Status Report on Computerized Management of Patient Files in Hospitals in the City of Kananga ()
1. Introduction
A patient’s file represents the complete and written memory of his or her time in a hospital establishment. It is also an element of centralization of the actions of all stakeholders in the field of health 90% to 100% of health personnel have knowledge of IT medical management [1].
Improving patient care inevitably involves maintaining an exhaustive medical file containing all the information necessary for patient treatment; this implies that it is adjusted to the doctor’s daily practice and that the data collected are well structured, adapted and personalized for all specialties 70% to 90% of patient information is in electronic version [2].
As a result, the personalization of an adapted computerized medical record is a priority for the health system, capable of meeting several functions, the main of which is the ease of maintaining, storing, and managing all data relating to this discipline, which will lead to an improvement in the quality of care 80% worldwide their electronic records [3].
Today, paper files formerly administrative, medical and care coexist in computerized files totally or partially designated by the acronyms of Computerized Patient File (DPI).
The patient file (PD), “written memory of a patient’s administrative, clinical, biological, diagnostic and therapeutic information is a fundamental and essential tool for medical practice”. It is built around the accumulation of data related to a patient’s care over time. The computerization of the DP has become essential, even if the computerization process is difficult, because copying the “paper” model is insufficient and “zero paper” is not an end in itself. If the steps to achieve the implementation of such a computerized file are quite different from one hospital institution to another, the reasons which led to this computerization are generally common: the increase in storage volumes, the need to reduce access and delivery times for medical information as well as the need to share information between different health partners and their different institutions. The hospital today can no longer be considered an isolated island. Its traditional image is changing with the establishment of healthcare networks, and the need to communicate is becoming a priority [4].
In Geneva, the Council of State set up the IRIS (Integration into the Health Information Network) foundation (private law and public utility foundation) which is responsible for creating a Community Medical Informatics Network. The RCIM is made up of public and private actors authorized to practice the various health professions. At the center of the network is the patient equipped with an electronic key which allows them secure access to their computerized file. The big challenge of setting up care networks and creating a common network between the two cantons Vaud and Geneva would be to cope with the diversity of the computer systems of the network members. Given that the two groups of university hospitals, the Hospices-Centre Hospitalier Universitaire Vaudois and the University Hospitals of the canton of Geneva constitute the core of the respective networks, the approach to mitigating the great heterogeneity of the information systems and IPRs put in place must start with these two hospital groups. It would first be necessary to carry out an analysis of the current situation by identifying and analyzing the differences and commonalities of the two systems put in place [5].
Maintaining the patient’s medical record is the responsibility of all healthcare professionals within the healthcare establishment. Neglecting this recipe will result in unwanted medications in the study concerning the wrap, among other quality care provided to patients [6].
The absence of the culture of IT tools: still to this day, few health training structures in Africa offer the possibility of training their students in basic IT and the Internet. Consequently, almost all health professionals begin to practice their profession without learning this necessary basis for the deployment of information systems. If fewer African health professionals are familiar with Internet technologies, they have not been their methods of rigor, organization, and monitoring of processes and procedures [7].
The observation is that the medical sector of the city of Kananga today is almost non-existent in the computerization of patient files and even the poor management of these files. A complete computerized medical record even makes it possible to advance research in the field of health.
Our reflection focuses on the advantages of the computerization of files in the health service, their individual or shared use by health professionals, their classification and their computing to propose a structure to meet the expectations of professional liver repositories. Thus, our question revolves around the following main question: What will the level of management of medical records in state hospitals in the city of Kananga in DR. Congo be in 2024?
The general objective of our study is to take stock of the computerized management of patient files with a view to contributing to the improvement of the computerized management of patient files in hospitals by managers of health institutions through the different information management software for health personnel, in the city of Kananga in 2023.
2. Methodology
2.1. Study Framework
Our study was carried out in 7 hospitals in the city of Kananga, which is the provincial capital of Kasaï Central, in the Democratic Republic of Congo. These are: The Kananga Provincial Hospital; Bon Berger Reference General Hospital in Tshikaji; Reference St Georges General Hospital; Lukonga Reference General Hospital; SNCC Reference General Hospital; Ndesha State Reference General Hospital and José Odney Reference General Hospital.
The city of Kananga is the capital of the Kasaï-Central province in the Democratic Republic of Congo. The town’s history dates to the 18th century, when the first farming villages settled in the region. The town then bears the name Luluabourg because it is located on the banks of the Lulua River.
