Engendering the meaningful use of electronic medical records: a South African perspective

Theoretically, the use of Electronic Medical Records (EMRs) holds promise of numerous benefits in healthcare provision, including improvement in continuity of care, quality of care and safety. However, in practice, there is evidence that the adoption of electronic medical records has been slow and where adopted, often lacks meaningful use. Thus there is a clear dichotomy between the ambitions for EMR use and the reality of EMR implementation. In the USA, a legislative approach was taken to turn around the situation. Other countries such as Canada and European countries have followed suit (in their own way) to address the adoption and meaningful use of electronic medical records. The South African e-Health strategy and the National Health Normative Standards Framework for Interoperability in eHealth in South Africa documents both recommend the adoption of EMRs. Much work has been done to establish a baseline for standards to ensure interoperability and data portability of healthcare applications and data. However, even with the increased focus on e-Health, South Africa remains excessively reliant on paper-based medical records. Where health information technologies have been adopted, there is lack of coordination between and within provinces, leading to a multitude of systems and vendors. Thus there is a lack of systematic adoption and meaningful use of EMRs in South Africa. The main objective of this research is to develop the components required to engender meaningful use of electronic medical records in the South African healthcare context. The main contributors are identified as EMR certification and consistent, proper use of certified EMRs. Literature review, a Delphi study and logical argumentation are used to develop the relevant components for the South African healthcare context. The benefits of EMRs can only be realized through systematic adoption and meaningful use of EMRs, thus this research contributes to providing a road map for engendering the meaningful use of EMRs with the ultimate aim of improving healthcare in the South African healthcare landscape