Revolutionizing Jamaica’s Healthcare: The Digital Shift to Electronic Health Records
Modernization of the Jamaican healthcare system with the implementation of the Electronic Health Record (EHR) is long overdue. In July 2023, Christopher Tufton and the Ministry of Health & Wellness announced an EHR initiative as part of the Health System Strengthening Programme (HSSP), which was funded by a USD$50 million loan from the Inter-American Development Bank (IDB) [1-3]. The UK-based Phoenix Partnership (TPP) is responsible for delivering the systems. The EHR is expected to advance health data management to hospitals and clinics, with features that include secure patient record storage, integrated diagnostic imaging, electronic progress notes, real-time access for healthcare providers, telemedicine, and mobile app functionality for patients.
In the past, reduced physician-physician communication forced patients to bring diagnostic records to their referral appointments, and when records were lost, patients had to absorb the cost of repeat imaging or laboratory tests. Thus, synchronized sharing will certainly circumvent this issue, enabling patients to receive continuity of care even when moving between hospitals.
Under the HSSP, 13 healthcare facilities, including hospitals and health centers across various parishes, including St. Catherine, Clarendon, and St. Ann, will experience upgraded infrastructure and digital capabilities. As of August 2024, the Spanish Town Hospital is among three health systems, including May Pen Hospital and May Pen East Health Centre that have fully operational EHR systems [1, 4-6]. On September 23, 2024, the EHR was deployed at the St Ann’s Bay Regional Hospital, and efforts to integrate EHR in patient care are ongoing.
Jamaicans are already benefiting from improved efficiency and patient care
Undoubtedly, this modernization effort by the Ministry of Health & Wellness is essential for improving patient outcomes to better address both non-communicable and communicable diseases. Post-implementation feedback has already demonstrated positive results, with hospitals and patients reporting efficient record-keeping and reduced wait times.
In addition, it was reported that EHR patient registration and appointment management have allowed for efficient triage and reduced bottlenecks from the start of a hospital visit [7-8]. High-demand areas like the emergency room have also reported that services are being performed in nearly half the time compared to before the EHR system was implemented [8]. Such changes come due to the reduced provider manual workload and more time to treat more individuals in a given timeframe, and go a long way towards enhancing patient satisfaction [7-8].
Future Impact & Gaps
We, at The Barriffe Insurance Group (BIG), believe these efforts will help to increase healthcare utilization in Jamaica and improve care. However, to ensure vulnerable populations are not left behind, addressing notable gaps in access and health literacy will be critical to ensuring the full potential of the EHR system is realized. At this time, a major issue will be the accessibility of the app-based system for patients. Individuals without compatible smartphones and internet service, which are often those in low-income or rural communities, may not have easy access to their medical records. As of now, it is estimated that Jamaica has a high rate of smartphone usage, with mobile phones generating approximately 60% of web traffic [9]. Barring this, it is estimated that 54.2% of smartphone users are between 18 and 24 years-old [10], highlighting the potential limited reach of the app-based portion of the EHR system. This digital divide could limit the effectiveness of the EHR for a significant portion of the population. Moreover, healthcare literacy remains a challenge in Jamaica. For many patients who want to take an active role in their health, navigating the electronic health records or understanding the significance of content in their records will pose challenges.
The Ministry of Health will need to take proactive steps, which may include public education campaigns and secondary methods for accessing health records. Public education campaigns will be necessary for improving healthcare literacy and teaching people how to access and understand their digital health records. This can be done through community outreach, local health fairs, and partnerships with private non-governmental organizations (NGOs), including BIG. Second, the government might consider setting up physical kiosks or community centers where patients without smartphones can access their EHRs with the help of trained staff. Finally, providing affordable or subsidized smartphones to low-income populations could bridge the gap in digital access, ensuring that all citizens can benefit from the EHR.
Another significant drawback is the lack of widespread, sustainable electricity, which poses barriers, as not all healthcare facilities have backup generators. At this time, it is unclear whether the implementation of reliable generators at all 13 hospitals is being funded under the HSSP. To address this issue, the Ministry of Health should also expand generator capacity in hospitals and health centers to prevent EHR disruptions during power outages, especially in regions prone to more damage during hurricanes and storms.
Sources
[1] Health Ministry inks agreement for historic introduction of electronic … https://www.moh.gov.jm/health-ministry-inks-agreement-for-historic-introduction-of-electronic-health-records-to-jamaica/
[2] Electronic Health Records System Launched at May Pen Hospital https://jis.gov.jm/electronic-health-records-system-launched-at-may-pen-hospital/
[3] Tufton inks deal for introduction of electronic health records to Jamaica https://www.jamaicaobserver.com/2023/02/28/tufton-inks-deal-for-introduction-of-electronic-health-records-to-jamaica/
[4] Electronic Health Records (EHR) Implementation – Jamaica – IFHIMA https://ifhima.org/electronic-health-records-ehr-implementation-jamaica/
[5] Electronic Health Records System launched at May Pen Hospital https://jamaica-gleaner.com/article/news/20240113/electronic-health-records-system-launched-may-pen-hospital
[6] Electronic health records system to roll out at May Pen Hospital in … https://jamaica-gleaner.com/article/news/20231216/electronic-health-records-system-roll-out-may-pen-hospital-january
[7] Contract Signed for Electronic Health Records System https://jis.gov.jm/contract-signed-for-electronic-health-records-system/
[8] Streamlined EHR System Halves Wait Times in Jamaican Public … https://healthpoint.com/data-and-information/streamlined-ehr-system-halves-wait-times-in-jamaican-public-hospitals/
[9] Share of web traffic in Jamaica in December 2023, by device
[10] Smartphone Users in Jamaica