Investigation of Key Factors Affecting Quality of Patient Data from National Antiretroviral Therapy Electronic Medical Record System in Malawi

Abstract

The Ministry of Health in Malawi implemented a National Antiretroviral Therapy Electronic Medical Record system currently deployed in over 150 health facilities. It thus expected quality and timely quarterly cohort reports. However, the raw electronic reports are rarely complete, accurate and consistent requiring cleaning hence being delayed. Such reports are now very critical under the COVID-19  pandemic. Adopting a mixed-method approach, this study assessed the key factors that affect quality of data entered in the electronic medical records system and the reports produced by the system. The study interviewed 134 health-care workers in 17 sites and 10 Baobab Health Trust officers. Observations were conducted and secondary data analysed. The analysis shows that the EMRs lacks proper documentation and validation rules, making it hard to maintain and increasing chances of duplicate entry, respectively. Coupled with lack of trained personnel, it was revealed that one set of login credentials is used by multiple users and vital data elements being null compromising security and completeness, respectively. The electronic medical records system was not used at 40% of the sites as a point of care system hence being used as a back-data entry tool. Thus, there is need to revise the system to include necessary validations, security features, back data-entry form and data quality dashboards.

Keywords: Electronic Medical Records system, Data Quality, System Quality, Information Quality