Good Practices to Enhance the Perceived Usefulness of Computerized Hospital Information Systems – Case Study in Nigeria
Background and Purpose: Information systems that are not perceived useful, might not be used optimally. This can be seen as a waste of valuable resources and investments. The theoretical objective of the study was to see how Hanmer’s Model of Computerized Hospital Information System (CHIS) Use and Perceived Usefulness could be applied in a case in Nigeria. The practical objective was to build experiences of usefulness into good practices to motivate further CHIS use.
Methods: Hanmer’s model of CHIS use, developed and validated in South Africa, was used as a framework for this qualitative empirical case study. In-depth thematic interviews with clinicians (N=8), medical records officers (N=6) and hospital administrators (N=5) were conducted in spring 2011 at two Nigerian hospitals. Combinations of deductive and inductive content analysis were applied.
Results: The narratives of the respondents (N=19) fit into Hanmer’s categories of Knowledge and understanding about CHIS; Appropriateness of design; Performance; Availability and allocation of resources; Management commitment to success; and Effective use of CHIS outputs. However, poor infrastructure, interrupted power supply, political and cultural climate, historical aspects and environmental issues such as dust, moisture, heat, and compromised work ergonomics repeatedly emerged.
Conclusions: A new category Acknowledgement of the environmental context is proposed. As a practical contribution, 58 good practices to enhance the perceived usefulness of CHIS were retrieved from the narratives. Examples include adhering to the system hardware and network requirements, maintaining on-site technical staff and service contracts, involving different professional groups in ICT projects to initiate ownership of projects, and developing solutions for long-term archiving. These could be helpful not only to motivate the effective use of the current CHIS implementations and to lengthen the life cycle of systems in a sustainable manner but also to be utilized in future CHIS implementations.
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