Efficiency of an Electronic Health Information System for Antenatal Care: A Pilot Time-Motion Study

Abstract

Background Health information in Palestine is fragmented, characterised by repetitive paperwork and duplicated data entry. Palestinian healthcare providers spend considerable amounts of time on maintaining multiple client registers, files and books. The on-going implementation of an electronic registry (eRegistry) for maternal and child health (MCH) is expected to reduce the burden of health information management experienced by care providers. This has the potential to improve their ability to provide healthcare services of high quality. Methods This thesis presents the design and development of a study that will investigate whether the introduction of an MCH eRegistry leads to time efficiency. Efficiency will be measured in terms of reduced time spent on health information management in the context of antenatal care in primary healthcare clinics with and without the MCH eRegistry in the West Bank of Palestine. It describes the mapping of care providers’ workflow, the development of a data collection tool, and the conduct of a pilot time-motion style study. The time-motion methodology involves continuous observation of care providers’ work tasks and recording of the time taken to perform a set of predefined tasks. The results of the pilot study will inform and plan a time-motion study that has the statistical power to detect differences in effect. Results The pilot study results suggest that care providers in the clinics with the MCH eRegistry spend more time on both antenatal care consultations and health information management compared to care providers in clinics still using the paper-based system. The sample size was small and not balanced between the two groups. The results were not statistically significant. Conclusions The pilot study results suggest that there are no statistically significant differences in time spent on health information management between clinics with and without the MCH eRegistry. The sample size that was estimated to achieve statistical power requires a larger sample size than the number of clinics that are eligible. The MCH eRegistry should be fully implemented and matured before the conduct of the future time-motion study can take place.