Badeia Jawhari
University of Alberta, Canada
Title: Barriers and Facilitators to Electronic Medical Record (EMR) Use in Urban Slums - Kibera Field Study
Biography
Biography: Badeia Jawhari
Abstract
Nearly one billion people live in slums throughout the world, where they suffer from the health problems of vulnerable populations. Recognizing the potential of electronic medical records (EMRs) to improve communication, sharing and tracking of health care; this study explored facilitators and barriers to effective EMR use in an urban slum in Kibera, Nairobi. Descriptive qualitative methods were used to characterize perceptions of primary care staff about effects of EMR implementations in two different Kibera clinics. Ten staff participated in in-depth interviews guided by open-ended, semi-structured questions. Content analysis methods were used to explore transcribed data. Three major themes – infrastructure, software, social and organizational issues – emerged, with sustainability crossing all as an overriding concern for participants. Although many infrastructure (e.g., reliable power, networks and interoperability) and software (e.g., health data, confidentiality and deployment) challenges were described, social and organizational factors (e.g., identity management and EMR use incentives) appeared to be the most potent determinants of positive or negative EMR impacts. These findings are consistent with what others have reported, especially the importance of practical (infrastructure and software) barriers to EMR use in both limited resource settings and developed countries. Other findings appear to be uniquely impactful in slum settings, including the importance of identity management, meaningful incentives and sustainability programs.