UGANDA COLLEGE OF COMMERCE – SOROTI

THE EFFECTS OF ELECTRONIC RECORDS MANAGEMENT ON ORGANISATION

PERFORMANCE; CASE STUDY OF SOROTI REGIONAL REFERRAL
HOSPITAL (SRRH), SOROTI DISTRICT, UGANDA

BY;

APIO ANNA EVERLINE

UBB032/2018/B/D/A/429

A RESEARCH REPORT SUBMITTED TO UGANDA BUSINESS AND TECHNICAL

EXAMINATIONS BOARD (UBTEB) IN PARTIAL FULFILLMENT OF THE
REQUIREMENT FOR THE AWARD OF DIPLOMA IN RECORDS AND
INFORMATION MANAGEMENT (DRIM)

JUNE 2020

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DECLARATION

I, APIO ANNA EVERLINE declare that this my original work and has not been presented by
anyone for academic purposes, hence all rights reserved thereupon.

Signature: _________________________ Date: _____________________

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APPROVAL

This research report has been submitted with my approval as the Research Supervisor.

Signature: _________________________ Date: _____________________

MR. ............................
UGANDA COLLEGE OF COMMERCE – SOROTI

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DEDICATION

I dedicate this report to God Almighty, who has helped me good health during my academics, then,
my family including; my husband (....................) and my children (..................................), my
parents for their support in various areas, also, my lecturers for their knowledge and my supervisor
for his dedicated support towards the completion of this report and not forgetting my friends and
course comrades at Uganda College of Commerce – Soroti.

May God bless you all.

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ACKNOWLEDGEMENT

Let me take this opportunity to thank all the persons who in one way or the other contributed
towards the success of this research project.

First of all, I wish to thank the Almighty God for his sufficient grace and mercies for the gift of life
and for having granted me good health in my whole life and throughout my studies.

Secondly, I would like to thank my supervisor for the support, guidance and encouragement
throughout until the completion of my research project.

Thirdly, thanks to the management and staff of Soroti Regional Referral Hospital (SRRH) who
have pledged total cooperation and to avail information necessary to the completion of my
research project.

Lastly, I wish to take this opportunity to thank those people who directly or indirectly contribute to
the success of my academic endeavours.

May the Almighty God bless them all abundantly.

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TABLE OF CONTENTS
Declaration;-----------------------------------------------------------------------------------------------------ii
Approval;--------------------------------------------------------------------------------------------------------iii
Dedication;------------------------------------------------------------------------------------------------------iv
Acknowledgement;---------------------------------------------------------------------------------------------v
Table of contents;----------------------------------------------------------------------------------------------vi
List of tables;--------------------------------------------------------------------------------------------------viii
List of acronyms;-----------------------------------------------------------------------------------------------ix
CHAPTER ONE: INTRODUCTION AND BACKGROUND-------------------------------------------1
1.0 Introduction----------------------------------------------------------------------------------------------1
1.1 Background of the Study------------------------------------------------------------------------------1
1.2 Statement of the Problem------------------------------------------------------------------------------3
1.3 Purpose of the Study------------------------------------------------------------------------------------3
1.4 Specific Objectives of the Study----------------------------------------------------------------------3
1.4.1 Main Objective------------------------------------------------------------------------------------------3
1.4.2 Specific Objectives--------------------------------------------------------------------------------------4
1.5 Research Questions-------------------------------------------------------------------------------------4
1.6 Significance of the Study------------------------------------------------------------------------------4
1.7 Scope of the Study--------------------------------------------------------------------------------------4
1.7.1 Content Scope-------------------------------------------------------------------------------------------4
1.7.2 Geographical Scope------------------------------------------------------------------------------------5
1.7.3 Time Scope-----------------------------------------------------------------------------------------------5
1.9 Limitations of the Study--------------------------------------------------------------------------------5
CHAPTER TWO: REVIEW OF RELATED LITERATURE-------------------------------------------6
2.0 Introduction----------------------------------------------------------------------------------------------6
2.1 Key Concepts---------------------------------------------------------------------------------------------6
2.1.1 Records Management----------------------------------------------------------------------------------6
2.1.2 Records---------------------------------------------------------------------------------------------------6
2.1.3 Automation-----------------------------------------------------------------------------------------------7
2.1.3 Management---------------------------------------------------------------------------------------------8
2.1.4 Performance---------------------------------------------------------------------------------------------8
2.1.5 Electronic Records--------------------------------------------------------------------------------------8

