EFFECTIVENESS OF ELECTRONIC HEALTH RECORD SYSTEM

ON PATIENT’S HEALTH CARE

BY

CHEPKEMOI WILLITER

PROJECT REPORT SUBMITTED TO KENYA NATIONAL

EXAMINATION COUNCIL IN FULLFILMENT OF THE
REQUIREMENT FOR THE AWARD OF CERTIFICATE IN HUMAN
RESOURCE MANAGEMENT

July Series

DEDICATION
I dedicate this project work to my family members and more so to my sister Chebet Eddah who has
been supporting me all the way with financial help all the time in my college and the Almighty God
who gave me good health and strength throughout the whole academic session.
 DECLARATION
I Chepkemoi Williter declare that this research project be submitted to the Kenya National
Examination Council for an award of Certificate in Human Resource Management is my original
research project and has never been submitted to any examination body for the same award.

SIGN: ……………………………………DATE……………………………..
SUPERVISOR

NAME: Mr. Basil

SIGN: ……………………………………DATE…………………………….

ACKNOWLEDGEMENT
I give special acknowledgement to the Almighty Father for giving me strength and wisdom towards
establishment of the final year project. Special thanks go to my beloved sister who managed to help
me through the accomplishment of this project. More thanks to my supervisor Mr. Basil for his great
words that encouraged me towards accomplishment of this project work.
 LIST OF ABBREVIATIONS
CASCO: County Aids and STI Control Coordinator Strategy

STI: Sexually Transmitted Infections

CDH: County Director of Health

HMT: Health Management Team

PMCT: Prevention of Mother to Child Transmission

SI: Strategic Information

TB: Tuberculosis

HTC: HIV Testing and Counseling

HIV: Human Immune Virus

ART: Anti-retroviral Therapy

IT: Information Technology

HER: Electronic Health Record

ABSTRACT
Health Information Technology, particularly Electronic Health Records (EHR), will improve quality
and efficiency of healthcare organizations, from small practices to large groups. This research covers
the need of implementing EHR systems in health organizations and how it can help to curb the
problems caused by loss of essential data when data is lost in health facilities.
Adoption of Electronic Health Record (EHR) systems promises a number of substantial benefits,
including better care and decreased healthcare costs, serious unintended consequences from the
implementation of these systems have emerged. Poor EHR system design and improper use can cause
EHR-related errors that jeopardize the integrity of the information in the EHR, leading to errors that
endanger patient safety or decrease the quality of care. These unintended consequences also may
increase fraud and abuse and can have serious legal implications. This literature review examines the
impact of unintended consequences of the use of EHR systems on the quality of care and proposed
solutions to address EHR-related errors. This analysis of the literature on EHR risks is intended to
serve as an impetus for further research on the prevalence of these risks, their impact on quality and
safety of patient care, and strategies for reducing them.

