وجهات نظر العاملين اتجاه النظام الصحي المحوسب المطبق في مستشفيات وزارة الصحة الفلسطينية
Users' Perspectives on the Computerized Health Management Information System in the Ministry of Health Hospitals in the West Bank - Palestine
محمد محمود مصطفى بني عوده
Mohammad Mahmoud Mustafa Baniode
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Background: Health Management Information Technology, e-health, is rarely used in the Palestinian health sector. The first pilot initiative in Palestine was implemented in the MoH Rafedia and Darweesh hospitals. However, there is a lack of evidence on the impact of the system and the challenges for the implementation. Aim/objectives: To assess the users' perspectives toward the recently implemented Computerized Health Management Information System (CHMIS) in MoH hospitals and the challenges for implementation from user perspectives. The focus of the assessment was; ease of use (user friendliness), efficiency (time and cost saving), effectiveness (patient safety), Computer Ordering Physician Entry impact on the resources utilization, and extent using system the reports in decision making. Methods: A cross-sectional design was used. All the estimated 500 medical and paramedical staff in the two hospitals was targeted. Data was collected using a self-administered questionnaire. Findings: The overall response rate was 80.5%. 72.1% of the participants were from Rafedia hospital staff and (27.9 %) from Darweesh Nazzal hospital. Almost half of the respondents were males (55.0%) compared to females (45.0 %). Of the total participants 92.8 % (283) are using the system to perform their daily tasks and activities. This shows a high extent use of the system. The general results for the main domains were as follow; ease of use domain (user friendly and usability) was 76.0% of positive responses, effectiveness domain (patient safety and accuracy of documentation) was 73.0% of positive responses, the COPE (rational use of resources and communication speed) was 58.3%, the efficiency of CHMIS (time saving and efficient communication) domain received an overall of (75%) positive responses. The main challenges were (74.0%) limited number of distributed computers in hospital's departments, and the lowest one was (28.0%) trusting in system's capability. T-test and one way-ANNOVA test were used to examine the relationship between dependent and independent variables. Whereas, females scored significantly higher than males toward the ease of use (P<0.001), effectiveness (P=0.007). As for age groups the results show that there is significant association iv between the participants' age groups and the ease of use (P<0.001), effectiveness (P=0.05). A relationship was found between profession (physician, nurse, laboratory technicians, radiology technicians, and pharmacists) and study domain at (P< 0.05), where there are significant differences between the following study domains: ease of use (P=0.001), effectiveness (P=P 0. <001), and finally reports using (P=0.042). A strong relationship is found between previous experience of using CHMIS outside the hospitals and study domain at (P< 0.05), where there are significant differences between the following the study domains: ease of use (P=0.001), effectiveness (P=0.001), COPE (P=0.001), and finally efficiency (P=P 0.<001).The highest score was for those who didn‟t use the system before. Conclusions: Obviously, the results show that using a cutting-edge information technology in managing and monitoring health facilities has a significant effect on the patient's safety, eliminating errors as well as on time saving. In addition it‟s enhancing evidence-based decision making. However, the main challenges remain to be the lack of equipment and financial resources for the system.