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2.2 Need for Records Management in a Service Organization--------------------------------------9
2.2 Extent to Which Records Management Contribute To Performance-------------------------11
2.3 Impact of Electronic Record Management on Performance-----------------------------------12
2.5 Challenges of Keeping and Managing Electronic Records------------------------------------13
2.6 The Effects of Technological Advancement on Records Management-----------------------14
2.7 Strategic Role of Records Management-----------------------------------------------------------15
2.4 Relationships between automation of records and organizational performance-----------16
2.4.1 Conclusion----------------------------------------------------------------------------------------------17
CHAPTER THREE: METHODOLOGY------------------------------------------------------------------18
3.0 Introduction--------------------------------------------------------------------------------------------18
3.1 Research Design---------------------------------------------------------------------------------------18
3.2 Research Population----------------------------------------------------------------------------------18
3.3 Sampling procedures----------------------------------------------------------------------------------18
3.4 Research Instruments---------------------------------------------------------------------------------19
3.5 Validity of Research Instrument--------------------------------------------------------------------19
3.6 Reliability of Research Instrument-----------------------------------------------------------------19
3.7 Project Risks and Mitigation------------------------------------------------------------------------19
3.8 Data Analysis-------------------------------------------------------------------------------------------20
3.9 Ethical Considerations-------------------------------------------------------------------------------20
References;-----------------------------------------------------------------------------------------------------21
Appendix I: Letter Of Introduction;-----------------------------------------------------------------------22
Appendix II: Questionnaire;--------------------------------------------------------------------------------23
Appendix III: Work Plan;-----------------------------------------------------------------------------------25
Appendix IV: Budget Estimates;--------------------------------------------------------------------------25

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LIST OF TABLES
Table 3.1: Population and Sample Size of the Study------------------------------------------------------18

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LIST OF FIGURES

Table 3.1: Population and Sample Size of the Study--------------------------------------------------18

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LIST OF ACRONYMS;

AIDS Acquired Immune Deficiency Syndrome

ARMA Association of Records Managers and Administrators International

ART Anti Retroviral Therapy

EMR Electronic Medical Records

ERMS Electronic Records Management Systems

H/C Health Centre

HCT HIV Counselling and Testing

HIV Human Immune Virus

ICT Information and Communications Technology

ISO International Standards Organization

LG Local Government

MoH Ministry of Health

NPHC National Population and Housing Census

OPD Out Patients Department

RO Records Officer

SRRH Soroti Regional Referral Hospital

UBOS Uganda Bureau of Statistics

UBS Uganda Bureau of Standards

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 CHAPTER ONE: INTRODUCTION AND BACKGROUND

1.0 Introduction
This chapter will include; the background of the study, problem statement, purpose of the study,
objectives of the study, relevant research questions and justification of the study.

1.1 Background of the Study

Recent studies have pointed out the significance of record keeping in an institution as the most
vital tool that can help develop or bring it down in equal measure. Records Management (RM) is
the supervision and administration of digital or paper records, regardless of format. Records
management activities include the creation, receipt, maintenance, use and disposal of records. In
this context, a record is content that documents a business transaction (Harding M.K, 1990).

Government health facilities like Soroti Regional Referral Hospital produces, collects,
disseminates and utilizes a large volume of records (health records) and information than any other
organizations. These records are important for the lives of the public and are also used to hold the
facility accountable for the performance and electronic records performance.

