RESULTS
Barriers to adoption of the EHR in sub-Saharan Africa
The main issues that emerged from the studies reviewed are grouped under four major themes.
High Implementation and Maintenance Costs:
The cost of EHR implementation is one of the most frequently identified factors that limit EHR adoption. Studies have shown that low adoption of EHR in sub-Saharan Africa, a resource-limited region, can be linked to high costs of implementation and maintenance due to hardware, software, training, and support costs.[18,19] Many hospitals and physicians in sub-Saharan African countries are mainly concerned about the large capital outlay associated with hardware, software, and installation; broad-brand connection costs; the cost of accessories such …show more content…
Physicians reported a series of skill-related factors that they believe would make it difficult to use an EHR. These included lack of typing proficiency, low/no understanding of how to use a computer, lack of understanding of how to use the EHR system, and inability to type while talking with patients [4,20-22]. The study conducted on computer and internet use by doctors in one of the Sub-Saharan African countries showed that the overall proficiency of the respondents in computer based competencies was below average[20]. The researchers stated further that the Appalachian Regional Informatics Consortium Survey of 2005 in Ohio, United States showed that 91.4% of doctors could use an EHR. In the Canadian Medical Association physician resource survey of 2000, 84% of doctors showed computer use proficiency. Similarly, higher values were seen in a study of student doctors in Malaysia in 2002, where 94.4% of the subjects could use a computer well [20]. only 32 (26.7%) were sufficiently familiar with computer tools to perform advanced tasks. As a result of low level computer literacy in the sub-Saharan African countries, many physicians and others key health personnel are not eager/ willing to adopt an EHR, and ultimately low EHR adoption in the …show more content…
For instance, Awokola and colleagues reported that for many months, they could not use the EHR consistently because of constant power outage. In addition, Pantuvo et al. stated that many hospitals in this region do not have access to constant electricity supply. [7 ] In fact, many hospitals depend mainly on the alternative power supply commonly called “generator” for their operations. Due to the infrastructure problems throughout the country and lack of guarantee of always-on internet connection or even unsure an uninterrupted electrical supply [2,7,11], wider implementation of EHR in some sub-Saharan countries may not be possible. Furthermore, the study conducted on the use of health information and communication technologies by health workers in seven state hospitals and a private hospital in the North-Eastern Zone, Ogun State, Nigeria. Reported that only one of the hospitals examined was connected to the internet and none of them have a website [3]. Jimoh, Pate and Lin noted that the internet penetration was very low. For instance, the internet penetration of less than 16% and average broadband download speed of 1.38Mbps (compared with 10.1Mbps the United States [23]. Overall, poor electricity supply and lack of internet connectivity have been reported as strong barriers to EHR
Barriers to adoption of the EHR in sub-Saharan Africa
The main issues that emerged from the studies reviewed are grouped under four major themes.
High Implementation and Maintenance Costs:
The cost of EHR implementation is one of the most frequently identified factors that limit EHR adoption. Studies have shown that low adoption of EHR in sub-Saharan Africa, a resource-limited region, can be linked to high costs of implementation and maintenance due to hardware, software, training, and support costs.[18,19] Many hospitals and physicians in sub-Saharan African countries are mainly concerned about the large capital outlay associated with hardware, software, and installation; broad-brand connection costs; the cost of accessories such …show more content…
Physicians reported a series of skill-related factors that they believe would make it difficult to use an EHR. These included lack of typing proficiency, low/no understanding of how to use a computer, lack of understanding of how to use the EHR system, and inability to type while talking with patients [4,20-22]. The study conducted on computer and internet use by doctors in one of the Sub-Saharan African countries showed that the overall proficiency of the respondents in computer based competencies was below average[20]. The researchers stated further that the Appalachian Regional Informatics Consortium Survey of 2005 in Ohio, United States showed that 91.4% of doctors could use an EHR. In the Canadian Medical Association physician resource survey of 2000, 84% of doctors showed computer use proficiency. Similarly, higher values were seen in a study of student doctors in Malaysia in 2002, where 94.4% of the subjects could use a computer well [20]. only 32 (26.7%) were sufficiently familiar with computer tools to perform advanced tasks. As a result of low level computer literacy in the sub-Saharan African countries, many physicians and others key health personnel are not eager/ willing to adopt an EHR, and ultimately low EHR adoption in the …show more content…
For instance, Awokola and colleagues reported that for many months, they could not use the EHR consistently because of constant power outage. In addition, Pantuvo et al. stated that many hospitals in this region do not have access to constant electricity supply. [7 ] In fact, many hospitals depend mainly on the alternative power supply commonly called “generator” for their operations. Due to the infrastructure problems throughout the country and lack of guarantee of always-on internet connection or even unsure an uninterrupted electrical supply [2,7,11], wider implementation of EHR in some sub-Saharan countries may not be possible. Furthermore, the study conducted on the use of health information and communication technologies by health workers in seven state hospitals and a private hospital in the North-Eastern Zone, Ogun State, Nigeria. Reported that only one of the hospitals examined was connected to the internet and none of them have a website [3]. Jimoh, Pate and Lin noted that the internet penetration was very low. For instance, the internet penetration of less than 16% and average broadband download speed of 1.38Mbps (compared with 10.1Mbps the United States [23]. Overall, poor electricity supply and lack of internet connectivity have been reported as strong barriers to EHR