2.2. Data Collection
We used a questionnaire, interview and observation to collect data.
2.3. Study Period
Our study covers a period of 12 months, from January to December 2023.
2.4. Methods
The present study is descriptive cross-sectional, it concerns the computerized management of patient files.
2.5. Study Population
Our study population is made up of healthcare providers (doctors and paramedics) as well as administrative staff.
2.6. Sampling and Sample Size
Seven hospitals made up our study unit and 86 personnel were conveniently chosen as key people from whom the information should be drawn.
2.7. Inclusion and Exclusion Criteria
All workers present at the time of our visit to the hospitals and who agreed to answer our questionnaire were included in our study while any personnel not present at the workplace (Hospital) during our visit were excluded from our study.
2.8. Data Analysis and Processing Method
The data collected was with Kobocollect and analyzed using Epi-Info software version 7.2.5.0 and Excel 2013. We collected the data using a questionnaire as a tool and the individual interview was the technique used.
2.9. Conflict of Interest and Ethical Approval
No conflict of interest were declared and on an ethical level, we are committed to confidentiality, respect for human dignity as well as autonomy.
3. Results
Table 1 reveals that the age group from 18 to 23 was the most represented. The average age was 32 (±6.03), the minimum age 18 and maximum 30 years.
It appears from Table 1 that the majority of participants were male (69 or 80.23%).
Table 1. Distribution of respondents according to socio demographic and professional profile.
Variable |
Frequency |
Percentage |
Age |
|
|
18 - 23 |
40 |
46.5 |
24 - 29 |
30 |
34.9 |
30 - 35 |
10 |
11.6 |
35 and above |
6 |
7.0 |
Gender |
|
|
Female |
17 |
19.8 |
Male |
69 |
80.2 |
Professionnal profile |
|
|
Administrator manager |
10 |
11.6 |
Secretary |
6 |
6.9 |
Nurse |
25 |
29.1 |
Doctor |
35 |
40.7 |
Pharmacist |
3 |
3.5 |
Receptionist |
7 |
8.1 |
Study level |
|
|
Secondary |
10 |
11.6 |
Undergraduate |
20 |
23.3 |
Graduate |
56 |
65.1 |
Total |
86 |
100 |
Table 1 reveals that 40.7% of the respondents were doctors, followed by nurses with 25 or 29.1%.
Table 1 tells us that 56 or 65.1% of respondents had a higher level of study (Graduate).
It appears from Table 2 that 43 or 50% of the respondents were either from the Laboratory, the imaging department, or the administration.
Table 2. Distribution of respondents according to the service of the respondents.
Service |
Frequency |
Percentage |
Gynecology |
10 |
11.6 |
Internal medicine |
15 |
17.4 |
Pediatrics |
8 |
9.3 |
Surgery |
3 |
3.5 |
Receptionist |
7 |
8.2 |
Other (Lab, imaging, administration) |
43 |
50 |
Total |
86 |
100 |
Table 3 shows us that 80, or 93% of our respondents had knowledge of medical management IT.
Table 3. Distribution of respondents according to knowledge of IT for managing patient records.
Knowledge of medical management IT |
Frequency |
Percentage |
No |
6 |
7.0 |
Yes |
80 |
93.0 |
Total |
86 |
100.0 |
It appears from Table 4 that 53.5% of respondents use the forms to manage patient information at the hospital.
Table 4. Distribution of respondents according to the management of patient information at the hospital.
Patient information management in hospital |
Frequency |
Percentage |
On paper |
20 |
23.3 |
Electronic |
4 |
4.7 |
Form |
46 |
53.5 |
Register |
10 |
11.6 |
Others |
6 |
7.0 |
Total |
86 |
100 |
Table 5 reveals that in 90.7% of cases, medication management is computerized.
Table 5. Distribution of respondents according to computerized medication management in the health facility.
Computerized medication management in the health facility |
Frequency |
Percentage |
No |
8 |
9.3 |
Yes |
78 |
90.7 |
Total |
86 |
100 |
It appears from Table 6 that in 64% of cases, respondents considered electronic file management good.
Table 6. Distribution of respondents according to the assessment of the management of electronic patient files.
Appreciation of the management of electronic patient files |
Frequency |
Percentage |
Good |
21 |
24.4 |
Poor |
10 |
11.6 |
Very good |
55 |
64.0 |
Total |
86 |
100 |
93% of respondents spoke about security as a mechanism to combat information leaks in data management (Table 7).