This emphasizes the importance of proper records keeping ensuring government accountability in
a democratic society. Proper record keeping is critical for the survival and efficient operation of
day-to-day business activities (Reinhold K. and Carl H. 1965). For these reasons, Soroti Regional
Referral Hospital records department maintain a system for records keeping. In support of the
above, Reinhold and Carl (1965), argue that governments must ensure the permanent keeping of
its records since it needs to account to its citizens for its administrative actions. An effective
keeping of records will enable compliance with transparency requirements.

Government will be able to prove their administrative process through the records preserved. This
provides evidence of human activities and transactions, to protect the rights of both the public and
government, and that is good for democracy and good governance. Similarly, the Soroti Regional
Referral Hospital creates and maintains records. It creates, maintains and uses patients’ records for
different purposes in rendering its health service to clients through its medical units and
administration departments.

Managing electronic records presents a significant challenge for organizations of any size or
sector. For those that store their records in file systems (including shared drives), which have no
formal controls in place, the risk of alteration or deletion makes this challenge even greater.

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Soroti Regional Referral Hospital may have well maintained paper records system but this is not
necessarily appropriate as a template for maintaining electronic records. This is because the
volume of electronic records and variety of file formats, compared with the ease of creation.

Electronic records management needs to be very carefully considered and structured to ensure the
integrity of the records is not compromised upon capture and they remain retrievable for as long as
they are required.

Amuria District is one of the Local Government under the Uganda Government decentralization
policy. Amuria district is bordered by Otuke district to the North, Napak district to the north east,
Katakwi district to the east, Soroti district to the south, Kaberamaido district to the south west and
Alebtong district to the west. The municipality of Amuria is located approximately 45 kilometres
(28 miles), by road, north of Soroti, the largest district in the sub region. Amuria district is
composed of three (03) Counties; Amuria, Kapelebyong and Orungo.

Orungo county is an administrative unit of Amuria district, the county has four (04) Sub counties
with a total of six (06) Health Centres; i.e. three (03) Health Centre IIIs and three (03) Health
Centre IIs which include; Ococa St. Clare Health Centre III, Soroti Regional Referral Hospital,
Morungatuny Health Centre III, Akeriau Health Centre II, Abeko Health Centre II, and Olwa
Health Centre II.

Soroti Regional Referral Hospital is government founded health facility, founded in 2001 and is a
major health service provider of Orungo Sub County in Amuria. The facility is well facilitated
with twenty eight (28) technical staff and six (06) support staff. The activities carried out at the
facility include the following: Utra-sound Scanning, In Patients Department, Out Patients
Department (OPD), Maternity services, Nutrition services, ART Clinic, Laboratory services,
Outreaches, Counselling and Guidance, among others

Following the excellent quality of services provided, Soroti Regional Referral Hospital registered a
big volume of patients turn up as per the statistics bellow;

 Receives over 2,000 patients on average per month, these patients come from within and
outside the catchment area.

 Admits over 100 patients per month on average, these admissions are from the departments of;
pediatrics, general and maternity wards.

 Cumulatively, the health facility has enrolled over 1,300 HIV/AIDS+ clients of which over 700
clients are still actively picking their ARVs and CPT, the highest in Amuria district.

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1.2 Statement of the Problem

The problem that has led to this study is that health workers in the public health centres, such as
medical doctors, clinicians, mid wives, laboratory technicians and nurses, are usually not able or
are struggling to render timely and effective health services to citizens due to a lack of effective
records management systems. Ineffective records management systems usually lead to long patient
waiting times before patients receive health service.

The health workers usually end up not rendering certain services because the health history of the
patient is not contained in medical files. This is due to the fact that, if the health worker proceeds
treating patients without enough information about the patients’ health background s/he may end
up rendering poor health service that might be risky to patients’ health.

