Chapter One
Introduction
This chapter is concerned to supply some background information on Electronic Medical Record ( EMR ) , its definition and the related nomenclature, its practical utilizations, and its importance in the medical field. After this brief debut, the research motive, job statement, the aims, the range of the survey, and the research part will wholly be presented severally.
1.1 Background
Traditionally, infirmaries used to maintain paper-based profiles of patients to maintain path with the patients ‘ illness history, their development and their overall general wellness conditions. Though this traditional technique has long been adopted, it is non without practical jobs. One populating illustration of the defect of traditional infirmary profiling systems of patients ‘ informations was transpired inspired by Hurricane Katerina. Hurricane Katrina destroyed the medical records of untold Numberss of people, conveying new attending to the demand for electronic medical informations. Lost medical records expose patients to considerable hazard of medical errors because doctors would go unable to pull connexions between the presently wellness conditions of the patients and their medical history ; viz. , diagnosing, drugs ‘ effects, and surgery hazards appraisal ( Statements, 2009 ) .
The increasing Numberss of infirmaries and henceforth the figure of patients in recent old ages have posed a load to the profiling system of patients, rendering it unequal or exactly uneffective. Until late, more effectual profiling systems have been proposed with the assistance of Information Technology, IT. Medical Informatics ( MI ) has emerged as promising field to work out the profiling system jobs, using Fieldss of Computer Science, Information scientific discipline, Decision Sciences, and Epidemiology. Research workers in medical information sciences have developed new methods and techniques to better wellness attention, biomedical research, and instruction through information engineering ( Ward, Gordon, Field, & A ; Lehmann, 2001 ) . It is expected that MI would be able to supply a plausible solution for the infirmaries ‘ profiling system to cut down the congestion information retrieval of the patients ‘ history and related information.
Precisely, EMR is one type of health care information system ( HIS ) or medical information sciences like electronic wellness record ( EHR ) and computerized doctor order entries ( CPOE ) has late been introduced to assist better health care by triping the communicating among the users, to ease the patients ‘ informations retrieval, to cut down medical mistakes, and to supply medical enunciation support.
Although, still many infirmaries presents utilizing EMRs in Jordan and other states, but widespread usage of EMR and applications it by medical users has non yet occurred, because of the many challenges face of execution and or utilize the EMRs via health care professionals.
This may be attributed to a combination of assorted factors and fortunes still unknown ; we have many motives of this research to cognize and place these factors in Sweden, United Kingdom, Netherlands, Australia, Malaysia and besides Jordan ‘s medical organisations that will be described by inside informations in the job statement in following subdivision.
1.2 Motivation of the research
Jordan is considered to be the Centre of the Middle-East health care where a reasonably high degree of medical attention criterions is provided. Jordan ‘s medical sector is of high-level in general, and particularly in comparative to neighboring states ( Amer & A ; Ammari, 2006 ) . Therefore, it is goes without stating that the figure of international people around the universe would take Jordan for health care intents. The entire figure of patients who headed for Jordan in 2000 from both neighboring and foreign states was about 24, 800 patients. In 2001, the figure of patients who entered Jordan had been doubled ; 15, 370 patients entered Jordan within the first six months for medical intents. More late, the entire figure of patients who entered Jordan 2004 had even more than quadrupled ; exactly, it was 115, 000, in 2005 it was 135,000, in 2006 it was 160,000, in 2007 it was 190,000, in 2008 it was 210,000 and until August of 2009 it was 225,000 patients ( Jordanian infirmaries provide attractive offers to pull patients from Western countries* 16 of Oct/2009 ) . Patients ‘ addition will hold negative effects on health care because of the excess hustle but no existing resources will convey quality of health care down.
Consequently, the research worker expects that the figure of patients coming to Jordan to increase due to the continual development in the health care sector and to the good repute of the medical services that Jordan had established throughout the old ages ( Amer & A ; Ammari, 2006 ) . However, this good repute has started to confront some menaces because of the deficiency of medical engineering ( Amer & A ; Ammari, 2006 ) .
