title: Designing and implementing an electronic health record system in primary care practice in sub-Saharan Africa: a case study from Cameroon.
abstract: OBJECTIVE
  To review the key issues related to the design and implementation of an electronic health record (EHR) system in urban primary health care (PHC) practice in Cameroon.
  
  
  METHODS
  The goal of the project was to assess EHR as a tool to improve providers' performance, quality and continuity of care, and the availability of data in PHC practice in Cameroon. A locally designed EHR system called MEDCAB was developed. The system was based on the International Classification for Primary Care (ICPC) and was designed taking into consideration the PHC practice environment in Cameroon. An original cohort of 14 users was involved in the experiment.
  
  
  RESULTS
  Users generally showed good acceptance of the system. Monitoring the use of the system at the early stages of implementation was important to ensure immediate response to users' comments and requests. Some of the key issues identified during the development and implementation of the system were: user involvement, the choice of an appropriate terminology, pre-existing data collection culture and leadership issues. Some positive achievements brought about by the system included promotion of good medical practice and routine availability of consultation data.
  
  
  CONCLUSIONS
  Strengthening the medical record in general, and the EHR in particular, could contribute to its position as a valuable source of information for healthcare delivery, public health and policy making in Cameroon. Challenges to adoption are huge and successful implementation for any specific setting will require a comprehensive modelling of the local medical practice, the choice of an appropriate terminology and a co-ordinated approach involving all stakeholders.
authors.affiliation: Division of Operational Research, Ministry of Public Health, Yaoundé, Cameroon. raoul.kamadjeu@gmail.com
authors.forename: Raoul M
authors.initials: RM
authors.lastname: Kamadjeu
authors.forename: Euloge M
authors.initials: EM
authors.lastname: Tapang
authors.forename: Roland N
authors.initials: RN
authors.lastname: Moluh
mesh_terms: D017954:Africa South of the Sahara; D001292:Attitude to Computers; D002163:Cameroon; D015331:Cohort Studies; D003266:Continuity of Patient Care; D003625:Data Collection / Q000295:instrumentation; D003906:Developing Countries; D004526:Efficiency; D005240:Feasibility Studies; D006284:Health Plan Implementation; D006801:Humans; D038801:International Classification of Diseases; D016347:Medical Records Systems, Computerized / Q000295:instrumentation*; D011320:Primary Health Care / Q000458:organization & administration*; D011785:Quality Assurance, Health Care; D014504:Urban Health