TABLE OF CONTENTS
DEDICATION.................................................................................................................................................ii
DECLARATION.............................................................................................................................................iii
ACKNOWLEDGEMENT.................................................................................................................................iv
LIST OF ABBREVIATIONS..............................................................................................................................v
ABSTRACT...................................................................................................................................................vi
TABLE OF CONTENTS.........................................................................................................................vii
CHAPTER ONE........................................................................................................................................9
1.0 INTRODUCTION.................................................................................................................................9
1.1 RESEARCH OBJECTIVES......................................................................................................................9
1.2 RESEARCH QUESTIONS......................................................................................................................9
1.3 RESEARCH BACKGROUND..................................................................................................................9
1.4 HOSPITAL MANAGEMENT................................................................................................................10
1.5 ORGANIZATION LAYOUT..................................................................................................................11
1.6 STATEMENT OF THE PROBLEM........................................................................................................13
1.7 SIGNIFICANCE OF THE STUDY..........................................................................................................13
1.8 THE SCOPE OF THE STUDY...............................................................................................................13
1.9 RESEARCH LIMITATIONS..................................................................................................................14
1.9.1 JUSTIFICATION OF THE STUDY......................................................................................................14
CHAPTER TWO.....................................................................................................................................15
2.0 LITERATURE REVIEW........................................................................................................................15
2.1 INTRODUCTION...............................................................................................................................15
2.2 THEORITICAL FRAMEWORK.............................................................................................................15
2.3 CRITERIA FOR INSTALLATION AND USAGE OF DEVICES...................................................................17
2.4 PERSONNEL TO USE MACHINES.......................................................................................................17
2.5 INDICATOR OF HEALTH RECORD OFFICER PERFORMANCE..............................................................18
2.6 RELATIONSHIP BETWEEN ELECTRONIC DEVICES AND HEALTH OFFICERS PERFORMANCE..............19
2.7 CRITICAL REVIEW.............................................................................................................................19
2.8 RESEARCH FINDINGS........................................................................................................................20
CHAPTER THREE..................................................................................................................................21
3.0 RESEARCH DESIGN AND METHODOLOGY........................................................................................21
3.1 STUDY DESIGN.................................................................................................................................21
3.2 TARGET DEPARTMENT.....................................................................................................................21
3.3 SAMPLE DESIGN...............................................................................................................................22
3.4 DATA COLLECTION PROCEDURES....................................................................................................23
3.5 DATA ANALYSIS................................................................................................................................23
CHAPTER FOUR....................................................................................................................................24
DATA ANALYSIS, PRESENTATION AND INTERPRETATION..........................................................................24
4.0 INTRODUCTION...............................................................................................................................24
4.1 ORGANIZATIONAL BACKGROUND INFORMATION...........................................................................24
4.2 QUALITY AND QUANTITY OF MACHINES.........................................................................................26
4.3 PERFORMANCE APPRAISAL..............................................................................................................26
4.4 RELATIONSHIP BETWEEN ELECTRICAL HEALTH SYSTEM AND THE STAFF PERFORMANCE...............27
4.5 METHODS OF ACQUIRING E.H.R MACHINES....................................................................................27
CHAPTER FIVE......................................................................................................................................28
SUMMARY, CONCLUSIONS AND RECOMMENDATIONS................................................28
5.0 SUMMARY.......................................................................................................................................28
5.1 CONCLUSION...................................................................................................................................28
5.2 RECOMMENDATIONS......................................................................................................................28
QUESTIONNAIRES......................................................................................................................................30
REFERENCES..............................................................................................................................................33
 CHAPTER ONE

1.0 INTRODUCTION
This chapter covers the background information of the study and that of the organization under
which the research was undertaken, the statement of the problem, objectives of the study,
research questions, and significance of the study and the scope of the study.

1.1 RESEARCH OBJECTIVES

1. To find out how Electronic Health Record System (EHRS) helps to provide health care to
patients.
2. To identify barriers to adoption of Electronic Health Record System in hospitals.
3. To find out ways of combating missing cases of client’s files and other important details.
4. To understand the importance of keeping and ensuring safety of client’s details and
health status in hospitals.
5. To find out the necessary education on the use of Electronic Health Records System.

1.2 RESEARCH QUESTIONS

1. How does the use of Electronic Health Record System used by physicians to provide
improved care to patients?
2. What are the obstacles to adoption of EHRS from a work flow perspective?
3. How do we minimize missing cases of client’s details and health status?
4. Why is it important to keep safe client’s details and health status?
5. What is the necessary education on the use of EHRS?

1.3 RESEARCH BACKGROUND

The study was based on the effect EHRS on the health record system on patients care.
The research was done at Longisa County Referral Hospital. Health records storage is
vital to every health facility so as to make treatment efficient and effective. Some of the
problems that patients go through is long waiting time for clinics and retrieval of their
previous details pertaining to their illness. This has resulted to worse outcome such as
death and patients’ conditions becoming more critical.
 These and many other problems have prompted the researcher to study this subject matter
in order to come up with long term solution to the challenges.
The target institution is Longisa County Referral Hospital. It came into inception in the
year 1995. The organization is a health facility categorized as a referral hospital.