Electronic Records Management Systems (ERMS) can be used to ensure easy and fast access to
treatment and retrieval of information or records so as to enhance performance and ultimately
improve service delivery (Harding M.K, 1990). In traditional paper records management systems,
the records managers and clerks waste a lot of time looking for missing and/or misfiled records,
which is not conducive to the functioning of an organization. There is a need for an effective
records management programme to upgrade the records keeping system for easy and timely
retrieval of information, improved office efficiency and productivity (Reinhold K. and Carl H.
1965).

It is against this background that this study was instituted to investigate issues regarding the health
records and archives management and their effects on electronic records performance at Soroti
Regional Referral Hospital.

1.3 Purpose of the Study

The purpose of the study is to assess at the effects of electronic records management on
organization performance, a case study of Soroti Regional Referral Hospital (SRRH)

1.4 Objectives of the Study

The specific objectives are:

a. To assess the forms of electronic health records generated by Soroti Regional Referral Hospital.

b. To establish the relationship between electronic records management and organizational

performance at Soroti Regional Referral Hospital.

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c. To find out the challenges faced by Soroti Regional Referral Hospital in managing electronic
record management to enhance performance.

1.5 Research Questions

a. What are the types of health records kept by Soroti Regional Referral Hospital and what are
their functions?

b. What is the relationship between health records keeping and electronic records performance at
Soroti Regional Referral Hospital?

c. What are the challenges that Soroti Regional Referral Hospital records personnel face in
electronic record management so as to enhance performance?

1.6 Significance of the Study

a. The research study will enable the researcher to make recommendations to policy makers and
the community of Soroti Regional Referral Hospital in Soroti District on what strategies can be
adopted to lessen the effects of electronic health records management on organizational
performance.

b. To the researchers and academicians, it’s expected that the study will form a base for another
study. The findings of this study will also add new knowledge on the topic and serve as a base
for further research in areas where other scholars will identify a gap.

1.7 Scope of the Study

The scope of the research study will include the Content Scope, Geographical Scope and Time
Scope as detailed bellow;

1.7.1 Content Scope

The study will focus on the effects of electronic records management on organizational
performance at Soroti Regional Referral Hospital. The researcher will focus on electronic record
keeping and management specifically in matters dealing with medical care and hospital
management

1.7.2 Geographical Scope

The research study will be limited to Soroti Regional Referral Hospital, in Soroti District.

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1.7.3 Time Scope

The research study will be conducted in a timeframe of three (03) years at Soroti Regional Referral
Hospital from 2014 to 2019 because this is the period when the hospital computerized its
operations.

1.9 Limitations of the Study

The study will experience challenges that may hinder its smooth running and completion. This
includes; challenges interpreting medical terms, unpredictable weather conditions, unreliable
respondents who may give false information or refuse to cooperate at all and officials who may not
cooperate in giving reliable information.

CHAPTER TWO: REVIEW OF RELATED LITERATURE

2.0 Introduction

The following chapter elaborates the theoretical review of the research and reviews literature on
the study. The presents concepts, opinions and ideas on electronic health records management and
electronic records performance.
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2.1 Key Concepts

2.1.1 Records Management

Records management is often confused with other concepts such as information management,
administration, archives, etc. It is, therefore, the purpose of this chapter, to distinguish records
management from such concepts. To enable researchers to distinguish records management from
other related concepts, clear definitions of the concepts that fall within the scope of record
management are required. This chapter seeks to define concepts that fall under the subject of
records management, such as: records, management, electronic records management, and records
management itself.

Reinhold K. and Carl H. (1965) define records management as a systematic control of the recorded
information that an organization needs to conduct business. Harding M.K, (1990) also define
records management as a function of providing systematic control of records from creation, or
receipt, through their processing, distribution, organization, storage and retrieval to their ultimate
disposal.

