories (e.g., the type of medication or therapy they have received) and to determine appropriate future prescriptions — both of which are practically impossible without an efficient data to support an Electronic Health System.
Medical records are tough to come by in so many developing countries. The few hospitals with medical records are challenged with incomplete, inaccessible, and inconsistent patient data. In contrast, in the United States of America (USA), where healthcare of citizens and even immigrants are taken more seriously, EHRs have been projected as the solution and way out of the problem associated with patients’ hospital records.
The current electronic health record not only stores patients’ important information, but also helps manage the hospital workflow as it relates to tracking and managing patients’ billing information, prescription/test result, appointments and scheduling. Hospital workflow is broken down into different sections according to business requirements.
While many developing countries already operate with some electronic platforms in their healthcare, it is widely believed by people in rural communities that the privacy of patients’ data reduces their confidence in the usage of EHRs. People assume that whatever is electronic is less private. With my experience in the healthcare vis-à-vis health data management, I believe it is better to store healthcare data electronically than in papers or file records to provide more excellent privacy protection.
However, to protect and assure patients of the privacy and safety of their data, the governments of developing countries should devise laws, if not yet in place, that prohibit health workers or stakeholders in the health sector from releasing patients’ health records without authorization. In the United States, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) established national standards to protect individuals’ medical records and other health information. Having laws that protect the confidentiality and privacy of medical records would certainly enhance patients’ trust and assurance of the safety and protection of their health records.
There are many disadvantages in the use of paper-based records. I once worked as an administrative officer in the Department of Planning and Development at Ekiti State University Teaching Hospital, Ado-Ekiti, and other team members went from village to village to collect paper charts from primary health centres across the state of study to track the trend of diseases. Unfortunately, we had instances where data collected from those primary centres were misplaced, which affected the data’s integrity. We would have avoided such a problem if the data collection had been electronic.
Beyond minimizing or preventing data loss, EHR improves turn-around time. The design of an EHR is to have a central database where different stakeholders post and retrieve data. The patient flow is traditionally from the reception or Emergency Room, down to the cash point, triage station for vital signs collection, and to the physician. The traffic and inconsistencies associated with the process could be managed seamlessly via computers through efficient electronic health record software. If developing countries like Nigeria adopt this modern technology throughout their healthcare sector, it would automatically improve patients’ waiting time.
It is public knowledge that over the years, fraud and corruption have threatened the existence of public hospitals in Nigeria. However, when electronic health record is functional, it would increase healthcare providers’ revenue because patients’ bills are captured more accurately. Also, billing becomes more transparent, and the possibility of healthcare fraud is almost nonexistent or reduced drastically.
Over the years, Nigeria’s healthcare system has suffered several setbacks and challenges. Having reviewed some of the advantages of Electronic Health Records in today’s healthcare, poor infrastructure is the major setback for its implementation in Nigeria’s public hospitals.
Both Federal and state governments need to take healthcare more seriously by investing more in infrastructure and implementing impactful policies. Currently, a more significant percentage of private practitioners are spearheading the use of EHRs in Nigeria. If this trend continues, it will undoubtedly be the turning point for a sector that needs systemic change.
- Teniola, MSHI (Chicago), is a medical informatics professional.