Prema Muthuswamy

Bio: Prema Muthuswamy is an academic researcher. The author has contributed to research in topics: Medical record. The author has an hindex of 1, co-authored 1 publications receiving 17 citations.

Factors Affecting the Adoption of Electronic Health Records by Nurses

Abstract: Electronic Health Record has potential to improve patient care by managing patient's medical and personal information efficiently and effectively. It is easy to maintain patient information electronically compared to paper based records. Many studies have been done in other countries to study the effective use of Electronic Health Record, but a small number of studies exist in Indian situation. This study is a footstep in this route. This study has been done to know the use of electronic health records among nurses in private medium sized hospitals of Tamil Nadu, India. The objective of the study is to explore the use of Electronic Health Records and barriers in using it among nurses. This study also analyzes the factors affecting nurses to adopt electronic health record. Only a third of the nurses (33%) use electronic health record. Lack of training is the major hindrance in use electronic health record among nurses.

Quality of nursing documentation: Paper-based health records versus electronic-based health records

Abstract: Aim and Objective To assess and compare the quality of paper-based and electronic-based health records. The comparison examined three criteria: content, documentation process, and structure. Background Nursing documentation is a significant indicator of the quality of patient care delivery. It can be either paper-based or organized within the system known as the Electronic Health Records (EHRs). Nursing documentation must be completed at the highest standards, in order to ensure the safety and quality of health care services. However, the evidence is not clear on which one of the two forms of documentation (paper-based versus EHRs) is more qualified. Methods A retrospective, descriptive, comparative design was utilized to address the study's purposes. A convenient number of patients’ records, from two public hospitals, were audited using the Cat-ch-Ing Audit Instrument. The sample size consisted of 434 records for both paper-based health records and EHRs from medical and surgical wards. Results EHRs were better than paper-based health records in terms of process and structure. In terms of quantity and quality content, paper-based records were better than EHRs. The study affirmed the poor quality of nursing documentation and lack of nurses’ knowledge and skills in the nursing process and its application in both paper-based and electronic-based systems. Conclusion Both forms of documentation revealed drawbacks in terms of content, process, and structure. This study provided important information, which can guide policymakers and administrators in identifying effective strategies aimed at enhancing the quality of nursing documentation. Relevance to Clinical Practice Policies and actions to ensure quality nursing documentation at the national level should focus on improving nursing knowledge, competencies, practice in nursing process, enhancing the work environment and nursing workload, as well as strengthening the capacity building of nurses practice to improve the quality of nursing care and patients’ outcomes. This article is protected by copyright. All rights reserved.

The Attitude towards and Use of Electronic Medical Record System by Health Professionals at a Referral Hospital in Northern Ethiopia: Cross-Sectional Study

Abstract: Background and Purpose: Electronic medical record (EMR) systems are increasingly incorporated into the healthcare systems of developing countries to improve the effectiveness and efficiency of the healthcare institutions. Inaccuracy, non-timeliness, incompleteness and inconsistency of paper-based data are basic triggering points to adopt EMRs in developing countries. The purpose of this study was to assess the attitude, use, and hindering factors of health professionals’ use of EMR in one referral hospital in Ethiopia that has used the EMR for the last two years. Methods: An institutional based cross-sectional quantitative study was conducted in March 2014 among 501 health professionals. Self-administered questionnaire was used to collect data. Data were entered and analysed using Epi-Info version 7 and SPSS version 20 respectively. Descriptive statistics were computed to describe study variables. Bivariate and multivariate logistic regression analyses were used to show the presence of association between the study and outcome variables. Odds ratio at 95% confidence level was used to describe the strength of association. Results: A total of 428 health professionals participated in the study with a response rate of 86%. The majority, 318 (74.3%) were computer literate and more than half, 246 (57.5%) of them had computer access. A large number (71.0%) of respondents used EMR and more than half (56.1%) had a good attitude towards it. Health professionals’ age, computer literacy, computer assess, working experience, regular meeting and training on the EMR system were significant factors (p-value <0.05) to the attitude and use of EMR system. Educational level, knowledge on EMR and using EMR were also variables affecting users’ attitude towards EMR. Conclusions: Majority of the respondents used the EMR system in their daily works and more than half of them had a good attitude towards EMR. Technical (computer literacy, knowledge), organizational (computer access, infrastructure, training access, regular meeting, management support), and personal (age, working experience) variables are significant factors to develop a good attitude towards and high use of the system. Improving skills, awareness, infrastructure, management and resource allocation are important interventions to improve the EMR system performance and positive attitude towards health professionals in the study area. Keywords: Electronic Medical Record, Ethiopia, Attitude.

