背景:雅温得中心医院(YCH),位于喀麦隆首都,是喀麦隆领先的转诊医院之一。医院有几个科室,包括妇产科(以下简称“产妇”)。该临床科室在临床信息化管理方面面临着诸多问题,包括缺乏高质量和可靠的临床信息,无法获得这些信息,以及对这些信息的不良使用。
目的:我们的目标是改善在YCH产房产生的临床信息的管理,并描述挑战,成功因素,以及在实施和使用过程中吸取的教训。
方法:基于开源医院信息系统(HIS),该干预措施在YCH的孕产妇处实施了临床信息系统(CIS),并使用HERMES模型进行-第一部分旨在涵盖门诊咨询,billing,和产妇的现金管理。日内瓦大学医院支持这个项目,最后测量了几个结果。评估了以下结果:项目管理,技术和组织方面,领导力,变更管理,用户培训,和系统使用。
■项目的第一部分已经完成,CIS被部署在YCH的孕产妇中。主要技术活动是采用开源的HIS来管理门诊咨询并开发集成的账单和现金管理软件。除了技术方面,我们实施了其他几项活动。它们包括实施适当的项目治理或管理,改善产妇的组织流程,促进当地数字医疗领导力和变革管理绩效,并实施用户的培训和支持。尽管在项目期间遇到了障碍,6个月评估显示,前6个月CIS得到了有效使用.
结论:在喀麦隆等资源有限的环境中实施HIS或CIS是可行的。TheCIS是根据YCH孕产妇的良好做法实施的。这个项目取得了成功,但也面临许多挑战。除了项目管理和技术和财务方面,在非洲实施卫生信息系统或HIS的其他主要问题在于数字卫生领导,治理,和变更管理。这个数字健康领导,治理,和变革管理应优先考虑数据作为提高生产力和管理卫生机构的工具,并在卫生专业人员中促进数据文化,以支持思维方式的改变和信息管理技能的获取。此外,在像我们这样高度集权政治制度的国家,这类项目往往需要一个高层次的战略和政治支柱,以保证它们的成功。
BACKGROUND: Yaoundé Central Hospital (YCH), located in the capital of Cameroon, is one of the leading referral hospitals in Cameroon. The hospital has several departments, including the Department of Gynecology-Obstetrics (hereinafter referred to as \"the Maternity\"). This clinical department has faced numerous problems with clinical information management, including the lack of high-quality and reliable clinical information, lack of access to this information, and poor use of this information.
OBJECTIVE: We aim to improve the management of clinical information generated at the Maternity at YCH and to describe the challenges, success factors, and lessons learned during its implementation and use.
METHODS: Based on an open-source hospital information system (HIS), this intervention implemented a clinical information system (CIS) at the Maternity at YCH and was carried out using the HERMES model-the first part aimed to cover outpatient consultations, billing, and cash management of the Maternity. Geneva University Hospitals supported this project, and several outcomes were measured at the end. The following outcomes were assessed: project management, technical and organizational aspects, leadership, change management, user training, and system use.
UNASSIGNED: The first part of the project was completed, and the CIS was deployed in the Maternity at YCH. The main technical activities were adapting the open-source HIS to manage outpatient consultations and develop integrated billing and cash management software. In addition to technical aspects, we implemented several other activities. They consisted of the implementation of appropriate project governance or management, improvement of the organizational processes at the Maternity, promotion of the local digital health leadership and performance of change management, and implementation of the training and support of users. Despite barriers encountered during the project, the 6-month evaluation showed that the CIS was effectively used during the first 6 months.
CONCLUSIONS: Implementation of the HIS or CIS is feasible in a resource-limited setting such as Cameroon. The CIS was implemented based on good practices at the Maternity at YCH. This project had successes but also many challenges. Beyond project management and technical and financial aspects, the other main problems of implementing health information systems or HISs in Africa lie in digital health leadership, governance, and change management. This digital health leadership, governance, and change management should prioritize data as a tool for improving productivity and managing health institutions, and promote a data culture among health professionals to support a change in mindset and the acquisition of information management skills. Moreover, in countries with a highly centralized political system like ours, a high-level strategic and political anchor for such projects is often necessary to guarantee their success.