1.4 HOSPITAL MANAGEMENT

The management is composed of:
 Hospital Committee.
 Hospital Superintendent.
 County Health administrator.
 Sub-county Health administrator.
 A representative from Local Authority.
 Public Health Officer (Sub-county and County).
 Area MCA.
1.5 ORGANIZATION LAYOUT

SUB-COUNTY HEALTH MANAGEMENT

PMTC ST TB HTC ART

IT HEALTH RECORD LAB PHARMACY NUTRITION COMMUNITY

Figure 1: Showing Longisa County Referral Hospital Organization Chart.

 PROGRAM MANAGER

This hospital serves the entire County of Bomet and its environs. Recently it incorporated an Eye
CASCO CDH COMMUNITY PROGRAM ACCOUNTS
Unit and a Renal Unit in the institution to meet the rising number of patients suffering from the
REPRESENTATIVE COORDINATOR
optometry and of more important is the installation of dialysis machine to curb kidney problems.

The hospital has several departments, they include:

1. X-ray department.
2. Laboratory department.
3. Medical Engineering department.
4. Maternity department.
5. Dental department.
6. Radiography department.
7. Oral Health department.
8. Orthopedic department.
9. Accounts department.
10. Transport department.
11. Supplies department.
12. Nursing department.
13. Occupational therapy department.
14. Casualty department.
All these departments have their own records but they get them from Records department since
the organization only uses centralized registry to produce records.
The storage and up keep of these information or records is a key function to any organization.
The use of this system will eradicate mishandling, misplacing and missing cases of records. If
this issue is not solved, the provision of services in the hospital will be inefficient and ineffective
thus leading to closure of the hospital.
Finally, it is the responsibility of the institution’s registry to keep its records and the management
should provide the relevant equipment to store and produce these records in a first and efficient
way.
1.6 STATEMENT OF THE PROBLEM
It is clearly known that health records are the raw material for the treatment. This is because no
treatment will be made before personal details and health information is given out to the
reception department. This department will create the first medical records of the patients.
Proper storage of these fundamental details will lead to efficient delivery of treatment services.
The institution behind this Electronic Health Records System is to stimulate the efforts of Health
Records Officers to apply this technology in record keeping. This will minimize missing cases of
patient’s case records or out-patients records.
It has been observed as of late that absence of proper keeping of records/information regarding to
patients will inconvenience provision of quality services in hospital hence worsening the
condition of patients.
Generally the need for Electronic Health Record System is as a result of high increase rate of
patients attending hospital while the existing system is stagnant and ineffective in terms of cost
and search efforts of records hence rendering a facility to be insensitive to its clients.

1.7 SIGNIFICANCE OF THE STUDY

i. The system will be used as a basis of advice to the hospital and organizations to adopt
this technology so as to improve records and integrity.
ii. It will help the organization/ hospital on the best way to curb the problem of missing
cases and complains from patients about their records.
iii. It will help clinicians or record officers to see the need of working perfectly so as to get
rewards or incentives since they are based on the performance.
iv. It will assist other researchers who will be digging further on other issues that concerns
with health record handling.

1.8 THE SCOPE OF THE STUDY

The research will be carried out mainly at Longisa County Referral Hospital. The institution is
well staffed and the number of clients served is quite high. The records officers have worked
together towards achieving the organization’s goals. The personnel concerned with record
keeping are majorly affected by this outdated method of producing and storing records.
The organization was chosen due to its proximity and accessibility by the researcher. It is less
costly in terms of time and finance as it is just near to the researcher’s college.

The study will mainly deal with E.H.R system without the involvement of other issues happening
in the hospital.

1.9 RESEARCH LIMITATIONS

The researcher faced a lot of problems while doing the research. The respondents failed to
respond to the questionnaires appropriately. To alleviate these obstacles the researcher opted to
involve ward attendants, doctors and even nurses to administer the questionnaires to the record
officers in their departments. It also includes personal visits to the hospital superintendents and
clinical officers in their offices to give their views and opinions regarding to this matter.