Jordan ‘s authorities is presently be aftering to follow the Electronic medical record ( EMR ) via Medsphere Systems Corporation in USA for all Jordanian infirmaries ( “ Midland Memorial Hospital Hosts Kingdom of Jordan e-Health Team, ” 2008 ) .
However, the jobs are when current EMR system may non be to the full utilized, and jobs non addressed, will do the new systems to confront failure.
1.3 Problem Statement
The speedy handiness of recovering the relevant information of the patients offered by EMR engineering offers enormous chances in bettering the health care criterions, staff proficiency and experience, and the patients ‘ overall wellness conditions. Among the benefits of EMR that can be thought of are: to back up health care professionals in their daily and research work, to cut down clinical mistakes, and to better the quality of wellness attention ( ENSP Rennes, 2005 ) .
A preliminary treatment with the ministry of health care should that hold although the top infirmaries in Jordan have implemented EMR, they have non achieved more than 50 % utilized as compared to similar infirmaries in Sweden, United Kingdom, Netherlands, Australia ( Amatayakul, 2004 ; Ash & A ; Bates, 2005 ) .This indicates that Jordan is dawdling left buttocks in utilizing EMR extensively, given the immense sum of investing. The survey of the Sweden, United Kingdom, Netherlands, Australia infirmaries showed effectual or positive consequences of EMR execution that was due in portion to the new advanced engineering from the one manus, and to the efficient plans that were directed to fix the EMR users ( doctors, nurses, druggists and clerical staff ) from plans familiarisation with the new engineering and researching the potency of the broad scope of the usage of the EMR assist the staff and patients to accept the system.
There are a batch of researches already conducted in the field of electronic medical records ( EMR ) in many states, ( Sultan 2006 ) nevertheless, there are limited researches done in Jordan to place and look into the chief barriers that are lending to the deficiency successful the execution of EMR systems in Jordan. This job is made sufferings by the, many challenges and barriers are still expecting the acceptance of the execution for electronic medical records systems ( EMRs ) in Jordan ( ALnassar, Abdullah, & A ; Osman, 2009 ) .
In Jordan, among the jobs sing the execution of EMR is the inefficient use of all of its available maps. That is, EMR has a assortment of maps that the users are non familiar with or can non even detect despite the multiplicity of maps available, its easiness of usage, and effectivity. Despite the handiness of patients ‘ informations entry through many sections of the infirmary ( as radiology, research lab and pharmacological medicine ) utilizing the EMR, infirmary staffs are non familiar with it and hold jobs in covering with its chief maps. To set it in field footings, the job is the uneffective Modus Operandi of EMR in Jordan which is expected to supply practicians with timely entree to patients ‘ complete wellness history ( ALnassar et al. , 2009 )
Furthermore, some medical organisations want to implement EMRs but they are unable to do the bold measure in implementing electronic medical record system ( EMRs ) at their infirmaries ( ALnassar et al. , 2009 ) . May hold other grounds that contributes to the limited EMR execution in Jordan such as effectual preparation plan for wellness attention users, high execution cost, deficiency of computing machine background amongst users, hold in informations entry, package immatureness, deficiency of criterions, security, privateness, limited entree, patient confidentiality and others. We strongly believe that understanding identifies or definition and these barriers and holding the right scheme to cover with these will guarantee the success of EMR execution in Jordan.
Harmonizing, to Mary ( 2008 ) of her research was focus on explores physician attitudes toward acceptance in an academic environment where usage is discretional. It besides examines physician attitudes toward this system prior to execution. In recommendations of her research for post- execution and prior- execution, future research could besides turn to extra user groups within the same health care system, such as doctors, nurses, druggists, decision makers or clerical staff.
1.4 Research inquiry
The research worker believes that there is a demand to place and analyze the factors that affect the usage of EMR, this survey intends to look into the undermentioned research inquiry:
• What are the factors that affect the usage of electronic medical record ( EMR ) in Jordan health care environment?
