Management of Electronic Health Records in Virtual Health Environments: The Case of Rocket Health in Uganda

Management of Electronic Health Records in Virtual Health Environments: The Case of Rocket Health in Uganda

Tlou Maggie Masenya, Francis Ssekitto, Sarah Kaddu, Sam Simati
DOI: 10.4018/IJHISI.342089
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Abstract

This article examined the management of electronic health records in virtual health environments using rocket health as a case study. The specific objectives of the study were to determine the healthcare services provided at rocket health; examine the electronic health records management practices adhered to at rocket health; and determine the inhibitors to effective electronic health records management at rocket health. A case study with a mixed-methods research approach was used. Data was collected using questionnaires, document reviews and structured interviews. The study finds that rocket health provided a range of healthcare services encompassing telehealth, pharmacy, last mile delivery, and an online store. These services predominantly operated in a digital format, resulting in the generation of electronic health records (EHRs), and therefore to capture and maintain these EHRs from multiple service points, rocket health implemented a cloud-based system.
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Introduction

Globally, there has been an increase in the adoption of Information Communication Technologies (ICTs) for health care service provision. According to Adedeji et al. (2021), digital health has transformed the delivery of healthcare services globally. Digital health service providers, as highlighted by Akwaowo et al. (2022) and Namatovu and Semwanga (2021), play a crucial role in streamlining the process of healthcare service delivery. Building upon this, Kamulegeya et al. (2020) conducted an insightful study, noting that these providers offer a spectrum of healthcare services, including call centers, e-consultations, e-psychiatry, and e-health information dissemination. Their findings underscore the remote delivery of these healthcare services, facilitated by various ICTs, thus emphasizing the pivotal role of digital health service provision. All these healthcare services are remotely delivered using different ICTs which facilitate digital health service provision. According to Kiberu et al. (2018), digital health by its nature requires ICT infrastructure for efficiency and to ensure sustainability. Therefore, when it comes to records management, digital health technologies facilitate the electronic capture, processing, storage, and exchange of health data, thus resulting in voluminous electronic health records (EHRs) (Namatovu & Semwanga, 2021; Ngusie et al., 2022).

Ngusie et al. (2022) define EHRs as: “repositories of patient data in digital form, stored and exchanged securely, and accessible by multiple authorized users” (p. 2). EHRs date back to the 1960s when Dr. Lawrence Weed developed problem-oriented medical records (Abdullah, 2022). However, the first EHRs were recognized in 1972, and became more common in the 1990s, the period when the Institute of Medicine replaced its paper-based medical records with electronic records (Abdullah, 2022). Currently, the adoption of EHRs has become pervasive, particularly within the realm of digital health service providers. These providers leverage EHR systems extensively to enhance the efficiency and quality of healthcare services. The seamless integration of EHRs has become a cornerstone in the operations of many health institutions, serving as a comprehensive digital repository for patient information.

Digital health service providers utilize EHRs to facilitate various aspects of healthcare delivery, including streamlined communication, prompt access to patient data, and the efficient coordination of care. This widespread integration of EHRs not only exemplifies the evolution of healthcare practices but also underscores their indispensable role in modern health institutions. The integration of EHRs stands as a testament to the ongoing digital transformation in the healthcare sector, fostering improved patient outcomes and overall healthcare management. Worth noting, EHRs are currently used in 96% of non-government hospitals in the United States and the United Kingdom, while in France and Australia, a digital health strategy has been adopted to digitize all patient records (Abdullah, 2022).

However, most developing nations are yet to digitize their patient records (Pai et al., 2021). In Uganda, while digital health service provision has mostly been part of donor-funded public health projects, there are private digital health service providers such as The Medical Concierge Group specializing in digital health service provision (Kamulegeya et al., 2020). These digital health service providers are also managing electronic health records. Adopting EHRs has the potential to improve service delivery for digital health service providers (Ngusie et al., 2022). This is because EHRs facilitate the management of accurate and complete information, reduce costs and medical errors, reduce the need for physical storage facilities and equipment, promote easy information access and retrieval, reduce waiting times, aid decision-making, and enhance records security, thus improving health care service delivery (Ngusie et al., 2022; Attafuah et al., 2022). However, despite the above benefits, the implementation of EHRs in most low-income countries has been a challenge due to poor infrastructure characterized by electrical power interruptions, digital divide, high internet costs, and resistance to technology (Ngusie et al., 2022).

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