The user-friendliness of a hospital information system using telemedicine in a traditional personnel culture at tertiary Inkosi Albert Luthuli Central Hospital of KwaZulu-Natal in South Africa.

Abstract

The research study assessed the user-friendliness of a hospital information system within a telemedicine context at Tertiary Inkosi Albert Luthuli Central Hospital (IALCH) in order to achieve the broad objective of developing a model for managing the implementation of these systems in the province. The current situation with the Hospital Information System implemented in IALCH is that doctors and nurses have difficulties in accessing the X-Ray images; ordering drugs, making patient notes, and accessing patient records at follow up sessions at a later date in the format they want. There are also problems with patient and staff confidentiality for some types of records. These problems raise the following questions: Have doctors adapted to change from traditional to computerised Hospital Information Systems implemented in IALCH? Have nurses adapted to this change and how user-friendly is the Hospital Information System at IALCH? The effectiveness and efficiency of the MEDICOM hospital information system and telemedicine system at IALCH for these groups in relation to their participation in the hospital information system and telemedicine system related activities was investigated using Geyser’s (1992) framework for a user-friendly information system and frameworks from Coiera, Westbrook and Wyatt (2006), Rigby (2006), and IMIA (2006). The population of the study were seven hundred and eighty six (786) doctors and one thousand eight hundred and sixteen (1816) nurses working at Inkosi Albert Luthuli Central Hospital. Pertinent questions regarding the user-friendliness of the MEDICOM hospital information system and telemedicine system were addressed and answered. Based on surveys by questionnaire survey, focus group interviews and observation the factors that affect the user-friendliness of MEDICOM hospital information system and telemedicine system were identified. The survey data was evaluated and analysed manually. The study revealed that the nursing, pharmacy and billing modules of MEDICOM hospital information system were not user-friendly, but the system was reliable and always in operation when needed. The users could manipulate the logical operators of the system effectively, generally could control the system and handle errors. They were happy with the output of the hospital information system in terms of layout. However, the system provided technical support only and users wanted more training on the system.

In summary, the study concludes that the Department of Health in KwaZulu-Natal should not roll-out the MEDICOM hospital information system to all hospitals in the province as yet. Since there is no single hospital information system or health information system in South Africa, it is therefore time to develop an eHealth Strategy for South Africa to enable a patient-centric focus to health care delivery across a networked model of care. Therefore, a single integrated and comprehensive hospital information system could be implemented in South Africa provided the issues raised for attention in the study are addressed.