1.9.1 JUSTIFICATION OF THE STUDY

Little or no research has been done on the adoption of Electronic Health Record System in the
hospitals. The challenges of integrating the system of using electronics when it comes to creation
and storage of health records data pertaining to patients is so critical. Health record department
noted the impact of electronic technologies on research such as increasing demand for electronic
searching capabilities, demand for access to scholarly texts and use of network discussion group
for scholarly communication i.e. doctors sharing a certain information with other doctors in
diasporas.
The hospital need to put into consideration the procurement and installation of computers and
other electronic devices so as to aid in facilitating retrieval production of records.
 CHAPTER TWO

2.0 LITERATURE REVIEW

2.1 INTRODUCTION
According to Busher (1980), a literature review attempts to identify, locate and synthesize,
complete each report, article, book and other materials about the problem of the research by
providing and suggesting answers to such problems.
The chapter aims at;
i. Acknowledging the contributions of other people in related fields.
ii. To identify the gaps in existing knowledge regardless of the topic interest.
iii. Provide support to major issues in the study. It also confirms or rejects some of the
questions raised in the course of the study.
iv. Helping the researcher to develop familiarity in the area of the study particularly on
variables and the way they are related.
v. Showing continuity of the previous work that has been done and the present study.

2.2 THEORITICAL FRAMEWORK

The origin and discoveries about electronics devices is explained by quite a number of scholars.
A lot of theories have been put forward to explain various phenomenon’s about these electronic
machines. The machines can be optical or magnetic but the former is very much useful today.
The following people came with theories to explain more about invention and discoveries of
electrical devices.
Gougliemo Marconi (1874-1937) is known as “the father of wireless”. He believed that
telegraphic messages could be transmitted without wires. Indeed information can be send
throughout the hospital with computers.
Caneus and Muschenbrock (1974) discovered the first electronically capacitor- a storage
mechanism for electrical charge.
Another contributor also is known as Andre’ Marie Amp’ere. He formalized the understanding
of the relationship between electricity and magnetism using algebra. The theory is called electro-
dynamics.

These theories and very many others helped scholars and other inventors to develop electronic
devices. The devices could aid scientist such as meteorologist, astronomers, physicians, doctors
and political leaders to solve various issues pertaining to all spheres of life.
In medical docket, electronic devices help in recording, diagnostic activity, recording, examining
and even operational exercises. And a point to note is the fact that each and every understanding
mentioned above has its own machine or device to be used.
The following devices are samples of apparatus found in hospital.
TYPES OF ELECTRONIC DEVICES
1. Blood Pressure Monitors
Blood pressure monitors typically have a cuff that goes around the fingers, the wrist and
the upper arm. Its features include:
 Fat movement
 Memory
 A printer and different sized cuffs.
Some models have electronic inflation (automatic) and some require you to use a pump
(manual).
2. Body-fat Analyzers
Body fat analysis can be used as a metric to measure progress in personal fitness
programs or weight control and has the potential to be a better metric than absolute
weight.
A co-measure fat track (Linear System) is a measurement system that uses calipers to
measure body fat, provide a fitness rating and remember up to three personal profiles.
3. Thermometer
They are used in all areas and levels of care, from routine physical examinations of
clients to emergency department triage to in-patient care. These are now electronic ones
can be set for the specific part of the body being measured such as the mouth, under the
armpit, rectally or the ears.
4. Scales
The features it possesses are:
 a) Multiple data storage mode.
b) Guest mode.
c) Differing weight and capacities.

d) Graphical displays.
e) Percent body fat.
f) Differing resolutions.
5. Heart Rate Monitors
Most heart rate monitors resembles wrist watches and many come with features that have
been on digital watches for a long time.
They include a chest strap that does the actual measurement; allowing the read out device
to stay on wrist.
The highest end model comes with a pyramid display for exercise intensity, 99-lap
memory stop watch, average heart rate and other features. None of the monitors has the
ability to interfere with a PC.

