Standards and Guidelines for Electronic Medical Record Systems in ...

· The infrastructure requirements – hardware, networking, and Internet connectivity are
some examples of infrastructure requirements that need to be considered
· The vendor agreement – some vendor systems will come with a support agreement.
EMR implementations may adopt either a data clerk centered approach (retrospective data entry)
or a clinician centered approach (point of care systems). Both approaches will have different HR
requirements in terms of numbers of staff and their skill levels.
It is best practice to quantify HR requirements for EMR installations based on competencies and
well-defined roles and responsibilities. It is also noted that within resource-constrained settings,
one staff may assume multiple roles relating to an EMR installation.
3 general categories of staff have been identified for successful implementation and operation of
EMR systems:
1. Facility based users who are responsible for collecting, entering, and reporting health data
using the EMR system;
2. Higher level managers who use information collected and stored in the EMR system for
service delivery and resource management decisions, and
3. IT / system developers and administrators who develop and maintain hardware and EMR
software as well as provide general user support.
Required Competencies for a Functional EMR System
Defining the minimum recommended competencies for these three staff groups (facility-based
users, higher-level managers and IT/system developers and administrators) to use and support an
EMR system is critical to the success of an implementation. However, few training programs in
developing countries comprehensively identify or address health informatics competencies for any
of these cadres. 25 Experience from various developed countries indicates that some health
information system and EMR system competencies apply across all three cadres, while other
25 Hersh, W, Margolis A, Quirós F, and Otero P. Building A Health Informatics Workforce In Developing
Countries. Health Affairs, Supplement 2010; 29(2): 274-277.
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