Medical Records in Rural Ethiopia

An Ethiopian community hospital serving 1.7 million people now has a quick and efficient patient registration and medical records system, thanks to the efforts of School of Public Health graduate Rex Wong ’00 and Professor Elizabeth Bradley, Director of the Health Management Program and Global Health Initiatives and Professor of Epidemiology.

In their study published in the International Journal for Quality in Health Care, Wong and Bradley report that the new system has not only reduced the need to re-gather patients’ medical history at the beginning of each visit, but has also increased physician satisfaction by 47%, shortened patient waiting time, and increased hospital efficiency.

In Ethiopia, where, according to WHO, there is only one physician per 10,000 people, this increase in efficiency at a relatively low cost is vastly important in the health system’s ability to provide high quality care.

Before the improved system was established, long wait times were common for those seeking medical care. The medical staff often embarked on searches through the haphazardly organized records until correct and necessary documents for each patient were found.

“This is a hospital that serves so many patients, and it really was chaotic without having some measure of record keeping,” said Bradley.

Working closely with the Ethiopian Ministry of Health and administrators of the hospital, Wong and Bradley assisted with the development of a computerized patient registration and records system. The system is further backed by a paper system, vital in Ethiopia, where electricity comes and goes and where sand can cause unpredicted hardware breakage.

The project was not without its challenges. The natural resistance to change meant convincing the hospital staff, who would need to learn how to operate the new machines and to type, that the new system would be worth the efforts. Finding a keyboard that supported typing in Amharic, the official language of Ethiopia, presented an additional hurdle.

However, by offering significant increases in efficiency at a relatively low cost, the new patient registration and medical records system has provided an impetus for other hospitals around Ethiopia to adopt similar systems. Under a new initiative by the Ministry of Health, a new national patient record database is being established. With the introduction of a standardized patient form to be adopted by health centers around the country, Ethiopia may be on its way in seeing vast improvements in medical records efficiency in the years to come.