Information And Communications Technology (ict) And Health Workers Proficiency As A Determinant Of Health Information Management (a Case Study Of Health Facilities Ogun Southwestern Nigeria)

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Abstract.

The study investigated the application of ICT for health information management (HIM) in the health facilities and the proficiency of the health workers in the geopolitical east zone of Ogun State. The study adopted a non experimental survey method where self-structured questionnaires were administered to four hundred and fifty (450) health workers in the zone through a multi-stage sampling technique and frequency/percentage distributions were used to analyze the data obtained. Four hundred and twenty (420) (95.6%) health workers always use the ICT (e-mail, text messages, phones calls) for communication, followed by usage of ICT for research activities, where 345 (76.67%) use the ICT and 105 (23.33%) rarely use the ICT for research work, then the results revealed that 315 (70%) health workers always collaborate with the colleagues with the aid of ICT. The use ICT for HIM (data /records management and medical diagnosis) is relatively lower among the health workers-50 (11%) health workers use ICT for Data/Record Management while 30 (6%) use ICT for medical diagnosis. On the other hand, the average of results on the proficiency of the health workers indicated that only 35 (7.78%) of health workers are proficient, 98 (21.78%) not proficient and 321 (71.23%) were indifferent to computer system for HIM and not show interest with the computer system-the majority of the health workers are within the lower cadres where paper based systems are commonly used for health information sharing and management. The government should then equip/ implement ICT resources/ application in all the health facilities, making ICT training compulsory for the health workers and computerize the activities of the health facilities where information can be shared easily for efficient healthcare delivery system.

 

1. INTRODUCTION

The country Nigeria despite her well endowments with both natural and human resources, unfortunately, her health indices are embarrassing. One of the reports of the World Health Organization (WHO) available also negate the past and present administration avowed commitment to the fundamental rights of Nigerians access to quality healthcare as enshrined in the 1999 constitution. For instance, the country’s health system ranks 197th out of 200 membe nations of the World Health Organization (WHO) Enogholase (2010). The infant mortality is 103 per 1.000 live births, while maternal mortality is 800 per 100,000 live births (National Population Commission) cited in (punch, January 7, 2009). This is an indication of pertinent and burning issues affecting the healthcare systems of the country.

For instance, overall management weakness, technical incompetence, poor attitudes and behaviour of health staff and poor record keeping are some of the several indicators of the poor quality of health care delivery system in Nigeria (Chrisv, 2007). One of the key issues raised in the study by (Chrisv, 2007) is the hospital record system which is the focus of this study, critically looked at the manpower, workers efficiency and motivation, health information and record management with the application of Information and Communications Technology (ICT) in Nigeria Health Facilities.

Today, new technology has brought significant changes in health sector (Bates, 2005). In their studies, Harden (2002) and (Davis and Harden, 2001), believed that health services has also undergone profound changes due to recent technological advancements. Furthermore, health services providers particularly in the developed countries, has invested heavily in Information and Communication Technologies (ICT), not only to deliver health care, but to improve the quality of services that health professionals provided.

The availability and quality of ICT services are growing rapidly across Africa, with mobile network coverage rising from 16% in the late 1990s to over 90% of its population in 2011. Growth in this sector has led to increased investments, decreased costs and rapid growth in technology-enabled services (Shekar & Otto, 2012). The report further gave an insight about the application of ICT in health sector, that gains in ICT infrastructure have not as yet benefitted the health sector in a systematic way. Although there are many ongoing projects across Africa that attempt to improve the health sector through the use of ICTs, most remain pilots, few are evaluated and even fewer are designed or assessed for scalability (Shekar M & Otto, 2012).

Though, ICT has been introduced in many sectors in Nigeria. According to Hassan O. M et al (2011) ICT has been implemented in health care systems in Nigeria. However, research has shown that, scarcity of human resources in the health sector is a serious problem; it can be a particular beneficiary of ICT-mediation. Therefore, lack of qualified health professionals, poor distribution of facilities and poor access to the latest infrastructure are some of the issues to be addressed to improve the quality of services in our health facilities. Advanced technology can address at least some of these problems. In fact, international organizations such as the United Nations (UN) and the World Health Organization (WHO) have acknowledged ICT as a useful tool to address health care sector in developing countries (WHO, 2005; Drury, 2005).

Accordingly, United Nations Millennium Development Goals have articulated the significance of the use of ICT to address health issues (UN Millennium Development Goal, 2004). In terms of technology we are starting to see individuals using multiple devices in a variety of ways. The technology exists to allow safe and secure sharing of information at all level across an organization without the need to structure national sized data repositories. Goodenough (2009), opine that use of ICT in health services will help statistical data collection, but to do so, will need consistent semantics on a more global level. On the other hands, Grace (2009) focuses on the difficulty of integrating the disparate parts of the current health record into an electronic form.

