Factors associated with data completeness on electronic hospital information system at Muhimbili National Hospital, Dar Es Salaam

Abstract

Background: Electronic Hospital Information System is a computerized health records used to capture, store, access and share summary information for a patient between health care organization and providers. Since the inception of Hospital Information System (HIS) in Tanzania, various studies on HIS have been conducted but data completeness on clinical and demographic information in the HIS is largely unexplored. Effective utilization of health system work flow for quality provision of health services through clinical data entry, clinical decision making and integrated communication support is still a challenge in health sector in Tanzania. Study Objectives: To assess the factors associated with data completeness in the electronic HIS at MNH and improve data capturing and subsequently enhance provision of quality of service Methodology: This explorative cross-sectional study was conducted in Muhimbili National Hospital. The study involved electronic Hospital Information System (HIS) as the tool for capturing patient’s information. Also, document review technique was used to examine the magnitude of data completeness in the electronic HIS among clinicians, nurse and health records staff. Pearson chi square test and logistic regression analysis methods were conducted. In analysis frequency measures were used to provide descriptive characteristics of study population. The degree of association between variables was tested by using Pearson chi square test value of p < 0.05 at 95% confidence interval was considered to be statistically significant. Fisher’s exact test was used when expected number was less than 4. The influencing factors on the completeness of documentation were evaluated in total and by the groups. The influencing factors on the completeness of documentation were evaluated in total and by the groups. Additionally, the analysis to obtain frequency distribution of all variables was performed. Logistic regression and multiple logistic regression analyses were done to determine the odds ratio and adjusted odds ratio for different predictors of data completeness in the electronic HIS. Results: About (90%) of clinical and demographic data of patients were incomplete in the electronic HIS at MNH. Factors associated with incompleteness data included 15(33.80%) of respondents indicated lack of sustainable and sensitization training on HIS, 10(40%) indicated that there is negative attitude towards data capturing in the electronic HIS, 20 (65%) indicated poor knowledge and skills on data capturing process led to incompleteness of data in the electronic HIS, 25(80%) of the respondents indicated that high workload and insufficient computer devices led to incompleteness of data in the electronic HIS. Data incompleteness were found to be higher thirty-two (32) times (AOR=32.14, 95% CI =12.81-80.59), behavior were five (5) times higher (AOR=5.47, 95% CI=2.40-12.43), inadequate training were fifteen (15) times (AOR=15.25, 95% CI=7.32-43.98) and usage in technology and communication were (4) times poor (AOR=3.86, 95% CI =1.55-9.62.) towards data completeness in the electronic HIS. Conclusion and recommendations: The rate of incompleteness of patients’ information in the electronic HIS in the hospital is high due to poor emphasis by management on the usage of the electronic HIS in capturing patients’ information in the system. Therefore, MNH should organize and coordinate sensitization training to improve knowledge and skills on usage electronic HIS and hence address the problem of negative attitude and perception of data capturing in the electronic HIS revealed by the study. On the other hand, strong initiatives and commitment from the top management especially on recruitment of staff and procurement of sufficient number of computer devices is of great importance to reduce the problem of high workload and hence facilitate improvement of staff in capturing patients’ information in the HIS system. It is also important to develop strict rules and regulations on the need of capturing all patients’ information in the electronic HIS so as to address the problem of negative attitude of staff towards data capturing processes in the electronic HIS. Therefore, strong initiatives and commitment from the top management is of great importance to facilitate improvement of the staff in capturing patients’ information in the HIS system. It is also important to develop strict rules and regulations on the need of capturing all patients’ information in the electronic HIS so as to improve quality health services delivery at MNH.