In consideration of the above definitions of records management by different scholars, the concept
records management is defined by the researcher as a system through which organizations fully
monitor movement of records within their organizational structures and thus ensure accountability,
transparency, performance and good governance.

2.1.2 Records

Records are either defined in terms of the physical formats in which they appear, or along with the
information they contain. It must be noted that records differ in format or size, and have different
contents. A concept record is defined by Huffman, E.K. (1994), as written or oral evidence that
information has been collected and kept for use in making decisions. The most common records
(such as forms, correspondence, reports and books) are written, printed or typed on paper.

The Association of Records Managers and Administrators Inc. (ARMA International, 2007)
defines records as a recorded information, regardless of medium or characteristics, made or
received by an organization, that is useful in the operation of the organization. The National
Records and Archives Act 2001, defines a concept record as recorded information, regardless of
form or medium.

In view of the above, much emphasis is placed on the role of records in providing evidence to
document the transaction of business. Based on the above definitions, records can, therefore, be
defined as follows: Recorded information in any form, including data in computer systems,
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created, received and maintained by an organization or person in the transaction of business or the
conduct of affairs, and kept as evidence of such activity.

Regardless of physical form or characteristics means that the medium may be paper, film, disk,
or other physical type or form, that the method of recording may be manual, mechanical,
photographic, electronic, or any other combination of these or other technologies.

Made means the act of creating and recording information by agency in the course of their official
duties, regardless of the method(s) or the medium involved. The act of recording is generally
identifiable by the circulation of the information to others or by placing it in files accessible to
others.

Received means the acceptance or collection of documentary materials by agency personnel in the
course of their official duties, regardless of their origin(for example, other units of their agency,
private citizens, public officials, other agencies, contractors, government grantees) and regardless
of how transmitted (in person or by messenger, mail, electronic means, etc).

Preserved means the filing, storing, or any other method of systematically maintaining
documentary materials by an organization.

Appropriate for preservation means documentary materials made or received which in the
judgment of the organization should be filed, stored, or otherwise systematically maintained by an
organization because of the evidence of an organization’s activities or information they contain,
even though the materials may not be covered by its current filing or maintenance procedure.

2.1.3 Automation

Automation is a tool that can be used to facilitate records management and archival functions. In other
words automation is the use of machines or systems to perform tasks normally performed or
controlled by people .Many functions in life can be automated, including washing clothes or dishes
using washing machines or dishwashers, transporting goods using cars or trucks, or adding up lists of
numbers using calculators. In this module, automation refers to the use of computers to manage the
administrative and information processing tasks in records offices, records centers, and archival
institutions.

If used wisely, computers can assist records personnel in managing records better to ensure their
continued value as evidence. Automation can help organizations implement authentic and reliable
record-keeping practices, through the improved tracking of records through their life cycle as well as
the consistent application of records schedules and descriptive standards. Maintaining evidence

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through authentic and reliable records is a cornerstone of good business practice and helps ensure a
valuable record for society.

2.1.3 Management

Benfell P. (2002) defines management as achievement of objectives through coordination of tasks

and staff”. It involves motivating staff to do necessary tasks and controlling the quality of products
or services. Management is responsible for planning, organizing, leading and controlling the
organization.

2.1.4 Performance
The accomplishment of a given task measured against preset known standards of accuracy,
completeness, cost, and speed. In a contract, performance is deemed to be the fulfillment of an
obligation, in a manner that releases the performer from all liabilities under the contract.
Performance is the process or action of performing a function or task. We perceive it regarding
how successfully the person carries out that function.

Performance in an organizational setting involves analysing a company’s performance against its

objectives and goals. In other words, organizational performance comprises real results or outputs
compared with intended outputs. The analysis focuses on three main outcomes, first, shareholder
value performance; second, financial performance; and third, market performance.

2.1.5 Electronic Records

The definition of the concept record has a significant impact on what is understood by an
electronic record. One can start with the observation that electronic records are records in
electronic form, i.e. they are generated electronically and stored by means of computer technology.

