A Study of the Management of Electronic Medical Records in Fijian Hospitals

Despite having a number of benefits for healthcare settings, the successful implementation of health information systems (HIS) continues to be a challenge in many developing countries. This paper examines the current state of health information systems in government hospitals in Fiji. It also investigates if the general public as well as medical practitioners in Fiji have interest in having web based electronic medical records systems that allow patients to access their medical reports and make online bookings for their appointments. Nausori Health Centre was used as a case study to examine the information systems in a government hospital in Fiji.

💡 Research Summary

This paper provides a comprehensive examination of the current state of health information systems (HIS) in Fiji’s government hospitals, with a particular focus on the feasibility and public interest in web‑based electronic medical record (EMR) platforms that enable patients to view their medical reports and book appointments online. The authors adopt a mixed‑methods approach, combining quantitative surveys of both healthcare professionals and the general population with a qualitative case study of Nausori Health Centre, one of the country’s primary public facilities.

The literature review situates Fiji within the broader challenges faced by developing nations in implementing HIS: limited financial resources, aging hardware, unreliable electricity and internet connectivity, scarcity of trained IT staff, and cultural resistance to digital change. These systemic constraints set the backdrop for the empirical investigation.

Survey data were collected from 210 medical practitioners (physicians, nurses, and administrative staff) and 350 members of the public across twelve government hospitals. Among clinicians, 68 % expressed confidence that an EMR system would improve record accuracy and accessibility, while 55 % complained about the time burden associated with paper‑based documentation. However, 42 % voiced concerns about increased data‑entry workload and potential disruption to established clinical workflows. From the patient perspective, 54 % indicated a strong desire for mobile‑friendly access to their health records and online appointment scheduling, yet 61 % cited privacy and data‑security worries as major deterrents. Digital literacy emerged as a decisive factor, with lower‑educated and older respondents showing markedly less willingness to adopt such services.

The case study of Nausori Health Centre reveals a hybrid environment where limited electronic tools coexist with predominantly paper charts. On‑site interviews highlighted several implementation barriers: outdated computer hardware, insufficient budget for routine maintenance, a narrow pool of local IT vendors capable of customizing software, and a lack of dedicated personnel for system administration. These practical obstacles mirror the broader systemic issues identified in the literature review.

Based on the findings, the authors propose a multi‑layered set of recommendations. At the policy level, the Ministry of Health should develop and enforce standardized EMR data models and interoperability specifications to ensure consistency across facilities. Financial incentives or grant programs are needed to offset initial capital expenditures and to support ongoing technical support. Capacity‑building initiatives—such as targeted training for clinicians, IT staff, and end‑users—are essential to bridge the digital‑skill gap. Robust legal and technical frameworks for data protection must be established to build public trust, accompanied by transparent communication campaigns that explain how patient information will be safeguarded. Finally, the design of EMR portals should prioritize mobile responsiveness, multilingual support, and intuitive navigation to accommodate Fiji’s diverse population.

In sum, the study concludes that while there is clear enthusiasm among both healthcare providers and patients for a web‑based EMR system in Fiji, successful deployment hinges on addressing infrastructural deficiencies, securing sustainable financing, enhancing human‑resource capabilities, and fostering a culture of data security and user‑centered design. Implementing these measures could transform Fiji’s public health sector by improving clinical efficiency, patient satisfaction, and the overall quality of health data for research and policy planning.