ArticleJournal of the American Medical Informatics Association : JAMIA2016
Assessing the impact of a primary care electronic medical record system in three Kenyan rural health centers.
Article in Journal of the American Medical Informatics Association : JAMIA, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- The impact of eHealth use on general practice workload in the pre-COVID-19 era: a systematic review.BMC health services research · 2024Pooled it
- The Impact of Electronic Health Records on Nurses and Nursing Care in Low- and Middle-Income Countries: A Scoping Review.Nursing open · 2026Article
- Cloud Horizons: Strengthening Rural Healthcare Through Telemedicine's Digital Canopy.Health services insights · 2024Article
- Implementation challenges and perception of care providers on Electronic Medical Records at St. Paul's and Ayder Hospitals, Ethiopia.BMC medical informatics and decision making · 2021Article
- Designing a reference architecture for health information systems.BMC medical informatics and decision making · 2021Article
- Health care provider time in public primary care facilities in Lima, Peru: a cross-sectional time motion study.BMC health services research · 2021Article
- Development of standard indicators to assess use of electronic health record systems implemented in low-and medium-income countries.PloS one · 2021Article
- Article
- Patient satisfaction with the implementation of electronic medical Records in the Western Region, Saudi Arabia, 2018.BMC family practice · 2020Article
- Digital health Systems in Kenyan Public Hospitals: a mixed-methods survey.BMC medical informatics and decision making · 2020Article
- The role of medical data in efficient patient care delivery: a review.Risk management and healthcare policy · 2019Review
- Identification of the necessary data elements to report AIDS: a systematic review.Electronic physician · 2017Review
- Benefits and challenges of EMR implementations in low resource settings: a state-of-the-art review.BMC medical informatics and decision making · 2016Review
- Applying PEST analysis to evaluate the adoption of electronic health records in Tanzanian healthcare: A scoping review.Digital healthReview
Corrections and comments
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Authors and funding
11 authors at 5 institutions in 2 countries.
Funding
Abstract
objectiveEfficient, effective health care requires rapid availability of patient information. We designed, implemented, and assessed the impact of a primary care electronic medical record (EMR) in three rural Kenyan health centers.
methodLocal clinicians identified data required for primary care and public health reporting. We designed paper encounter forms to capture these data in adult medicine, pediatric, and antenatal clinics. Encounter form data were hand-entered into a new primary care module in an existing EMR serving onsite clinics serving patients infected with the human immunodeficiency virus (HIV). Before subsequent visits, Summary Reports were printed containing selected patient data with reminders for needed HIV care. We assessed effects on patient flow and provider work with time-motion studies before implementation and two years later, and we surveyed providers' satisfaction with the EMR.
resultsBetween September 2008 and December 2011, 72 635 primary care patients were registered and 114 480 encounter forms were completed. During 2011, 32 193 unique patients visited primary care clinics, and encounter forms were completed for all visits. Of 1031 (3.2%) who were HIV-infected, 85% received HIV care. Patient clinic time increased from 37 to 81 min/visit after EMR implementation in one health center and 56 to 106 min/visit in the other. However, outpatient visits to both health centers increased by 85%. Three-quarters of increased time was spent waiting. Despite nearly doubling visits, there was no change in clinical officers' work patterns, but the nurses' and the clerks' patient care time decreased after EMR implementation. Providers were generally satisfied with the EMR but desired additional training.
conclusionsWe successfully implemented a primary care EMR in three rural Kenyan health centers. Patient waiting time was dramatically lengthened while the nurses' and the clerks' patient care time decreased. Long-term use of EMRs in such settings will require changes in culture and workflow.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.