2.3 CRITERIA FOR INSTALLATION AND USAGE

OF DEVICES
The institution/ hospital should be having stable power source so that the machine are left
running when electricity goes off. Some of the machines in the hospital such oxygen plant
require a consistent and stable power

2.4 PERSONNEL TO USE MACHINES

Doctor or clinician or anybody coming into contact to this machine should adequately possess
relevant skills on how to use. Failure to understand its usage and application may results to
tragedy or accident.
Proper storage and storage equipment should be observed to avoid breakage and unnecessary
loss to be incurred
The hospital should invest more money so as to afford to buy long lasting equipment or machine
since the higher the expensive the higher quality and durability of the product .Maintenance cost
also should be checked out before any procurement is made out.
2.5 INDICATOR OF HEALTH RECORD OFFICER
PERFORMANCE
When electronics are in hospitals, offices in charge of health records finds theirs work simple
and friendly to them. Time saving is a key achievement to records handlers.
The following are some of the indicators of a functional electrical health record system in
hospital.
1. Maximum loyalty and commitment
This is done to conducive environment and a good condition for health officers.
Employees direct all their effort to the work assigned to them because the machine are aiding
them to work efficiently and effectively.
2. Increase production

This is achieved through a committed officer .The services of the hospital will become more
accessible and available all the time. The hospital will be able to reap more thus achieving its
goals and aspiration.

3. Change in behavior

Absenteeism will be alleviated since workers find their work enjoyable and friendly. Little or no
supervision will be achieved since officers know what is expected of them. No one will complain
of tedious and boredom since machines does most of the work.

4. Little or no wastage of resource

Since the officers have the relevant skills and knowledge on the use of machine, the record
storage and creation is cost effective in terms of space and time.

5. Innovation

Health record officers are likely to come up with new methods of storing creating and retrieving
of such record need. The creativity of designing medical information materials and storage will
be achieved. The organization will see tremendous changes when these machines are procured. It
is well known that when workers or people working in a certain organization are not comfortable
with condition and environment or machine they are using, more challenges and losses will be
experienced daily unless technical one happened. So their interest should be considered in
advance.

2.6 RELATIONSHIP BETWEEN ELECTRONIC

DEVICES AND HEALTH OFFICERS
PERFORMANCE
This is itself proves that extent of workers performances is largely depends on electronic
machines given to them. If the hospitals decide to digital machine to be used, it is likely to meet
its goals and objectively without much struggle. Failure to do so more problems will pop in and
the organization shall fail its clients. So in a nutshell, each other no one will work with the
absence of the other.

Electronic Device Effect Employee Performance

Independent Variable Dependent Variable

Figure 2 Showing Relationship between Electronic devices and Health Officers performance.

2.7 CRITICAL REVIEW

Despite the fact that a number of researches have been carried out in this field, the tendency of
low performance in terms of record keeping and retrieval is still eminent in work place. In most
of the occasions that the performance appraisal is carried out, the record’s integrity is rarely
recorded.

2.8 RESEARCH FINDINGS

The study has shaded more light to some of the menace in the hospital. The researcher found out
that the institution in question depended so much on manual keeping retrieval of their
information. It came out very clearly that most of the services rendered are sub-standard and
clients had expressed their dissatisfaction on services provided to them.
The statistics conducted by the researcher indicated that there was a serious crisis to be solved
especially registration department. The surgery and correction department lack quite a number of
instruments either for examination or recording purposes, this will lead to poor quality and
ineffective service.
The research work also brought into spotlight the behavior that some of the doctors and
clinicians are reluctant and demotivated in their areas of work. All these challenges and obstacles
enumerated will be eradicated if at all the institution will embrace new technologies and procure
the new electronic devices so as to ease diagnostic examination, operation and recording of such
information. This will make the hospital efficient, effective and quality is upheld.
 CHAPTER THREE

3.0 RESEARCH DESIGN AND METHODOLOGY

The chapter covers the centre stage of the project. It describes the method used for the
study, the target department where a sample is obtained.
It also explains the instruments used for data collection; the procedure followed during
collection and finally gives the brief introduction on the method used for analysis.

3.1 STUDY DESIGN

The researcher adopted the descriptive method or category in the design of the study. This
This is where a researcher describes the study basing on the objectives and research questions.
The significance of this design is that it helps the user as a matter of fact to understand the study.