1.5 Research Aims
The overall research aim of the research is to look into or to better understand the factors which may impact the usage of electronic medical record systems ( EMRs ) in Jordan.
In peculiar the research aims:
a ) To set up the current user ‘s perceptual experiences toward usage of EMRs, and to find the single features and socio proficient factors that affects or contributes to utilize of EMRs.
B ) To place the most of import factors those are perceived to better the usage EMRs in health care environment in Jordan.
degree Celsius ) To suggest new dimensions or new variables may be impacting the usage of EMR in Jordan ‘s infirmaries.
1.6 Scope of the Study
The range of this survey addresses the barriers that affect the usage of EMR in the Jordanian health care environment. This survey will include most of the private and public infirmaries, which already have implemented the EMR either in portion or in fully fledged execution, and which are considered to be the most celebrated and technologically advanced in Jordan.
All of these infirmaries can be classified as follows: ( 1 ) authorities infirmaries, ( 2 ) the infirmaries of ministry of defense mechanism, and ( 3 ) the infirmaries of universities and private sector. The unit of analysis of this survey will be collected from doctors, druggists, nurses, Laboratory technician, records staffs and administrative staffs.
1.7 Expected Contribution
This survey hopes to cast some visible radiation on the effects of EMR on practicians and professionals ‘ point of position under controlled conditions. First, such survey is expected to supply the information needed for determination shapers towards following, put ining and implementing the EMR in Jordanian environment. Second, it will supply first-hand experience of the possible jobs of the acceptance of EMR over the clerical, professional and administrative staffs. Third, it will besides supply insightful guidelines for practical utilizations to the practicians and professionals as how they should be prepared and trained to acquire familiarised with the new engineering. Finally, this survey can be expected to add to the overall cognition of scientific and healthcare organisations of EMR in footings of the interaction between EMR engineering and the staff in the development states in general and to specificity of Jordanian context in peculiar.
1.8 Research scheme
The research procedure consists of three chief phases which will mean to explicate how the research inquiry will be approached as illustrated in figure 1.1. In the first phase, healthcare information system ( HIS ) construct is to be identified from five resources: ( 1 ) health care, ( 2 ) information in health care, ( 3 ) health care system ( HS ) , ( 4 ) information communicating and engineering, and ( 5 ) electronic medical record. These five constructs which will be used to depict the HIS profile had been verified through the usage of illustrations taken from the literature on EMRs.
In the 2nd phase, the research worker ‘s preparation of the general factors that affect the usage EMRs are all based and derived from the history of EMR, advantages and disadvantages of EMR, execution of EMR, barriers to the usage and execution of EMR in the health care literature in Jordan. The 3rd phase involves a farther alteration of the theoretical account, utilizing engineering credence modeling ( TAM ) .
Finally, will be informations aggregation, analysis and consequences.
1.9 Proposal organisation
1.9.1 Chapter1: debut
This first chapter has provided overview and background information to the survey. It describes the research background and explains the principles for carry oning the research, the research objectives, the research job, and the part for the research.
1.9.2 Chapter 2: Healthcare information system ( HIS )
The 2nd chapter is a reappraisal of that comprehensive literature which is related to healthcare information engineering ( HIT ) from both the information communications and engineering ( ICT ) . The chapter starts with specifying healthcare information engineering, why we need to HIT. Besides, this chapter describe types of HIT that called health care systems, focal point describe by inside informations of electronic medical record ( EMR ) , that including history, advantages, disadvantages of EMR, execution and how EMR work, besides discuss of challenges of usage EMRs. In other side of this chapter describe for current health care in Jordan, conceptual model and hypotheses of this research.
1.9.3 Chapter 3: Research Methodology
This chapter describes by inside informations methodological analysis of research that will utilize to look into factors which may impact the usage of electronic medical record systems ( EMRs ) in Jordan. Research design will be foremost of this chapter, informations aggregation, demographics of survey population, survey population, pilot survey, computation of sample size and response rate.
