PIH Rolls Out Electronic Medical Records at J.J. Dossen Hospital in Liberia

Partners In Health-Liberia has implemented electronic medical records at J.J. Dossen Hospital in Maryland County, enabling efficient registration and digital access to patients’ medical histories as part of PIH’s multi-country effort to streamline how health information is collected, stored, and utilized.  

The July launch of an electronic medical record (EMR) system for J.J. Dossen includes the hospital's non-communicable disease clinic, outpatient department, and mental health services, with impacts that already are significantly improving health care delivery for the hundreds of patients who visit the PIH-supported facility every day.

The EMR system is replacing cumbersome paper records. As it expands across the hospital in coming months, the system will enhance workflows for areas including triage, laboratory work, pharmacy services, and prenatal clinics. 

The phased rollout will enable each department to learn from others, building an integrated records system that improves as it expands.

The system, called OpenMRS, is an open-source project co-developed by PIH in 2004 and now used by more than 100 PIH-supported facilities around the world, along with several governmental and partner organizations. PIH Sierra Leone, for example, announced its OpenMRS launch earlier this year.

PIH Liberia Director of Clinical Education and Child Health Dr. Rebecca Cook noted that having the EMR system at J.J. Dossen will enable health providers to enter vital signs, lab results, prescriptions and other diagnostic details during patient appointments, and will further PIH’s goal of establishing Maryland as a model county for Universal Health Coverage in Liberia.

Maryland County health officer Dr. Methodius George and J.J. Dossen medical director Dr. Kolu Davies, both Ministry of Health employees, commended the new EMR system at an event celebrating the launch. 

Emmanuel Debah, supervisor of the outpatient record room at J.J. Dossen, said that before the implementation of electronic records, he and his team manually retrieved charts for patients who visited the hospital. After a patient’s visit, his or her chart would be returned to the record room for storage on packed shelves.  

Debah said the process was tedious and time-consuming, and added that it sometimes did not allow staff to complete all entries for a patient’s records, because of the high volume of patients.

“Predominantly patients suffering from malaria, diarrhea and acute respiratory infections are the ones who visit the facility, and due to the workload, we are unable to complete entries and when the patient re-visits, it becomes difficult to refer (to their records),” he said. “We have been advocating for a solution and now that we have the EMR, our problems have been solved.”

Patients at J.J. Dossen now receive a card with their bio data, a serial number, and a barcode, which hospital staff scan to access the patient’s medical records. 

Joseline Toomey, a Maryland County resident, recently brought her 10-month-old son to the hospital because he was suffering from diarrhea. She said her first experience with the EMR made the visit much faster.

“I was worried I would spend the usual long hours to get checked in today, and end up spending half a day just to get my son diagnosed and given treatment,” she said. “But with this new system in place, my visit has been without any problems, and very fast and convenient.”

Better data, better care

Cyrus Randolph, PIH physician assistant for non-communicable diseases, said electronic records will also help his team provide integrated primary care, as comprehensive records for multiple ailments will be more easily accessible.  

Through mentorship from PIH’s monitoring, evaluation and informatics teams, seven staff from PIH and the government’s Maryland County Health Team have been trained to use the EMR, enabling clinicians to quickly access the medical records of more than 5,500 patients registered to date.

The effort is part of PIH’s global effort to improve data systems to better serve patients and communities and better inform health care delivery, policy, and advocacy, with sustained support from the Wagner Foundation and the multi-year Building Impact Grant.

Dr. Emma Boley, health monitoring, evaluation, and informatics lead for PIH in Liberia, said teams soon will roll out the EMR system in other PIH-supported facilities in Liberia.

“As we roll out the system, we will continuously support hospital staff with training on how to transport old records on paper onto the electronic system, in order to completely go paperless,” she said.