3.2 TARGET DEPARTMENT

The researcher chose Longisa County Referral Hospital as the treatment base centre for
study. This organization is majorly the service provider with its clients being the sick
patients. The number of patients attending per day ranges from 100-500, not inclusive of
in-patients.
The organization is characterized by the following features:
 There is a machine worth 50 billion.
 It has a board of governors.
 There are 260 members of staff.
 There is over 100 Subordinate staff.
 It has departments and sections which help in the achievements of corporate goals.
Generally, the target point is supply and procurement departments which have details
about machines acquired so far and their challenges.

3.3 SAMPLE DESIGN

After the identification of the targeted departments, the researcher went ahead and
selected a section (12 % of the population) randomly.
The criterion for selection is based on department as shown below. Each and every
department below will have four of its members selected for the study.

DEPARTMENT NUMBER OF STAFF

Administration 4
Registration 4
Admission 4
Laboratory 4
Dental 4
Orthopedics 4
Supplies 4
Casualty 4
Pediatrics 4
Record Management 4
Medical Engineering 4
Radiography 4
Accounts 4
This helps the researcher to acquire the information need because there was no previous
knowledge of the sample undertaking that has influenced the outcome. This size is good to give
reliable result.
The researcher obtained a permit from the hospital medical superintendent. This enables
him to be fully accepted by staff since he was served with a name tag for identification.
The study was purely based on questionnaires which for this case is an instrument for
data collection. The nature of the questionnaires which for this case is an instrument for
data collection. The nature of the questionnaires is the structured interviews basing on the
objectives and research questions of the study.

This ensures that the end results are encouraged because the data instrument was
carefully selected.

3.4 DATA COLLECTION PROCEDURES

During the research exercises there were some major and prime activities that were
looked at keenly to ensure the successful collection of the data. The following were
the procedures followed:
a) Instrument Design
The instruments were fully designed in order to facilitate proper collection of
data.
b) Pilot Study
The instruments so designed were tested against pre-determined standards of the
data to be collected in order to establish their viability and reliability.
c) Revising the Instruments
Where there were problems, defects or challenges in the instruments were revised
in order to come up with the best alternative which suited the exercise.
d) Data Collection
This follows after the instruments are ready. It involves the real field work that
brings together the researcher and the staff where the researcher is the interviewer
while the later is interviewee or respondent.
e) Final touches
The collected data was coded, analyzed, edited and subsequently tabled. At that
level, the findings were having the meaning and were ready for use.
3.5 DATA ANALYSIS
The researcher opted for use of analysis of the data through application of pie charts and
tables to present its information.

CHAPTER FOUR

DATA ANALYSIS, PRESENTATION AND

INTERPRETATION

4.0 INTRODUCTION
In this chapter, the data are collected and presented in the most appropriate method. This
information will be presented using pie-chart, bar graphs, tables and even expressed in
percentages. This chapter intends to give interpretation of what has been analyzed and
presented so as to enable those who will access or use this work to derive the appropriate
meaning. This will eradicate confusions and un necessary assumptions.
Thus facilitating proper application of this work or study. The description was used in
exercise of data analysis and presentation.
Data was analyzed and presented categorically using the interview guide (questionnaires)
as the basis hence was divided into the following parts:
a) Organizational background information.
b) Types of available electronic devices (quality).
c) Methods of acquiring machines.
4.1 ORGANIZATIONAL BACKGROUND
INFORMATION
Table Showing Departmental Representation

SIZE CATEGORY/DEPARTMENT TYPES OF PERCENTAGE

(DEGREES) MACHINES STILL NEEDED
PRESENT (%)
80 Registration File, Computers 76

60 Laboratory Old Machines 80

60 Record Centre Computer and 49

Files
46 Radiology Not fully Equipped 50

46 Medical Engineering Few Machine 82

available
44 Dental Modern Machine 10

24 Account Computer and 82

Figure 3 showing the different departments representation at the Hospital.
Ledger
book
Chart Showing Departmental Representation at the Hospital

KEY

Registration Department
Laboratory Department
Records Department
Radiology Department
Medical Engineering Department
Dental Department