Table 7. Distribution of respondents according to the mechanism for protecting files against information leakage.
Mechanism |
Frequency |
Percentage |
Monitoring |
6 |
7 |
Code security |
80 |
93 |
Total |
86 |
100 |
Table 8 tells us that the DHIS2 software was used in 97.7% of cases.
Table 8. Distribution of respondents according to software used at the hospital.
Software used |
Frequency |
Percentage |
DHIS2 |
84 |
97.7 |
Other |
2 |
2.3 |
Total |
86 |
100 |
Table 9 tells us that in 88.37% of cases, the information was shared on social medias.
Table 9. Distribution of respondents according to patient information, their results are shared on the networks.
Sharing information on networks |
Frequency |
Percentage |
No |
10 |
11.6 |
Yes |
76 |
88.4 |
Total |
86 |
100 |
We observed that 69, or 80.2% of respondents, spoke of lack of resources as a reason for not using software to manage patient files (See Table 10).
Table 10. Distribution of respondents according to constraints that prevent them from using computer software.
Constraints that prevent using software |
Frequency |
Percentage |
Lack of IT tools |
17 |
19.8 |
Lack of means |
69 |
80.2 |
Total |
86 |
|
4. Discussion
Social demographic and professionnal profile
We observed that the age group from 18 to 23 years old was more represented as shown in Table 1 with an average age of 32 (±6.03); the minimum age and maximum age being 18 and 30 years respectively. Most respondents were male (Table 1) 80.23%. A study carried out in Lubumbashi also found a predominance of the female gender (65.83%) while the age group between 24 and 28 was the majority represented (40.83%) [1].
Table 1 reveals that 40.7% of respondents were doctors, followed by nurses with 25 or 29.1%. Our results are similar to those found by Georges et al. in Lubumbashi [1]. Most respondents had a higher level of education, i.e. 65.1% of respondents had a higher level of education (Graduate) (Table 1).
Service of respondents
The laboratory department, that of imaging as well as the administration are full of half of our respondents as shown in Table 2. Our results are contrary to those of the study conducted by George in Lubumbashi where the PMTCT/AIDS service had more respondents [1].
Knowledge of computer management of patient records
In 93% of cases, the respondents had knowledge of medical management IT (Table 3). The World Health Organization found similar results [8].
Management of Patient information in hospital
Most respondents, 53.5%, use the forms to manage patient information in the hospital (Table 4). Our results are contrary to those of Niu, W., Huang, Z., & Zhang, M [9]. as well as those of the World Organization for Health [8].
Computerization of computerized medication management in the health structure
We observed from Table 5 that nine respondents (90.7%) believe that medication management is done in a computerized manner in their health structures. Our observations were also made by Torki [9].
Appreciation of the management of electronic patient records
Table 6 shows us that in 64% of cases, respondents considered electronic file management good. The results of George’s study indicate that 61 or 50.83% of respondents spoke very well, followed by good with 39 or 32.50% [1].
Mechanism to protect files against information leakage and software used
93% of respondents believe that respondents had talked about security on the side as a mechanism to combat information leaks in data management Table 7.
DHIS2 is the most used Software used (Table 8) in the hospital. The same result was found in a study conducted in Lubumbashi by George [1]. and also in Dali by Gao à, J., and Li, W. [10].
Sharing patient information on networks
In 88.3% of cases, patient information was shared on social networks (Table 9). The networks of the Universities of Geneva maintain that social networks allow patients to interact and can represent a good source of sharing experiences and advice. However, as with websites, vigilance must be exercised [2].
Constraints that prevent the use of computer software
In our study, 80.2% of respondents cited lack of resources as the reason for not using software to manage patient files in their hospital structures (Table 10).
5. Conclusions
The computerized management of disease records is an effective means for the continuity of care and the tracing of diseases. It also plays a big role in documentary research because non-computerized records are often not well preserved, hence the interest in our study.
We conducted a study on the status of computerization of medical records in some health structures in the town of Kananga in the Democratic Republic of Congo.
We observed that the lack of resources was a reason for not using software to manage patient files in their hospital structures.
In 93% of cases, the respondents had knowledge of medical management IT; Most respondents, 53.5%, use the forms to manage patient information in the hospital; 93% of respondents believe that respondents had talked about security on the side as a mechanism to combat information leaks in data management.
It is important to strengthen the capacities of medical providers in medical management IT, and provide computer hardware and online software to store health personnel information.
Conflicts of Interest
The authors declare no conflicts of interest.