ICT- LED HOSPITAL INFORMATION SYSTEM IN THE MANAGEMENT OF HEALTH SERVICES WITH PARTICULAR REFERENCE TO UNIVERSITY OF GHANA HOSPITAL, LEGON.

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ABSTRACT

The study investigated ICT- led hospital information system in the management of health services with particular reference to University of Ghana Hospital, Legon. The study utilized the qualitative method. Through the purposive sampling technique, 12 participants were selected for the study. The participants included 1 medical director, 1 administrator and 10 departments and unit heads of the Hospital. The qualitative instrument used for primary data collection was an interview guide. The findings of the study revealed that the Hospital has over a decade implemented two Hospital Information System (HIS) namely: System Consult (SC) (old software) and Equipment Business Frame (EBF) (New Software). It was found that the SC was implemented alongside the manual system using the parallel implementation approach, whilst the EBF was implemented using the direct conversion and hybrid implementation approaches. It was discovered that the process of implementation of the SC was difficult, expensive and the existence of the manual process did not motivate employees or staff to use the software as compared to the EBF which was found to be easier. The effect of the EBF on service delivery was found to be positive and reliable as compared to the SC which was negative and non- reliable. The basic elements underpinning the utilization of the HIS were access and use. Significant factors that propelled the effective implementation and use of the EBF were effective collaboration between staff and service providers, and the cost saving nature of the EBF, adequate training and education, easier use of the software, and the role of the medical director. Moreover, with regards to use, it was found that the SC had significant number of constraints including fewer staff that could use it, expensive nature of the SC, not getting value for money, poor records keeping, inability to do follow up, slower pace of work, unable to raise proper bill, delay in reporting, delay in laboratory result and frequent folder misplacement. In conclusion,  the study suggests that the implementation of the HIS in the University of Ghana Hospital focused critically on stakeholders integration of the Hospital whilst exploiting recent development within cloud technologies. On the basis of the constraints, the following recommendations were made. The Hospital should liaise effectively with the University of Ghana Computing Systems so that technical challenges such as network issues and computers are working adequately. Further, the Hospital must also continually ensure that HIS are upgraded, most especially the modules. This will help meet the changing demands of patients and        the      university                                           community

CHAPTER ONE

INTRODUCTION

            Background of the Study

In today’s world of technological advancement, the implementation and use of Information and Communication Technology (ICT) has permeated almost all aspects of life due to its significant effect on productivity and organisational management (Ranta, 2010; Oshikoya & Hussein, 2007). In recent times, the need to improve quality healthcare service delivery has challenged healthcare institutions and professionals to implement and use ICT to enhance their operational activities (Tossy, 2014; Oliveira, et al., 2011; WHO, 2007). This has led to the advancement of Hospital Information System (HIS) in almost every hospital both in developed and developing countries (Tossy, 2014).

Health Information Systems and Hospital Information System (HIS) are two different concepts. According to Aghajari (2013), any system that captures or collects, stores, manages or transmits information related to the individuals’ health or the activities of organisations that work within the health sector is termed health information systems. Moreover, studies on hospital information system, define the concept as an integrated electronic system that collects, stores, retrieves and displays the patients’ overall data and information such as the patients’ information, laboratory test results, diagnoses, billing and other procedures used in several departments in hospitals (Ismail et al., 2010; Hamid, 2010; Ariffin, 2008). Based on the size and mission of the hospital, components of a hospital information system may include clinical information system, financial information system, laboratory information system, nursing information system, pharmacy

information system, and radiology information system (Ismail & Abdullah, 2010). This suggests that HIS is limited to a specific hospital aimed at enhancing the delivery of quality healthcare service.

Currently, the demand for HIS is high in order to help handle the ever-growing population health needs and also assist health practitioners with timely services and quality in healthcare delivery (Joe-Rodrigues, 2010). According to Joe-Rodrigues (2010), the implementation and use of HIS  is very critical to health services management, as it aids the improvement of communication between health professionals and ensures confidentiality of patients’ data and records. Adding to this, HIS improves quality of healthcare service delivery and facilitates the standardization of medical procedures (Cline & Luiz, 2013; Feijooa, Fernandeza, Olverab & Calveta, 2010). This may lead to better access to healthcare facilities and improve the quality of healthcare delivery, which subsequently will translate into productive labor and the country’s development as a whole (Khan, Shahid, Hedstrom & Anderson, 2012; Oyeyemi & Wynn, 2014).

Although, HIS presents several prospective benefits to patients and hospitals, its implementation is quite demanding (Hamid, 2010). There are several factors that serve as constraints to the implementation and use of a hospital information system (Sadoughi, Kimiafar, Alhmadi, & Shakeri, 2013). These factors include among others; high initial costs (Boonstra & Brockhuis, 2010; Smelcer, et al., 2009); time needed (Tossy, 2014); technology and technical problems such as complex system and integration problems (Farzandipur, Jeddi, & Azimi, 2016; Kimiafar et al. 2015); basic problems such as lack or inadequate computer skills, complex tasks, complex functions (Ajami & Bertiani; 2012; Khalifa, 2013) and ethical issues such as certification, security, privacy, and confidentiality (Ahmadian, et al., 2014; Ahani, Nilashi & Ahmad, 2016).