NB: The above pie-chart depicts the type or status of various machines present (available)
use in monitoring, recording and keeping of patient’s information in various departments
reflected in the study. It is clearly noted or seen that files and books are mostly used to record
information in the hospital. Most of the departments lack modern equipments. Also the only
department which is well equipped is dental department.
 4.2 QUALITY AND QUANTITY OF MACHINES
Graph Showing the Quality and Quantity of Machines at the
Hospital
10
8
Quality 6
And
4
Quantity
2
0
t t t t t t t
en en en en en en en
rtm rtm rtm rtm rtm rtm rtm
epa epa epa epa epa epa epa
D D D D yD D D
nt
s gy g ry or ds al
u olo erin gist at cor ent
co di e Re r Re D
Ac Ra n gin La
bo
lE
ci a
ed
M Department

The departments like accounts, medical engineering, and laboratory and records center are
lagging behind. They lacked the most recent and efficient devices to use.

4.3 PERFORMANCE APPRAISAL

The findings showed that the performances of all sections are regularly appraised in order to note
the variation from the standard targets. This has enabled the hospital management to identify the
following:
a) Those departments who still need more equipment to use.
b) Those staff who need to be taught how to use these new machines.
c) The department which is running at the requisite direction.
d) The department accepted that they are regularly supplied with feedback of what they are
regularly supplied with feedback of what they aired (interval of 5 months). In deed all
departments expressed their displeasure about the state of the hospital ever since the
inception of the facility.

4.4 RELATIONSHIP BETWEEN ELECTRICAL

HEALTH SYSTEM AND THE STAFF
PERFORMANCE
 The outcome of the research indicated that service provision is catalyzed by enough
machines to be used.
 All the interviews stated that they always feel like sparing their effort while at work
when not given the right apparatus to be used so as to use then in other private
undertakings. At some point others revealed that they take their work as hobby and are
not interested in any other business outside the work place.
 A good percentage argued that unless they are supplied with relevant material to be
used, they are not ready to release their brilliant ideas they have in hospital. So for
treatment services to be effective and quality relevant and modern machines should be
purchased.

4.5 METHODS OF ACQUIRING E.H.R MACHINES

The organization may not opt to buy these devices directly or look for donors to meet their
purchase cost. If the former will be used then the government is responsible to findings. It
may also use the funds they receive from clients to purchase devices acquired.
 CHAPTER FIVE
SUMMARY, CONCLUSIONS AND
RECOMMENDATIONS

5.0 SUMMARY
The chapter pictures the findings of the study. The exercise was tough since there were
challenges but finally objectives were met.
Among the challenges that were prevailing is:
i. Language Barrier
Some of the respondents were unable to speak English and Kiswahili.
ii. Inadequacy of funds
The research required money for questionnaires, printing and other petty expenses.
iii. Shortage of time
Since the researcher was a student; he had a lot of time constraints since he had to
attend other school work to attend to.
iv. New Employees
These could not relay sufficient information that was required.

5.1 CONCLUSION
It was noted that the organization that was under the study had a few instrument/ devices to
be used. The tendency of convey results and new changes showed to be much pleasing to
staff.
 It was also concluded that, the compliance with the current technology has helped the
hospital to eradicate poor performance and client’s embarrassment. Another achievement is
that it has helped the organization to win the employees’ loyalty and commitment hence the
reduction of industrial action by doctors.

5.2 RECOMMENDATIONS
The following are some of the recommendation that the researcher came up with:
i. The organization (hospital) should employ acquisition programs for instrument required
in order to remain relevant to the people.
ii. The interval of acquiring such materials should adhere to.

iii. The hospital should try as much as possible conduct performance appraisal-evaluating
their services.
iv. The hospital should include doctors when suggesting developmental changes-
incorporating new machines.
QUESTIONNAIRES
I am Chepkemoi Williter, a student at Eldoret College of Professional Studies. Project research is
one of the core Subjects in our institution and everyone who is in his/her final year of study has
to do research. I request for your cooperation, this research is purely for academic purposes and
any information shall be kept with confidentiality.

