JMIR Publications

ABSTRACT

The Yaoundé Central Hospital (YCH), located in the capital of Cameroon, is one of the main referral hospitals in the country. The hospital has several departments, including the Department of Gynecology-Obstetrics (maternity). This clinical department faced numerous clinical information management problems: lack of quality and reliable clinical information, lack of access to this information and poor use of this information. To implement a clinical information system (CIS) at the YCH Maternity and to describe the challenges, success factors and lessons learned during its implementation and use. Based on an open-source hospital information system (HIS), this intervention consisted of the implementation of a CIS in the YCH Maternity and was carried out using the HERMES model. The first phase aimed to cover outpatient consultations, billing and cash management of the maternity. This project was supported by HUG and several outcomes had to be measured at the end. Results and Discussion: Implementation of HIS or CIS is feasible in our context. The first phase of the project was completed. The main technical activities were the adaptation of the open source HIS to manage outpatient consultations and the development of the integrated billing and cash management software. In addition to technical aspects and human resources, good planning, commitment of stakeholders and skills in change management are critical to increase chances of success. In this project we implemented several other aspects such as: the organization and marketing of the project, the involvement of all stakeholders, the improvement of clinical and administrative processes in the maternity, change management, sensitization, training and support of users. Despite barriers encountered during the project, this CIS was deployed in the maternity of YCH and used effectively by users during the first six months. After the end of the first phase, users stopped entering data. Beyond the technical and financial limits, the real problem of implementing information systems in Africa lies in leadership, governance and change management. We need a leadership and a governance that prioritizes data as a tool for improving productivity and managing our institutions. This leadership and governance must also promote a data culture among health professionals to support the change of mindset and the acquisition of information management skills (collection, processing, discussion, and use).