Before We Begin: Information Challenges in Your Setting

Before We Begin: Information Challenges in Your Setting

by Chamberlain Nwanne -
Number of replies: 25

After reviewing the course syllabus & overview, identify one challenge related to patient information, documentation, communication, reporting, or record-keeping in your organization that you hope this course will help you better understand or address.

Submission should be NOT MORE THAN 5 sentences

In reply to Chamberlain Nwanne

Before We Begin: Information Challenges in Your Setting

by Iwuanyanwu Anselm Chizurum -

One significant challenge in my organization is the frequent misplacement of physical patient records when individuals transition between different specialty departments, such as moving from the dental clinic to the ENT clinic. This often occurs because files are left behind at previous stations or delayed during manual retrieval from the central records room. Consequently, healthcare providers lack immediate access to essential patient history, leading to fragmented care and operational delays. I hope this course provides insights into digital tracking or integrated health systems that can eliminate these documentation gaps.. 

In reply to Iwuanyanwu Anselm Chizurum

Re: Before We Begin: Information Challenges in Your Setting

by Chamberlain Nwanne -
Hi Anselm - You have identified two important gaps that EHRs can help address: fragmented care and delayed care delivery. When implemented properly, EHRs improve information availability across departments and even different hospitals, reducing duplicate tests, repeated examinations, and loss of patient information. In many LMIC settings (not only in Nigeria), delays in accessing information can contribute to patients presenting with more advanced disease than they otherwise might have.
We'll explore several of these concepts through OpenMRS during this course.
In reply to Iwuanyanwu Anselm Chizurum

Before We Begin: Information Challenges in Your Setting

by Salimonu Hammed Akinkunmi -

Definitely, the transfer and retrieval of paper-based records remain a challenge in LMIC settings.

In reply to Chamberlain Nwanne

Re: Before We Begin: Information Challenges in Your Setting

by Nzenwa Magnus Nnaemeka -
One major challenge I face is that radiology and pathology results for breast cancer patients arrive as separate paper reports, often getting lost or delayed and leading to incomplete cancer staging. I hope this course will teach me how to use health informatics principles to design low-cost solutions like structured forms with mandatory fields and tracking mechanisms to ensure no critical result goes missing. Ultimately, I want to reduce data entry errors and improve care coordination and data completeness for breast cancer patients in my hospital.
In reply to Nzenwa Magnus Nnaemeka

Re: Before We Begin: Information Challenges in Your Setting

by Chamberlain Nwanne -
Magnus - Getting rid of paper records is one of the main advantages of EHRs. So issues of misplaced files, ineligible reports and disjointed reports are almost immediately fixed with EHRs. As we explore OpenMRS, pay attention to how structured documentation and centralized patient records can improve information availability and support more complete cancer care workflows.
You can adopt and adapt these processes to "improve care coordination and data completeness".
In reply to Chamberlain Nwanne

Re: Before We Begin: Information Challenges in Your Setting

by Ernest Oviosun -
Paperbase is the database system my institution loves. Despite the introduction of the Electronic system, we still found a way to be 95% invested in paper. Worse is that most department have their individual Electronic Health Management System... Why? Because Everyone was not carried along during development to understand indidualize workflow and peculiarity in individual system requirement
In reply to Ernest Oviosun

Re: Before We Begin: Information Challenges in Your Setting

by Chamberlain Nwanne -
Hi Ernest,
A major reason and benefit for implementing EHRs is to get rid of paper records in healthcare. It definitely defeats the goal when paper documentation is still heavily favored, when there is an electronic alternative. Of course hybrid systems are common and still work well, but if the usage is still this heavily (95%) skewed towards paper, there might be need for a massive effort to be invested in incentivizing and re-educating the users to improve adoption.
In reply to Chamberlain Nwanne

Re: Before We Begin: Information Challenges in Your Setting

by Purshottam Hoovayya -
One significant challenge in our organisation is the transition from paper-based Medical records to integrated electronic health record (EHR) workflows. In a busy tertiary care hospital environment, this often leads to resistance, duplication of documentation, communication gaps, and inadequate appreciation of the importance and potential of EHRs and digital health systems. I hope this course will help me better understand how patient information can be captured, documented, and shared efficiently through well-designed electronic workflows. I am also keen to learn the science of implementation, including change management, user adoption, workflow redesign, and strategies for successfully integrating digital health solutions into routine practice. Ultimately, I aim to improve the quality, accessibility, and use of patient information for patient care, quality improvement, and organisational decision-making.
In reply to Purshottam Hoovayya

