To digitise a hospital in West Africa, start with an assessment of your patient flow and your infrastructure, then computerise first the steps every patient goes through: identification at reception and payment at the cash office. Patient records, pharmacy, laboratory and inpatient care come next, following a written roadmap shared by the whole management team.
Key takeaways
- Digitisation is an organisational project before it is an IT project.
- First workstream: an assessment of patient flow, registers and power and network infrastructure.
- First module: reception and the cash office, which involve every patient and protect revenue.
- Move in phases, with a clear sign of success for each one.
- Train each role on its own tasks and appoint champions in each department.
Why “where to start” is the decisive question
Many projects fail because they try to computerise everything at once, or because equipment is bought before workflows are clarified. Staff then end up with a tool that does not match their real work.
Example: a district hospital installs computers in every department without deciding who enters what. A few weeks later, nurses are filling in both the register and the screen, then quietly go back to the register alone.
Step 1: assess the current situation
The assessment describes what really happens, not what the organisation chart says. It covers five points:
- the patient journey, from arrival to discharge, department by department;
- the list of registers, cards and forms in use, with what each one contains;
- pain points: queues, missing files, cash discrepancies, stock-outs;
- infrastructure: power supply, UPS units, generator, local network, internet connection;
- staff digital skills, by role.
To map the journey, use our method to streamline patient flow in hospital. Example: by following a patient from antenatal consultation to the cash office, a clinic in Kumasi discovers that her identity is copied into four different registers.
Step 2: lay the foundations
Governance
Set up a steering committee with management, the medical director, the finance manager and a nursing representative. Appoint an internal project lead who is available and respected, and a champion in each department.
Infrastructure
Secure power for computers and network equipment before go-live, with UPS units and a backup source. Plan regular backups and, if possible, two internet connections from different providers.
Master data
Gather the list of services and tariffs, the catalogue of medicines and consumables, the insurers, NHIS or HMO schemes you work with, and the list of users with their roles. Example: a tariff that varies by HMO should be approved by management before it is entered, not during the first day at the cash office.
The roadmap to digitise a hospital, phase by phase
The order below suits most facilities. Each phase builds on the previous one.
| Phase | Scope | Why at this point | Sign of success |
|---|---|---|---|
| 1. Reception | Registration, identification, appointments, queue | Every patient goes through it | Each patient has a single record |
| 2. Cash office | Services, payments, insurance cover | Protects revenue from the start | Cash closing without unexplained differences |
| 3. Patient record | Consultations, history, prescriptions, reports | Requires reliable identification | Doctors view patient history on screen |
| 4. Pharmacy and laboratory | Stock, batches, expiry dates, test requests and results | Links prescriptions, tests and consumption | Results arrive in the patient record |
| 5. Inpatient care and management | Admissions, beds, transfers, discharges, dashboards | Needs stable earlier modules | Management follows activity and revenue without re-entry |
The order can be adapted. Example: a clinic whose pharmacy is its main source of losses can bring phase 4 forward. What matters is not to start a phase before the previous one is stable. For phase 3, follow our method for moving from paper registers to electronic patient records.
Supporting your staff
Resistance is normal: people fear losing time or being monitored. It fades when staff see a concrete benefit in their own work.
- Present the project to each department, with its reasons and timetable.
- Train by role, on real cases, just before go-live.
- Have champions on the floor during the first days.
- Keep the period of double entry on paper and software short.
- Collect difficulties every week and adjust the settings.
Example: a midwife who has kept her register for years will accept change more easily if she sees that the software saves her from copying the same data for the monthly report. Our advice on training staff on new hospital software covers this step in detail.
Measuring progress
Choose a few simple indicators, measured before go-live and then every month:
- the proportion of patients registered in the software;
- the number of duplicate records detected;
- differences found at cash closing;
- the time needed to produce the monthly report for the district or for DHIS2;
- stock-outs discovered at the last minute.
Example: if the monthly report took several days of counting before the project, measure how long it takes three months after go-live.
MediFlow and your roadmap
MediFlow moves at the pace of this roadmap: attendance, on-call duty and stock, already available, support the first steps, those concerning team organisation and stock.
The platform, in development, is gradually adding smart medical follow-up, pharmacy, laboratory, inpatient care and billing, to support the next phases in the same tool.
Frequently asked questions
Should we computerise everything at once or go step by step?
In most cases, step by step. Going live in every department at the same time piles up problems simultaneously and wears staff out. Each phase should be stable before the next one starts.
Do we need to hire an IT officer before digitising the hospital?
Not necessarily full time. Above all you need an internal project lead and someone, staff or contractor, who can manage computers, the network and backups. This role must be clearly assigned before go-live.
What should we do with the old paper registers?
Keep them, filed and protected, according to the archiving rules that apply to your facility. Only transfer into the software the information needed to follow current patients, and leave the rest available on paper.
Want to see how MediFlow fits your facility? Request a free demo.
