Case study problem #2

The government of the Western Province wants to purchase a pre-existing or custom-built EMR management system from a local or multinational company that would lead to improvements in the:-healthcare of patients -accuracy of record keeping -efficiency of the hospital and clinics.

1. What is an EMR management system? What do they typically include? How would they help improve each of the points above? Would they be available in East African countries? Provide evidence for your answer!

EMR = Electronic Medical Record. So i'm guessing that an EMR management system is an electronic medical record management system... but I don't know. A EMR is usually a computerized legal medical record created in an organization that delivers care, such as a hospital and doctor's surgery. Electronic medical records tend to be a part of a local stand-alone health information system that allows storage, retrieval and manipulation of records. An EMR management system would help improve each of the points above because EMR's are organized, allow storage, retrieval, and manipulation of records. Yes, an EMR management system would be available in East Afrcian countries however at a price.

2. What options are available for pre-exisiting systems? What are the price points for those systems? What are the advantages and disadvantages to buying a pre-built system?

The options that are available for preexisting systems are that the Oobunta clinics and hospitals could get used computers for a cheaper price than new and implement an EMR sytem into them for a higher price which will allow for the cheaper computers to equal out the new database software. Electronic medical record (EMR) software prices typically range from $10,000 to $30,000 per physician, with higher and lower cost options on the market. In addition to the software license cost, implementation adds indirect costs. These include training; additional hardware or software; downtime or decreased productivity during implementation; vendor implementation fees; ongoing service or maintenance fees; and possible attorney, electrician, contractor, or consultant fees. The advantages for buying a prebuilt system is that it is cheaper than a new one however the system may have defects associated with it such as viruses or broken equipment.

3. What options are available for custom systems? What are the price ranges for those systems? What are the advantages and disadvantages to buying a custom system?

The sample presented below is from texmed.org:

Sample Costs (based on an average, 3.5-physician practice)
Software Licenses
Product A $ 31,980
Product B $ 61,020
Product C $ 71,000
Data Conversion
A 2,995
B 2,900
C 5,000
Other Licenses
-
B 6,691
C 8,000
Training
A 6,205
B 26,449
C 50,635
Installation
A 4,480
B 12,345
C 4,940
Discounts
-
B (23,215)
C (19,402)
Annual Recurring Costs
A 12,871
B 26,834
C 21,537
Hardware/Network
A 30,000
B 30,000
C 30,000
Project Total
A $ 88,531
B $ 143,024
C $ 171,710

As we can see, the higher and more custom an EMR system is than the more expensive it will be. There are advantages though to buying a custom system however. Some of these adantages may include easier accessibility, easier operation and manipulation, more storage or less storage depending on how many people go to the clinic per year. However, there are diadvantages too to custom EMR system because an EMR system is already large and can contain a lot of information. Upgrading one is, in my opinion, a waste of money (that these clinics have little of) and they should be looking more into physical IT systems rather than hardware and software systems.

4. Make a recommendation to the government of the Western Province; which type of system should they buy? Which options should it include? What compromises will they have to make?

I believe that the government of the Western Province should by pre-existing computers and spend more money on EMR systems. The more computers the clinics have along with the hospital, the more information can be passed to a fro between the two. You should buy cheaper computers, that are relatively new (last 10 years) and install EMR systems into them. I do not think that it is neccessary to have a custom system installed because it is a waste of money and more physical IT systems should be purchased instead (xray systems, MRI's). I believe that you will have to help the clinics of Oobunta, whether you see it in the countries best interests economically, because when people need help, it should be given to them despite their distance from the hospital and/or their state in the economic ladder.