Re: Before We Begin: Information Challenges in Your Setting

by Chamberlain Nwanne -
Hi Purshottam,
The clean transition of paper records to an integrated electronic health records system is the ideal. But in a busy tertiary care hospital environment as you mentioned, that doesn't always happen smoothly because you have to factor in disruptions in patient care, user resistance in learning a completely new system and loss of revenue during the learning phase. There can be a hybrid coexistence of paper and electronic workflows as an temporary phase.
In this course we hope to cover areas such as the using EHRs to improved workflows, completing documentation and improving patient safety. Areas such as change management and organizational decision making are however, beyond the scope of this course.
In reply to Chamberlain Nwanne

Re: Before We Begin: Information Challenges in Your Setting

by Aromolaran Precious Adebisola -
In my organization, a significant challenge is the fragmented communication of patient information during shift changes and interdepartmental transfers. This lack of standardized handoff reporting often leads to duplicated documentation efforts and increases the risk of omitting critical patient details. Based on the course overview, I hope to learn actionable strategies and best practices for implementing standardized communication frameworks to bridge these information silos. Ultimately, I aim to apply these insights to streamline our record-keeping processes, reduce communication errors, and enhance overall patient safety.
In reply to Aromolaran Precious Adebisola

Re: Before We Begin: Information Challenges in Your Setting

by Chamberlain Nwanne -
Hi Precious,
Fragmented communication is a major challenge in many health centers. When patient information is not passed clearly from one provider, shift, or department to another, important details can be misunderstood or completely missed. One major value of standardized documentation is that everyone records information in the same way, making it easier to find and trust.
A practical strategy is to use a structured handoff template so that key patient information is consistently shared during every transition of care. The design, development and implementation of such a template might be an excellent capstone project idea.
In reply to Chamberlain Nwanne

Re: Before We Begin: Information Challenges in Your Setting

by Janiel Johnson -
A significant challenge in my organization is the lack of interoperability between internal case management documentation systems and external VA electronic health record platforms, creating gaps in real-time information sharing across care teams. As a Healthcare Navigator in a transitional housing program, I frequently coordinate veteran healthcare needs across multiple providers and systems, yet documentation updates from outside providers are often delayed or unavailable within our workflow. This fragmentation increases the risk of incomplete navigation plans and missed follow-up actions, particularly for veterans managing multiple chronic conditions requiring coordinated care. I hope this program, particularly the courses in Health Data Standards and Interoperability and EHRs and Health IT Systems, will deepen my understanding of how integrated digital health systems can bridge these communication gaps. Ultimately, my goal is to apply these competencies to strengthen care coordination workflows and improve health outcomes for the veterans I serve.
In reply to Janiel Johnson

Re: Before We Begin: Information Challenges in Your Setting

by Chamberlain Nwanne -
Hi Janiel,
I hear you about the lack of interoperability between internal systems and organization EHRs. When information from one healthcare system cannot be easily seen or used in another system, care teams may not have the complete picture they need to support patients/clients. Interoperability should be a primary consideration in the selection and use of any health system. Most certified EHRs support many of the interoperability standards like HL7, FHIR etc.
I have worked with 3rd party case management applications such as WellSky CarePort Transition 2, which was fully embedded in our EHR in a seamless transparent way. Is that an option at your organization?
In reply to Chamberlain Nwanne

Re: Before We Begin: Information Challenges in Your Setting

by Janiel Johnson -
Hi Dr. Chamberlain,

Thank you for that insight and for sharing your experience with WellSky CarePort Transition 2. That level of seamless EHR integration sounds incredibly efficient. In my organization, we use MCR as our internal platform for all patient data documentation, while HMIS serves as our external reporting platform. The challenge is that HMIS only captures a portion of what is documented in MCR, meaning the VA does not have visibility into the full scope of services and interventions being provided. This year will be my first audit cycle, so I am still developing a deeper understanding of how these two systems interact and where the gaps exist. Much of my workflow knowledge has been self-taught on the job, which makes this course especially valuable as I work to build a more formal informatics foundation to better understand interoperability standards and how they can be applied to improve information sharing across platforms.
In reply to Janiel Johnson

Re: Before We Begin: Information Challenges in Your Setting

by Chamberlain Nwanne -
I think a lot of the concepts and topics we have learnt (and will learn) provide a better understanding of how you can help improve your workflow. I'm not familiar with your workflow and its intricacies as a Navigator, but I'm quite conversant with case and utilization management. I do know though that there is a fair amount of overlap between the 2 roles so please feel free to bounce questions or ideas off me, if you need to.
In reply to Chamberlain Nwanne

Re: Before We Begin: Information Challenges in Your Setting

by Janiel Johnson -
Thank you, Dr. Chamberlain. I will keep that in mind.
In reply to Chamberlain Nwanne

Before We Begin: Information Challenges in Your Setting

by Salimonu Hammed Akinkunmi -

Currently, my organization is witnessing the transition from paper-based documentation to electronic health records. 

