Information system in the context of the use of electronic patient record in Burundi

Abstract

Abstract Objective The Information System is an essential catalyst for the performance of a hospital. In order to strengthen the hospital information system, the patient record computerization project has been initiated since 2014. Our objective was to assess the hospital information system in the context of using the electronic patient record to highlight the factors to be strengthened. Methods This is a cross-sectional survey using the Health Metrics Network assessment tool. Eleven hospitals were included in the study, including 4 computerized in 2015 and 7 computerized in 2017. We carried out an evaluation of the hospital information system as a whole and an evaluation of the level of filling of patient files. In each hospital, the director of care, the chief nursing officer and the data manager were surveyed. Data collection was done in October 2019. Results This evaluation showed that 4 components (resources, indicators, information product and the use of information) were satisfactory with a score varying from 55% to 67% while 2 components (data source and data management) were present but not satisfactory. The score was 61% for resources, 60% for indicators, 41% for data sources, 43% for data management, 55% for information product and 67% for dissemination and use of information. The proportion of files with the main diagnosis at discharge was 61% before computerization, while it was 81% when using EPR (p < 10-4). It was also noted that the electronic patient record had 2.73 [1.83 - 4.07; p < 10-4] times more likely to report the main diagnosis on exit than the paper file. Conclusions the source components of the data and data management have shortcomings. Corrective strategies should be considered to support the ongoing hospital information system strengthening reforms Key messages The health metric network tool for evaluating the health information system adapted to the national level can also be used to assess the hospital information system. The computerization of the patient record is not enough to make the hospital information system efficient.