The challenge of implementing health information systems : a case study in Charlotte Maxeke Johannesburg Academic Hospital

Date
2013-03
Authors
Serobatse, Moilwa Denton
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH ABSTRACT: This thesis investigates the complexities involved in Health Information Systems. The focus is on the factors of a) efficiency and b) usability. A case study is made of a recently implemented system in Charlotte Maxeke Johannesburg Academic hospital. The first objective of the research was to gain a deeper understanding of the complexities of Health Information Systems, and secondly to evaluate the situation at Charlotte Maxeke Johannesburg Academic Hospital. In Chapter 1 a detailed introduction of the thesis is offered. This includes, explaining what triggered the research, the objective of the research and the methodology used to conduct the research. In Chapter 2 the focus is on a literature review of Health Information Systems, system fundamentals and planning and implementation. It is clear that without a methodology, systems development becomes haphazard and subsequently a risky and expensive undertaking. While change is pervasive, introducing operational efficiencies sometimes may necessitate reviewing of information systems and business strategy, knowledge management and process orientation. In Chapter 3 the issue of usability is investigated. Several healthcare institutions have implemented information systems but evaluations of the usability of these systems are still under debate. For purposes of this research an evaluation method for system usability and survey questionnaires were developed. In Chapter 4 the case study of Charlotte Maxeke Johannesburg Academic Hospital is reported. The chapter also describes the data collection design, research limitations and delimitations, survey findings and interpretations. In Chapter 5 the implications and applications of Health Information Systems are discussed. After analysis of the survey results, it appears that the impact and benefits of the new Health Information System are only positive or realized in the patient administration division. The rest of the health professionals continue to manually capture clinical notes and other management information on pieces of papers, spread sheets and word documents. The thesis comes to the conclusion that despite widespread use of technology in other sectors, clinicians in hospitals do not use implemented automated systems. Implementation of systems is complex and problems associated with usability are not resolved and that traditional systems implementation methodologies may not apply.
AFRIKAANSE OPSOMMING: Die tesis ondersoek die faktore wat Gesondheidstelsels (HIC) ingewikkeld maak. Die fokus is op a) doeltreffendheid, en b) bruikbaarheid (uit gebruikersoogpunt). ‘n Gevallestudie word gemaak van ‘n stelsel wat onlangs by Chalotte Maxeke Johannesburg Akakdemiese Hospitaal in gebruik geneem is. Die eerste doelwit van die ondersoek was om die ingewikkeldheidsgraad van sodanige stelsels te probeer bepaal, en tweedens om die situasie in die hospitaal self te evalueer. In hoofstauk 1 word die agtergond en aanleiding tot die ondersoek uiteengesite, woel as die metodologiese keuses wat gemaak is. Hoofstuk 2 bied ‘n oorsig oor relevante literatuur ten ospigte van HIC. Dit is duidelik stlselontwikkeling riskant, onnodig duur en koersloos is as dit sonder ‘n duidelike metodologie geïmplementeer word. Verandering vind voortdurend plaas en die implementering van oprasionele doeltreffendheid mag vernadering in besigheidstrategie, informasiestelsels, kennisbestuur en processoriëntasie noodsaaklik maak. In hoofstuk 3 word bruikbaarheid ondersoek. Verskeie mediese instellings het soortgelyke stelsels in gebruik geneem, maar die bruikbaarheid daarvan is steeds onseker. Vir die doeleindes van hierdie tesis is ‘n eie evaluasiemetode ontwikkel en ‘n vraelys op grond daarvan opgestel. Hoofstuk 4 rapporteer die gevallestudie in Charlotte Maxeke Johannesburg Akademiese Horspitaal hospital. Datakolleksie, navorsingsafbakening en – beperkinge, sowel as vraelysresultate word aangebied. Hoofstuk 5 bespreek die implikasies en toepassings van HIC. Dit blyk dat die voordele van die stelsel slegs deur die pasiëntadministrasieafdeling geniet word. Alle ander afdeling gaan steeds voort met papiergebaseerde inligtingstelsels, aangevaul deur ad hoc gebruik van Excel en woordprossering. Die tesis kom tot die gevolgtrekking dat kliniese personeel avers is teen die gebruik van geoutomatiseerde informasiestelsels.
Description
Thesis (MPhil)--Stellenbosch University, 2013.
Keywords
Medical informatics, Information storage and retrieval systems -- Medical care, Health facilities -- Administration -- Data processing, Dissertations -- Information science, Theses -- Information science
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