The main challenge I observed is the inconsistent and incomplete patients' data in electronic health records due to poor adoption and integration of electronic health records among the healthcare personnels.

I look forward to learning the efficient ways to foster the smooth transition into and integration of electronic health records to ensure complete and consistent patients' data to improve treatment outcomes.

In reply to Salimonu Hammed Akinkunmi

Re: Before We Begin: Information Challenges in Your Setting

by Chamberlain Nwanne -
Hi Salimonu - Please can you share what EHR your organization is transitioning to?
I can relate to the challenge of inconsistent data entry in the EHR. Users may get by with the minimal documentation but there are huge downstream impact of that lack of completeness. For example, external referrals that should seamlessly populate patient info from the EHR come up as incomplete because the foundational data are not there in the first place. Also, reporting and data analytics become almost impossible.
We should encourage users to document on ALL necessary fields, and not just the mandatory ones.
In reply to Chamberlain Nwanne

Re: Before We Begin: Information Challenges in Your Setting

by Salimonu Hammed Akinkunmi -

Thank you, Dr Chamberlain.

My organization is transitioning into a national EHR tagged 'Health in a box '.

I agree with you; due to low digital literacy and poor digital resilience , users may not deliberately complete the non mandatory fields. 

Moreso, the data sometimes is inconsistent because of inadequate integration of standardized tools into EHR.

In reply to Chamberlain Nwanne

Re: Before We Begin: Information Challenges in Your Setting

by Olatunde Olaniyi Abiodun Oluwafemi -
My institution's key challenge is interoperability between the laboratory and the hospital's electronic medical record platform. This leads to delays in clinical decision-making, the quality of care, and overall patient outcomes for the hospital. This interoperability gap affects the patient journey across the various healthcare units in the hospital. My knowledge of EHRs and HIT systems through platforms like OpenMRS will help address this challenge holistically. This will reduce report turnaround time, enhance healthcare coordination, and improve patient outcomes through a smooth information and documentation protocol workflow.
In reply to Olatunde Olaniyi Abiodun Oluwafemi

Re: Before We Begin: Information Challenges in Your Setting

by Chamberlain Nwanne -
Hi Olatunde - Is the lab at your institution on an Laboratory Information System (LIS) too? Or still paper based?
The system interoperability challenges come in many flavors and may not necessarily be due to lack of ability to connect fragmented systems and data silos.
A major barrier that I've seen is where the different systems run proprietary software and are provided by different vendors. In many cases, this mean that the level of customization that the vendors allow is limited. This limits how much you can modify the EHR and LIS in order to effectively talk to each, even when they are connected..
In reply to Chamberlain Nwanne

Before We Begin: Information Challenges in Your Setting

by Dr Aminu Bello Liman -

My institution is currently transiting from paper-based records to EHR. One major challenge we face is occasional electricity failure and network glitches. The frustration and delays necessitate documentation in physical case files and lost of data flow in the EHR. Staff are not motivated to enter the previous paper documentations into EHR when available. During this course, I hope to gain insights into how these challenges can be tackled in LMIC.

In reply to Dr Aminu Bello Liman

Re: Before We Begin: Information Challenges in Your Setting

by Chamberlain Nwanne -
Hi Aminu - Lack of infrastructure (sporadic power, aged hardware) as you mentioned at very typical retardants to successful EHR implementation in LMICs. But with a little bit of creativity helps smoothen out some of these wrinkles. For instance, for electricity solar power equipment (panels, inverters and storage batteries) can be deployed. The initial start up cost may be a bit higher, but the ROI is pretty decent over time.
Knowing that implementations have steep learning curves (which is stressful to people) and also mean less time for staff to do their jobs, I understand why staff may be reluctant to document twice on paper and then EHR. In such situations, I advise hiring temporary dedicated data entry staff who manually type in the paper records into the EHR. And then scan the paper into a repository as a back-up.
In reply to Chamberlain Nwanne

Before We Begin: Information Challenges in Your Setting

by Emelike Prince Samson -

A major challenge we face in our primary health center in our rural areas is the poor documentation and management of patient health records. Most Primary health care facilities still rely on paper based records, which are often incomplete, difficult to retrieve, vulnerable to loss or damage, and prone to errors. This affects continuity of care, delays clinical decision making, and compromises the quality of health data used for reporting and planning.

In reply to Chamberlain Nwanne

Before We Begin: Information Challenges in Your Setting

by Salako Omolabake Fathiat -

I think a major issue remains the fragmentation of data, especially as it results in time toxicity in cancer care. Every unit seems to use the EHR differently and the lack of uniformity in EHR practice ultimately affects the patients' care cycle negatively. I would love to learn on how to mitigate this and improve patients' care journey.