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DEVELOPING AN INTEROPERABLE FRAME WORK FOR ACCESSING ELECTRONIC HEALTH RECORDS BY EMERGENCY MEDICAL
SERVICES IN UGANDA, ACASE STUDY
OF CITY AMBULANCE, Kampala.
CHAPTER ONE
Background of the study
Electronic Health Records has been embraced as a pragmatic solution to manage Health data, ensure its quality and integrity, and make it accessible to the medical practitioners and patients whenever necessary both now and in the future (Nowrozy et al., 2024). It is recognized globally as a best practice in managing heath records and a standard that gives a competitive advantage to institutions supporting: finding, accessing, interoperating, and reusing (FAIR) health data (Johnson, Neuss and Detmer, 2021). The increasing adoption of Electronic Health Records (EHRs) across healthcare facilities in Uganda has the potential to transform patient care by providing a centralized repository of health information. However, challenges in interoperability often hinder Emergency Medical Services (EMS) from accessing critical patient data during emergencies. Despite the global efforts, electronic data continues to be affected by a lack of standards, insufficient guidelines, and support services hindering its adoption in low developing countries (Aminabee, 2024).
Globally failure to acquire medical attention by patient which is normally caused as a result of lack of access to patients timely medical history are a substantial cause of mortality worldwide, responsible for an estimated 45%–54% of all deaths (National Academies of Sciences, Engineering, and Medicine, 2018), some specific conditions such as sepsis and myocardial infection, benefit from high-quality emergency care, and rapidly lead to death if left untreated. The burden of deaths due to lack of timely access to medical records is much greater in low and middle-income countries (LMICs) than in high-income countries, the difference being around threefold (Williamson et al., 2020). Despite the urgent need to respond to this burden, health system provision for acute care has not historically received attention in funding or research, with focus instead on care for specific diseases, Ability to Accesses Electronic Health Records has been given lukewarm attention in low developing countries and as a consequence, it remains in formative years, fragmented, and lacking (Luyckx et al., 2021), This may be attributed to continued research data loss, mishandling, misuse, and inaccessibility when needed. Limited access to timely and accurate health records, especially in urgent situations, can impede the quality and efficiency of emergency care. An interoperable framework for accessing EHRs by EMS providers could significantly enhance decision-making, reduce medical errors, and ultimately improve patient outcomes.
In Uganda A high proportion (84%) of deaths specifically related to maternal health are preventable, but due to Significant delays to care occurred within health-care facilities, Marjory as a result of delay in accessing health information of patients, therefore a well-supported, and timely maternal death review process is necessary (Namagembe et al., 2022). The absence of standardized protocols and compatible data-sharing systems across different healthcare providers in Uganda has created fragmented EHRs, complicating the continuity of care in emergencies. The urgency for interoperability is compounded by the need for seamless communication between EMS teams and hospitals, ensuring real-time access to medical histories, allergies, medications, and other critical health information. Without access to a complete medical history, healthcare providers may lack crucial information that could affect diagnosis and treatment decisions. This could lead to delays in treatment, misdiagnoses, or improper care, the World Health Organization (WHO) has estimated that medical errors are a leading cause of death globally, with a large percentage tied to miscommunication, missing data, or incomplete medical records (Hossain et al., 2022). In Uganda, efforts to develop health information systems have been growing, but a comprehensive framework that enables interoperability between EMS and healthcare facilities is yet to be implemented. Technical, regulatory, and infrastructural challenges, such as data security concerns, compatibility between systems, and limited digital literacy, have hindered the establishment of such a framework. It is against this background that this study intends to that addresses these challenges and supports EMS in accessing necessary health records efficiently.
Statement of the problem
The adoption of Electronic Health Records (EHRs) has emerged as a promising solution to improve healthcare data management, ensure data integrity, and enhance the accessibility of patient information for healthcare providers and patients. In Uganda, the increasing implementation of EHRs in healthcare facilities presents an opportunity to centralize patient health information, potentially transforming patient care, especially in emergency medical services (EMS). However, the lack of interoperability among EHR systems remains a significant challenge, particularly in emergency situations where timely access to patient data is critical.
