ABSTRACT
The use of paper for record keeping (or a manual system) has been the order of the day in almost all health care facilities in resource poor countries. This system has presented numerous challenges, which the use of Electronic Medical Records (EMR) seeks to address. The objectives of the study were to identify the facilitators and barriers to EMR implementation in Komfo Anokye Teaching Hospital's (KATH) Emergency Centre (EC) and to identify lessons learned. These will help in implementation of EMR in ECs in similar settings.Methods:This was a non-interventional,descriptive cross-sectional and purely qualitative study using a semi-structured interview guide for a study population of 24. The interviews were manually recorded and analysed thematically. EMR implementation was piloted in the EC. Some of the EC staff doubled as EMR personnel. An open source EMR was freely downloaded and customised to meet the needs of the EC. The EMR database created was a hybrid one comprising of digital bio-data of patients and scanned copies of their paper EC records.Results:The facilitators for utilising the system included providing training to staff, the availability of some logistics, and the commitment of staff. The project barriers were funding, full-time information technology expertise, and automatic data and power backups. It was observed that with the provision of adequate human and financial resources, the challenges were overcome and the adoption of the EMR improved.Discussion:The EMR has been a partial success. The facilitators identified in this study, namely training, provision of logistics, and staff commitment represent foundations to work from. The barriers identified could be addressed with additional funding, provision of information technology expertise, and data and power back up. It is acknowledged that lack of funding could substantially limit EMR implementation
Subject(s)
Communication Barriers , Electronic Health Records , Ghana , Hospitals, TeachingABSTRACT
OBJECTIVE: The effects of alcohol on mortality due to motor vehicle accidents was studied. MATERIAL AND METHODS: During the first semester of 2003, a sample of 243 fatality victims of traffic-related accidents and their blood alcohol levels were analyzed in the state of Nuevo Leon, Mexico. The age-adjusted mortality rate for traffic accidents was 8.9/100000 pop. (13.2 for males and 3.21 for females, per 100000). Fatal accidents were more common in the Metropolitan Area (MA). RESULTS: Fatalities were four times greater in males and the mean age was 34.7±18.2 years. Blood alcohol was detected in almost half of the victims who were drivers of the vehicles; the other cases of fatalities may be associated with road/car condition, weather and other factors. CONCLUSIONS: Alcohol intoxication levels were primarily associated with male drivers ages 16 to 45 (p=0.029); levels increased with age. In females, alcohol played a lesser role, affecting mostly ages 31 to 45 y (p=0.055).
OBJETIVO:Durante seis meses de 2003 se estudió el efecto del alcohol en 243 víctimas fatales relacionadas con accidentes viales del estado de Nuevo León, México. MATERIAL Y MÉTODOS: Se realizó autopsia en todos los casos y se determinó el nivel de alcohol en sangre. La tasa de mortalidad ajustada por edad para accidentes viales fue 8.9/100000 hab. (13.2 para hombres y 3.21 para mujeres, por 100000). Accidentes fatales fueron comunes en el Área Metropolitana. RESULTADOS: Las fatalidades fueron cuatro veces mayores en hombres y la edad promedio fue de 34.7±18.2 años. Se detectaron niveles de alcohol en sangre en casi la mitad de los conductores que fueron víctimas; los otros casos de fatalidad fueron asociados con las condiciones del camino, el auto, factores meteorológicos, entre otros. CONCLUSIONES: Los niveles de intoxicación alcohólica fueron básicamente con conductores masculinos, de 16-45 años (p=0.029), aumentando con la edad. Entre las mujeres, el alcohol jugó un papel menos preponderante, afectando mayormente las de 31-45 años (p=0.055).