ANALYZING DESIGN-REALITY GAPS INFLUENCE ON ELECTRONIC MEDICAL RECORDS USE: THE CASE OF MALAWIAN HEALTH CENTRES

Abstract

Information Technology (IT) has changed the way we do our daily activities. The advancement of technology has resulted in the development of Electronic Medical Records within the health sector. Electronic Medical Records (EMRs) are patient level data management information systems. Globally, over 50% of Electronic Medical Records deployed are occasionally used or not used at all. In Malawi, EMRs use faces several challenges. EMRs like Chronic Care Clinic and Admissions, Discharge and Transfers have never been used after initial trainings. This study intended to analyse Design-Reality gaps that influence EMR use in Malawi. The research used Outpatient Department (OPD) and Antiretroviral Therapy (ART) EMRs found at Area 25 and Area 18 Health Centres. The study found that OPD EMR reporting features do not have reports required by the end users, OPD EMR require several complex steps to accomplish a single task. Another finding is that OPD EMR has distorted the workflows of the clinic. There is low staffing to use the EMRs than planned. The huge gaps have influenced negatively on the use of OPD EMRs whereas for ART EMRs the lack of gaps promotes the use of it. In this light, the study recommends the addition of necessary reports that are required by OPD EMR stakeholders, implementers should reduce OPD EMR steps to complete a task. In order to have workflow adherence, stakeholders should the EMR designs should mirror manual processes. MoH should ensure that staffing levels are sufficient in the hospitals to support the use of EMRs.