Over the years, Ghana has sought to digitalize the health sector database, beginning with the adoption of a National eHealth Strategy in 2010, which rolled out the plan to implement an Electronic Health Record (EHR) system in major government hospitals.

The digital platform enabled healthcare facilities to store, manage, and share patient information electronically, overseen by the Ghana Health Service (GHS).

The system provides doctors, nurses, and other healthcare providers the efficiency to access and share patient data, lab results, medical histories, and treatment plans.

The 38-year-old Prince Amoah visited the KNUST Hospital to receive his regular care.

As a patient who has used the facility for over seven years, often dreaded his hospital visitations, recounting times his paper tests were often misplaced or torn.

Any new doctor he encounters has to rely on his verbal recount of his medical records or he is compelled to undergo a new test.

"I have been compelled to repeat tests because I couldn’t access the results. On some days too I leave it home. It was exhausting," he said.

Promise of Lightwave Health Information Management System

In 2018, the Lightwave Health Information Management System was formally commissioned as an e-health platform rolled-out in public hospitals in Ghana to help healthcare providers manage patient data and records for improved patient care and healthcare delivery.

The LHIMS, developed by Lightwave E-Healthcare Solution Limited, is a web-based software platform, assisting health care delivery and administrative functions.

LHIMS is used for patient records, appointment and planning, laboratory management, radiology, alerts and communication, improving patient data continuity.

The System is also used for National Health Insurance Authority (NHIA) claims.

Learning about the LHIMS in use at the KNUST, Mr Amoah is seemingly satisfied with how smoothly he is asked to move from one department to the other without waiting to access test results in sheet forms.

"I am not given any sheet to keep when I return from the lab. They just tell me to see the doctor. I will get there, and it seems my records are instantly accessible," he said.

The LHIMS has both clinical and administrative uses, providing a lifeline accessibility.

HopeXChange Medical Centre, operating under the Catholic Health Service of Ghana, is reaping the tangible benefits of the LHIMS.

Medical Director at the facility, Dr. Akosua Frimpomaa Amoateng, speaks unreservedly about its impact and its support to departments in retrieving clinical outcomes instantly.

“The introduction has helped enhance patient care by reducing maneuvers and increasing productivity. LHIMS' information is stored on the server and it can be kept more efficiently and safely as compared to using the paper system. The LHIMS also helps make it easy for results from support departments like diagnosis and labs to be easily assessed.

“We have the electronic medical record session and the administrative use covers areas like procurement and finance that's able to help the hospital improve management of its support services. Because of how data is kept, you have easy access to patient data for research and that can be used to improve clinical outcomes,” she said.

The Challenges of a Digital Leap

Despite the promised digital innovation, LHIMS is not a perfect panacea.

The visible lack of full interoperability across public and private hospitals, coupled with non-existing user feedback mechanism, and limited integration with systems like Picture Archiving and Communication (PACS) for external records, is delimiting its seamless functionality.

Patients like Mr. Amoah seeking prompt and specialized services stand at potential crossroads at the tail end of the transformation.

The functionalities of the Lightwave Health Information Management System have not always been smooth as recounted by Dr. Amoateng.

Mr. Amoah has also felt the system's limitations recounting a similar incident of being told to wait close to an hour for network issues to be resolved.

“After the test, the screen just froze. So the nurse told me to wait. I asked how long, and she couldn’t tell the time. So I waited until it came back, and that was almost an hour,” he said.

Network reliability is a persistent issue compelling Hope XChange to rely on a backup local area network (LAN).

“There are network issues. LHIMS comes with this WLAN network but it's not always reliable. Sometimes, it is not reachable. For Hope X Change, we currently rely mostly on our system Local Area Network for support or backup,” Dr. Amoateng said.

Technical hitches and operational delays are creating difficulties to materialize the support from the LHIMS.

The system is marred with half-functioning integration of results transmission.

“A laboratory analyzer has not been fully integrated. It's been done by it's not being successful. Laboratory data will not have to be manually entered into the LHIMS.

“When the integration is done, the analyzer would be able to transmit the data straight to the LHIMS. And that will reduce the human interface involved and it will reduce errors,” Dr. Amoateng says, disclosing that the intention of minimizing human error and saving time is not fully achieved.

A critical concern in a field where precision is a thin line holding life and death, is the occasional failure of LHIMS to match the reliability of raw data.

“There are also some issues with a question of some of the reports that are generated from the LHIMS. So you generate a report, compare it to the data, and might not be as accurate as you'd want it to be. So those are the challenges that we've had or the issues we've had with the functionalities of LHIMS,” Dr Amoateng said.

The Vision for Improvement

There has been adequate envisioning between users and beneficiaries of the platform - nurses, doctors, data departments of hospitals, and even patients for a robust system.

The user adaptability of the platform comes into discussion, as Dr. Amoateng suggests an in-built feedback mechanism to encourage providers and users to flag problems and ensure purposeful usage.

She discusses additional features that can refine the functionalities of the platform.

“When we have challenges, we keep them to ourselves. LHIMS should incorporate user feedback to realize the issues and the areas of lack. There’s also no picture archive and communication, thus, a PAC system integrated into the LHIMS. That will be very useful for clinicians. Patients may access services but come with external labs, and external investigations. We need to be able to attach these for future use,” she said.

With such features to create a more holistic view of patient history, the system will improve care and satisfaction, says Bernard Kwabena Ohene, a health seeker at the Kumasi Cocoa Clinic.

“I believe a resilience system like this can even make us feel like visiting hospitals. Fact that I have no long queues, no delays, I would be hopeful of getting treatment fast,’ he said.

The shortcomings of the platform are solvable.

The Medical Director, Dr. Akosua Frimpomaa Amoateng, is advocating for regular refresher courses and hands-on workshops for hospital staff, to troubleshoot the setbacks.

She stressed the need for a more robust infrastructure, with sporadic training on the Lightwave Health Information Management System usage.

“There would have to be comprehensive training programs for the staff aside the one done during the implementation. The initial training, some staff were not available, new staff have been recruited. Apart from that, there are new areas which are added or upgrades made to the LHIMS periodically. And if training is not done, medical staff are not aware of these areas, and they are not able to effectively utilize the LHIMS.

“You need a hands-on workshop so that you are able to use the LHIMS and be able to point out the difficulties that you have with the engineers involved in the LHIMS metric and with that you will be able to give them feedback,” she said.

The stakes are high for Ghana, as a nation showing dedicated signs of transformative digital landscape into modernity, and reward would be higher if digital systems are improved.

The Lightwave Health Information Management System is a testament to a foundation for healthier, equitable and patient-centered care. And that reward must not be forfeited.

This report is produced under the DPI Africa Journalism Fellowship Programme of the Media Foundation for West Africa and Co-Develop.