Framework for electronic health records and electronic medical records standards implementation in the health sector of Zimbabwe

Abstract

Following the pronouncement of Zimbabwe‘s e-Health Strategy (2012-2017), coupled with the general emergence and benefits of health information technologies, the health sector of Zimbabwe has witnessed the mushrooming of Electronic Health Records (EHRs) and Electronic Medical Records (EMRs) systems. These systems are part of a health information system in a country and their role is to enable the capture, distribution and analysis of health information. However, such systems seem to be implemented in a haphazard manner and tend to be characterised by the dearth of standards. Although the then Ministry of Health and Child Welfare (MHCW), now the Ministry of Health and Child Care (MHCC), in its e-health strategy for Zimbabwe seems to acknowledge and appreciate the cardinal role played by EHRs standards, there seems to be no commensurate action plan with respect to the implementation of standards for EHRs and EMRs. Against this backdrop, the study sought to explore the EHRs and EMRs standards atmosphere in the health sector in Zimbabwe and propose a framework that may guide the implementation of standards for EHRs in the health sector of Zimbabwe. The methodology of the study was qualitative and a case study design was used. Using interviews and questionnaires, the study gathered data from five participants consisting of the Deputy Director in the Department of ICT, Deputy Director of the Department of Policy, Planning, Monitoring and Evaluation and the Deputy Director of Health Information in the Ministry of Health and Child Care and a Manager and the Director General at the Standards Association of Zimbabwe (SAZ). The study revealed that the state of standards implementation for EHRs was unfavourable, with the MHCC not knowing which and how many EHRs systems were in existence in the health sector. There was not yet meaningful interoperability between the disparate EHRs systems in use in the health sector. It emerged that SAZ and the MCHH had standing MoUs for standards, but none for EHRs and there was generally a low priority given to standards for such systems. The study further established that there were no policies and sound legislation specific to the implementation of standards for EHRs and EMRs in the country. The study proposed a framework that may inform the implementation of standards for EHRs and EMRs in Zimbabwe.