The use of ICT in health service seems to create new and more effective service delivery which might likely increase the capacity and provide rapid, safe, effective and affordable health care services, but with sustainability, within health workforce and resource constraints For instance, in traditional paper-based reporting systems, collecting and exchanging quality and timely health data remains a challenge, as the process can consume the time and attention of health workers who are meant to be providing services instead, and can result in inaccurate or incomplete data. Electronic Health Information Systems (HIS) can help minimize time spent recording data Shekar M and Otto, K (2012). The position of Skekar and Otto is supported by Ojo (2012) and also use of ICT like electronic health record given doctors, patients and other healthcare providers quick and easy access to patient medical records facilities (Ojo, 2012).

Apart from a unique feature of ICT - enabled data collection, the data can be viewed and analysed in real time so that care providers and policy makers can make lifesaving decisions based on evidence. Such tools can save health workers time and costs of paper-based data entry and transportation Shekar M and Otto, K (2012). The medical record is permanent documentation of the history and progress of a patient’s medical care that can easily be accessible for planning purposes, regulatory bodies and medical research (Pickett, 2011).

Furthermore, the effect of ICT in healthcare will be substantial, due to most of its interaction with information. These effects will make impact upon the health information management role. This issue of Health Information Management shows in both theoretical and practical. The ability to use the ICT materials by health workers’ is likely to be influenced by their proficiency. That is, health workers skills about their capacity to work effectively using the ICT gadgets will stand as a factor in determining their patterns of information usage. As a result of these influences, their efficacy skills are strong determinants or predictors of level of accomplishment that the health service professional finally attains.

Fonkych and Taylor (2005) pointed out that although the benefits of ICT will not be realized without considerable changes in work processes and structures. Generally, proficiency refers to thorough competence derived from training and practice. It also connotes knowledge as well as technical skills possessed by the health worker. Therefore health workers should view the role of ICT in their profession and try to engage in activities that will increase their proficiency level. Kinzie, Delcourt and Powers (1994) submitted that, the capabilities to successfully accomplish a particular task lie in an individual expression of what he is capable of doing. It is continually being actualized in an individual’s mind, which Bandura (1997) called “mastery experience “or goal attainment. This view has also been supported by Albion (1999) whose findings belief in an individual capacity to work effectively with the computer is a significant factor in determining their patterns of computer use and a result–oriented accomplishment.

However, the hospital health information management (including both patient data and clinical knowledge) do exhibit its peculiarity difficulties, such that, they intimidate massive changes in healthcare. Increases in health information quality, quantity and access will bring both increased healthcare efficiency and quality. One of the key components of such a vision is the increasing use of ICT in the health arena, for example, an ubiquitous electronic health record (EHR) which has been in existence right from inception of ICT, but only now it’s coming to fruition. (Australian Medical Association Review of health workforce: submission, 2005). Health systems globally are facing increasing demands for highly sophisticated services, yet they have limited resources and current and projected shortages of health professionals.

 

Apart from the issues mentioned above, , information computing usage for data record is still being faced with significant number of obstacles such as usability of the applications by health workers, confidentiality and privacy of patient data, and the management of health care workers amongst others. Therefore, it usability by health workers is summarized in its attributes to learn, competence and satisfaction. Also, Health care information that is supposed to be treated with confidentiality and utmost privacy lack professional skills. Thus, every user of the system must be proficient to gain access to the system’s functionality.

Moreover, the level of ICT-Health based system’s usability does not only influence the users’ acceptance of the system, but may greatly influence the diagnosis and treatment processes in a health care centre. Other constraints to effectively make use of ICT is as a result of inadequate provision of infrastructure and insufficient Information and Communication Technologies (ICTs), its knowledge therefore limits the services of health workers, but the available once, how is it use with counterparts and other developed countries. Based on the aforementioned the researcher seeks to find out the implementation and application of ICT and the level of health workers proficiency in health information management (record management) across the health facilities in Ogun State Southwestern Nigeria as a case study.

 

1.2. Objective of the study

The objective of this study is to assess the extent of ICT usage and attitude of health workers towards health information management in health facilities in Ogun State Southwestern Nigeria.

1.2.1. The Specific objectives

  • To assess the use of ICT resources by health workers for Health Information Management
  • To assess the level of health information sharing with the use of ICt among the health care providers.
  • To assess level of proficiency of health workers towards use of ICT in Health Information Management.

With the stated objectives, the study sought answers to the following research questions.

  1. Do the health workers make use of ICT resources for the Health Information Management?
  2. Do the health workers share health information with the use of ICT?
  3. Do the health workers proficiencies affect the use of ICT resources in Health Information Management?

 

1.3. Brief description of the study area

 

The State has 20 Local Government Areas (LGAs) as enshrined in the Constitution. It is divided into Four Geo-Political Zones, Three Senatorial Districts, Nine Federal and 26 State Constituencies. The State Ministry of Health under the Health Sector Reform 2006 procured VSAT technology for the Ministry making information available at the fingertips of management and staff of the ministry. In providing enabling environment for the health workers in the state, a resource centre/library with internet facilities commissioned for workers in updating their knowledge on current trends (Ogun State Health Bulletin, 2006). Under the reform, most of the health facilities are supplied with ICT resources like computer systems with internet facilities for the running of the health facilities.

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