Investigation of the viability of an integrated cloud-based electronic medical record for health clinics in Free State, South Africa

Abstract

The use of paper-based medical records leads to gaps in patient healthcare. Paper-based records are prone to challenges such as lack of real-time access to patient data, and inability to share and exchange medical data among different health institutions. A solution to address most of the challenges associated with paper-based medical records is to have an information system, such as an Electronic Medical Record (EMR) system. EMRs have proven to be more complete and quicker to access as opposed to paper records.

Although EMRs may help resolve some of the problems with paper-based medical records, if the EMR systems are not linked or integrated, the problem of real-time accessibility and exchange of patient data remains unresolved. This leads to challenges in monitoring a patient’s health progress and providing continuity of care.

The emerging cloud-computing model, which leverages the Internet to allow the sharing of IT resources as online services, may offer a cost-effective solution of integrating diverse EMR systems. It can serve as an electronic medical record storage centre which simplifies the complexities with EMR exchange methods between different systems and saves the equipment setup expenses for smaller healthcare facilities. In addition, cloud computing may improve healthcare services and benefit medical research.

Despite the benefits offered by cloud computing, the adoption of cloud computing in the healthcare industry is the slowest compared to other industries. Further, adopting cloud computing involves many factors which require rigorous evaluation prior to introducing the new computing model to an organization. Very few empirical studies have focused on exploring factors influencing the adoption of cloud computing, especially in the public health sector.

This study aimed to investigate the viability of an integrated cloud-based EMR system by exploring factors which influence the intent to adopt cloud computing at public healthcare facilities in the Free State province, South Africa. Through a review of literature on existing studies on the adoption of cloud computing and the Technology-Organization-Environment (TOE) framework, TOE factors were identified and adopted to suit the study’s context. The study carried out a quantitative cross-sectional research by collecting data using a questionnaire which was surveyed to a sample of five principal network controllers from all districts of the Free State and 31 public healthcare facilities in the Free State (FS), South Africa. The data collected was analyzed using SPSS version 19. The study’s hypotheses were tested by conducting a Spearman’s Coefficient Correlation.

Results of the study revealed that most of the public healthcare facilities are using paper-based medical records with some form of IT to record basic patient information. Further, results of the study showed that some of the Health Information Systems (HIS) utilized at these healthcare facilities in the FS include Meditech, PADS, PharmAssist, Tier.net, HPRS, Rx Solutions, RDM, ETR and DHIS. According to this study, investments into IT infrastructure need to be considered by these health facilities as the current internet facilities will not be able to accommodate the use of cloud computing and only some facilities have internet facilities in place. Despite these challenges, these healthcare facilities are willing to adopt a cloud-based EMR system. Lastly, results of the study revealed that the factors associated with the intent to adopt cloud computing included relative advantage, security concern, organization readiness and top management support.