Impact of Electronic Health Records Implementation on Medical Education Internship at Tenwek Hospital in Bomet, Kenya.

Abstract

Electronic Health Record (EHR) is a digital version of a patient paper chart which has become a necessary component of healthcare in developed countries. However for Africa, it is until recent years in this millennium that health facilities began using HER. Few healthcare facilities in Sub Sahara Africa have adopted the use of EHRs while in East Africa, implementation began with hospitals who were running specific programs. Use of EHRs was implemented in Kenya in 2001 and Tenwek hospital initiated it in 2013 and by 2014 there was full transition from use of paper charts to completely paperless system. Since then, there is no study that has been done to determine its impact on medical education, precisely, internship program at Tenwek Hospital. The objectives of this study was to: Find out if use of EHRs fosters or hinders medical education for interns, Determine the implications of EHRs use on the MO and CO interns’ ability to apply critical thinking for clinical judgement and decision making, describe the challenges experienced by the MO and CO interns, regarding the use of EHRs and to Suggest recommendations regarding use of EHRs that can enhance the learning experience for medical and clinical officer interns at Tenwek Hospital. This was a qualitative, descriptive, cross-sectional study conducted at Tenwek hospital in Bomet County, Kenya. The study population was composed of purposively sampled: 4 Consultants from Surgery, Medicine, Paediatrics and OB/Gyn respectively, One Interns Coordinator, 5 Medical Officers and 5 clinical Officers who completed Internship at Tenwek in the last one year. Both trainers and trainees reported positive implications of EHRs use to include; easy retrieval of information, enhanced ability for clinical judgement and decision making among others, as well as well and negative implications such as temptation to copy-paste, procrastination and reduced trainee-patient interaction time. Use of EHRs impacts the internship learning both positively and negatively as implied by both the trainees and teachers, however, the factors that enhance learning outweigh those that hinder the same.