Electronic Health Record Implementation: A SWOT Analysis

Abstract: Electronic Health Record (EHR) is one of the most important achievements of information technology in healthcare domain, and if deployed effectively, it can yield predominant results. The aim of this study was a SWOT (strengths, weaknesses, opportunities, and threats) analysis in electronic health record implementation. This is a descriptive, analytical study conducted with the participation of a 90-member work force from Hospitals affiliated to Tehran University of Medical Sciences (TUMS). The data were collected by using a self-structured questionnaire and analyzed by SPSS software. Based on the results, the highest priority in strength analysis was related to timely and quick access to information. However, lack of hardware and infrastructures was the most important weakness. Having the potential to share information between different sectors and access to a variety of health statistics was the significant opportunity of EHR. Finally, the most substantial threats were the lack of strategic planning in the field of electronic health records together with physicians' and other clinical staff's resistance in the use of electronic health records. To facilitate successful adoption of electronic health record, some organizational, technical and resource elements contribute; moreover, the consideration of these factors is essential for HER implementation.

Factors influencing the use of electronic health records among nurses in a teaching hospital in Nigeria

Abstract: Background: Effective use of Electronic Health Records (EHR) by healthcare professionals has great potentials of optimizing the process of healthcare service delivery, especially in clinical sites. Despite high potentials for transformation of healthcare services through implementation of EHR as the core driver of prompt access, timely interventions, evidence-based decision making, cost-effective care, efficient management of scarce resources and client satisfaction; some EHR projects had fallen short of fulfilling these critical objectives. In recent past, factors ranging from human to socio-technical issues have been reported as determinants of use and non-use of EHR among target professionals. Therefore, this study investigated knowledge of EHR, access to electronic recording devices, awareness of an EHR named Made-In-Nigeria Primary Healthcare and Hospital Information System (MINPHIS), utilization of MINPHIS, and perceived factors responsible for use or non-use of MINPHIS among nurses in a teaching hospital in Nigeria. The nurse-user, institutional and societal related factors influencing utilization of MINPHIS in the pioneering teaching hospital was determined. Methods: A cross-sectional design was used to collect quantitative data using a structured questionnaire among nurses working in the teaching hospital of reference. Systematic random sampling was used to select 230 nurses, out of which 206 consented. Data analysis was done using SPSS version 17. Hypotheses were tested at p value < 0.05 using Chi square and correlation coefficient. Results: Majority of nurses (80.1%) had never used MINPHIS despite a significant percentage (79.6%) willing to use electronic health records. Only 37.4% claimed they were provided with MINPHIS computer system in their workplace, while 86.9% had never been trained. 26 of the 27 nurses that were trained claimed it lasted for few days while 25 affirmed it had no impact on use of MINPHIS. Consequently, 93.7% emphasized that paper documentation remained dominant. Statistically, there was significant relationship between use of the EHR (MINPHIS) and age (p = 0.045), years of working experience (p = 0.007), availability of computer system (p = 0.000), and training of users (p = 0.000). Conclusion: Nurses are willing to use Electronic Health Record system but the required practical on-the-job training, necessary equipment and enabling environment are not supportive of the reported interest. All factors, user-related, institutional and societal factors, need to be appropriately examined and supported for successful use of EHR for improved healthcare delivery in Nigeria and similar developing countries. Implication: Future researches should adopt a multi-level approach (i.e. individual, institutional and societal) in evaluating factors that may influence successful implementation of EHR projects among target users.