Evaluating a Newly Developed System for Electronic Medical Records in Tanzania: An Example of the Experience in...

The introduction of electronic medical records (EMRs) in health systems in high-income countries has streamlined access to care and quality of patient information. However, in low-income countries such as Tanzania, EMR remains in its initial stages. The aim of this study was to compare completeness of patient information in the paper medical records (PMRs) with that of the newly implemented EMRs. Using hospital records of newly diagnosed breast cancer patients treated at the Ocean Road Cancer Institute, demographic, diagnostic, and treatment data of 328 patients between January 2017 and April 2018 were abstracted and compared between PMRs and EMRs. The results showed that demographic information variables were documented significantly more in EMRs (occupation, 98.5%) compared to PMRs (occupation, 43.3%) (P < .001). However, diagnostic and treatment information variables were much less likely to be reported in EMRs (full blood panel, 8.2%) than PMRs (full blood panel:=, 93%) (P < .001.) The results showed that EMR utilization corresponded with a marked decrease in the overall documentation rate of patient information compared to the standard PMRs. Multiple barriers affected EMR use. A major one was the lack of EMR connectivity across health systems in the country. Future studies should focus on uncovering the barriers and facilitators to EMR utilization, health care workers perception of available EMR systems, and better ways to improve lifetime sustainability of EMR systems in Tanzania and similar low-income countries.