Insights, Issues and Challenges of Applying DBMS in Hospitals Within Developing Countries

Developing countries often face challenges in applying technology projects at the local level. This is particularly relevant to projects related to health services, such as hospital systems, since any implemented service is likely to directly affect citizens or patients. This paper reports on an investigation capturing insights from people working at hospitals in developing countries that have undergone a transition from a paper based system to the implementation of a Database Management System (DBMS). Most rural hospitals in Nigeria still use paper as a means of creating patient records manually. One such hospital, Sapele General Hospital is considering moving towards a DBMS and is used as a case study to capture the challenges, opportunities, issues and concerns of people working at a hospital considering implementing a DBMS. The paper is informed by a literature review covering relevant previous DBMS implementations in hospital systems and the challenges they faced. It is also informed by interviews and surveys of both people working at hospitals in developing countries that have implemented a DBMS and people from the case study considering such an implementation. The paper provides various contributions. First, it provides insights and guidance on issues, benefits, challenges and practical considerations in moving from a paper based hospital records system to an electronic system - informed by previous implementations - and which can be used to inform similar hospital implementations of DBMSs. Secondly, it provides insights on current concerns and challenges that hospitals face in moving from paper based systems to electronic DBMSs. It will further capture a balanced perspective on some of the likely benefits and challenges in implementing a DBMS within the context of developing countries.