Despite the growing adoption of EHRs, challenges such as fragmented data systems, absence of standardized protocols, and insufficient support services continue to hinder the full potential of EHRs in Uganda (Fuhr, 2019). Patients require accurate and immediate access to patient data. Delays or gaps in accessing this information, which are compounded by the fragmented and incompatible EHR systems, can lead to misdiagnosis, inappropriate treatment, and ultimately preventable mortality, In Uganda, the impact of these challenges is acutely felt in maternal healthcare, where an estimated 84% of maternal deaths are preventable with timely medical intervention (Patterton, 2016). The need for an interoperable EHR framework that can facilitate seamless data exchange between EMS providers and healthcare institutions in Uganda is urgent. An effective interoperable system would not only support better decision-making and reduce medical errors but also enhance the efficiency and quality of emergency care, potentially saving lives. Therefore, this study aims to explore the development of an interoperable framework for accessing Electronic Health Records by Emergency Medical Services in Uganda, focusing on City Ambulance in Kampala as a case study.
Purpose of the study
The purpose of the study is to develop an interoperable frame work for accessing electronic health records by emergency medical services in Uganda, case study of city ambulance, Kampala.
Objective of the study
- To examine the influence of software integration on accessing electronic health records by emergency medical services
- To determine the influence of Health care providers collaboration on accessing electronic health records by emergency medical services.
- To assess the relationship between User training & Capacity Building on accessing electronic health records by emergency medical services
Research questions
- What is the influence of software integration on accessing electronic health records by emergency medical services?
- What is the influence of Health care providers’ collaboration on accessing electronic health records by emergency medical services?
- What is the relationship between User training & Capacity Building on accessing electronic health records by emergency medical services?
Conceptual Background
INTEROPERABLE FRAME WORK FOR ACCESSING ELECTRONIC HEALTH RECORDS BY EMERGENCY MEDICAL SERVICES
INTEROPERABLE FRAME WORK ELECTRONIC HEALTH RECORDS
LITERATURE REVIEW
2.1 Software integration
According to the U.S. Department of Health and Human Services (2019), EHR systems help reduce medication errors, improve clinical decision-making, and streamline communication between EMS, hospitals, and primary care providers. One of the most significant barriers to integrating EMS with EHRs is the lack of interoperability between various healthcare IT systems. EHRs are often maintained on disparate platforms with different standards, making it difficult for EMS systems to access and exchange data seamlessly, more than 40% of hospitals use different EHR systems, which impedes communication between pre-hospital providers and healthcare facilities. Ensuring the privacy and security of patient data is another critical concern (Rasmi et al., 2020).
2.2 Health care providers’ collaboration
One of the most significant challenges in collaborative EHR access is the issue of interoperability. Different healthcare institutions often use different EHR systems, which may not communicate effectively with one another. As a result, EMS providers may struggle to access up-to-date, accurate patient information, particularly in systems where data is fragmented or stored in incompatible formats; EMS providers report difficulties accessing EHR data due to technical barriers like lack of system compatibility and inconsistent data exchange standards (Wu, Zeng, D. and Wang, 2020).
2.3 User training & Capacity Building
Another major challenge for EMS teams is the time constraints imposed by the nature of their work. EMS personnel work in high-pressure environments, often with little downtime. Additionally, shift work and frequent interruptions can hinder the opportunity for training sessions, making it difficult to ensure consistent and adequate training for all team members, despite the implementation of EHR systems, a lack of dedicated training time often led to gaps in knowledge among EMS providers. Training sessions that are too short or not well-integrated into the daily work schedule may fail to give EMS personnel the skills necessary to use EHR systems effectively under emergency conditions (McLeod, and Lomas, 2023).
METHODOLOGY
Research Design
A descriptive cross-sectional survey will be done to help the researcher; both qualitative and quantitative approaches will be employed.
Area of the Study
The study shall be carried out at city ambulance, Kampala.
Target population
The entity comprises of different employees in different at city ambulance.
Sample Size, Techniques and Selection
Using Krejcie and Morgan’s (1970) table for sample size determination approach, a sample size of 196 employees will be selected from the total population of 401 employees
Research Instrument
Questionnaires shall be used to obtain the necessary primary data to answer the research questions and achieving the research objectives.
Interviewing
The researcher will also use interviews to collect information from management staff at city ambulance.
Data Sources
Source of data will be from both primary and secondary sources.
REFERENCES
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