Part A: Respondents Background Information

Please give appropriate answer where applicable or make a tick inside the box.
1. Name of the Respondent: (Optional)
………………………………………………………………………………………
2. What is your gender?
Male Female
3. Department of the respondent:
………………………………………………………………………………………
4. What is your highest level of education?
University
College
5. How long is your work experience?
Below 2 years.
2-4 years.
4-6 years.
6-8 years.
10-Above.
6. Please indicate any other responsibly held.
………………………………………………………………………………………
Part B: Objectives of the Study
Types of Electronic Devices
1. Does every department have the required devices?
Yes
No

2. Are there some of the devices which are missing?

Yes
No

3. Are there some devices which are missing?

a) Body fat analyzers.
b) Blood pressure monitors.
c) Thermometers.
d) Scales.
e) Heart rate monitors.
f) Scanners and Screening machines.
g) Recording devices (Machine).
h) Reader Machines.

Criteria for Installing Electronic Machines

(Tick where Applicable)
1. Do you know how Electronic Machines are procured (purchased)?
Yes
No
2. If yes, tick one;
Personal to use machine.
Storage device.
Maintenance.
If any other specify, ………………………………………………………………………..
 ................................................................................................................................................
3. Does the management consult you when deciding criteria to use?
Yes
No
4. Staff Performance
i. Has your performance been appraised or assessed?
Yes
No

ii. If yes do you normally receive feedback?

Yes
No

iii. If yes still, is there any improvement in any views you have or suggestion you made?
Yes
No
5. Relationship between electronic devices and service provision.
i. Does the devices is of any importance to you?
Yes
No
ii. What effects does it have in you?
Positive
Negative
iii. Are you ready to release your beautiful ides to you area of specialization?
Yes
No
If no, then why: ……………………………………………………………..
………………………………………………………………………………………………
………………………………………………………………
 REFERENCES
1. Abramson EL, McGinnis S, Edwards A, Maniccia DM, Moore J, Kaushal R. Electronic
health record adoption and health information exchange among hospitals in New York
State. J Eval Clin Pract. 2011; 18: 1156–1162. doi: 10.1111/j.1365-2753.2011.01755.
2. Abramson EL, McGinnis S, Edwards A, Maniccia DM, Moore J, Kaushal R. Electronic
health record adoption and health information exchange among hospitals in New York
State. J Eval Clin Pract. 2011; 18:1156–1162. doi: 10.1111/j.1365-2753.2011.01755.x.
3. Ancker JS, Kern LM, Edwards A, et al. Associations between healthcare quality and use
of electronic health record functions in ambulatory care. J Am Med Inform Assoc 2015;
22:864–871.
4. Blumenthal D, Tavenner M. The “meaningful use” regulation for electronic health
records. N Engl J Med. 2010;363(6):501–504.
5. Bruen BK, Ku L, Burke MF, Buntin MB. More than four in five office-based physicians
could qualify for federal electronic health record incentives. Health Aff (Millwood)
30(3):472–480.
6. Chen P, Tanasijevic MJ, Schoenenberger RA, et al. A computer-based intervention for
improving the appropriateness of antiepileptic drug level monitoring. Am J Clin Pathol.
2003; 119 (3):432–438.
7. Jones SS, Adams JL, Schneider EC, et al. Electronic health record adoption and quality
improvement in US hospitals. Am J Manage Care. 2010; 16(12 Suppl HIT):SP64–71.
8. Sullivan June M. Recent Developments and Future Trends in Electronic Medical and
Personal Health Records. The Health Law. 2007; 19:16.
9. Sittig Dean F., Singh Hardeep. Defining Health Information Technology-Related Errors.
Archives of Internal Medicine. 2011; 171:1281.
10. Westin AF. Public attitudes toward electronic health records. Privacy and American
Business. 2005; 12(2):1–6.

APPENDIX I

TIME FRAME
Month Activities

Jan Proposal writing

February-March Project printing data collection and analysis

April Typing and printing

May Time of submission

APPENDIX II

BUDGET
DESCRIPTION APPROXIMATION (Kshs)

Internet 1,600

Typing and printing 1,500

Photocopy 400

Stationary 100

Transport 500

Lunch 1,200
Binding 50

Total 5,350