Electronic records include all components of an electronic information system, namely: electronic
media as well as all related items such as input documents, printouts, programs and metadata,
which is background and technical information on the information stored electronically (National
Records and Archives Act 2001).

Electronic records can be further described as recorded information that is communicated and
maintained by means of electronic equipment in the course of conducting a transaction. They may
consist of any combination of text, data, graphics, video, or audio information that is created,
maintained, modified, or transmitted in digital form, by a computer or related system. Owing to
difficult questions raised by the introduction of computers regarding the status of records, the
traditional definition of records as objects such as paper files, tapes, disks, etc has become
problematic when dealing with electronic records.
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Defining electronic records in terms of physical objects is no longer useful and specific
programming or planning is required to ensure that the essential characteristics of records are
maintained (National Records and Archives Act 2001). The Act further states three properties that
are important to maintain the essential characteristics of a record, 16 namely: Content, Structure
and Context.

In an electronic system, the properties of content, structure and context may be physically separate.
An electronic database may contain content in the form of data, but the information on its
structure, such as record format and context (what other records it relates to) may be kept
separately in software, technical documentation and directories. The problem is that content on its
own does not constitute a record as it is not sufficient to guarantee authenticity reliability for legal
purposes or operational continuity, and without context it is difficult to interpret the full meaning
of a document.

2.2 Need for Records Management in a Service Organization

Records management is an essential component of business administration. An effective records

management program allows the organization to render better customer service, provides legal
defensibility and leads to improved profitability. Hence, it is necessary to award high priority to
records management to avoid organizational problems that may arise owing to poor handling of
business records (Benfell P, 2002).

Records are the memory of an organization. They are the assets of an organization that are created,
processed, transmitted, used, stored, retrieved, retained, and eventually destroyed. Records
management is the systematic control of this memory throughout its life cycle. The records
manager is responsible for ensuring that all information required for operating the business is
accurate, and readily accessible (Harding M.K. 1990).

According to Adeyemi J (2012), the importance of records management is increasingly being

recognized in health institutions. It is therefore the responsibility of records managers to ensure
that they gain the attention of decision-makers in the health facility. Employees require
information in order to carry out their official duties and responsibilities efficiently and effectively
in a transparent manner. Records represent major sources of information and are almost the only
reliable and legally verifiable source of data that can serve as evidence of decisions, actions and
transactions in an organization.

According Benfell P, (2002), the role of records management is to ensure that members of staff
involved in different operations have the information they need, when necessary. Among their

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other purposes, records also act as raw materials for research in various disciplines, including
scientific research, which is an important ingredient of socio-economic development. Furthermore,
records can be used as an information resource for strategic planning purposes. The service
provided by records management is therefore of vital importance to both employees (end users)
and organizational success. Most importantly; it remains the function of records management to
ensure that an organization’s records are safe for future reference.

According to Kathleen M. and Eichenwald S. (2002), the role of a records management system is
that it acts as a control system that reinforces other control systems such as internal and external
auditing. The records themselves can serve to detect fraud and recover the loss. Since corruption
creates an environment that allows opportunities to commit fraud, once fraud is detected, records
can provide a trail for investigators to track the root of corruption. However, for records to be
useful in this capacity, they must be accessible.

The volume of electronic records is growing exponentially because of increasingly powerful and
easy-to-use computer hardware and software, the growing popularity of e-mail systems, the ease
with which records can be downloaded from Internet and the conversion of paper formats to
electronic formats. The increasing use of electronic document management systems, video and
audio machines continue adding to the growing volumes of records in electronic formats. ICTs
have developed rapidly over the past decade and provided the means to easily capture, store and
distribute documents in vast quantities and at an ever increasing speed. To be able to make good
use of this information instead of becoming swamped by it, scientific controls need to be applied
(Huffman, E.K, 1994).

Since the dawn of the 21st century records are primarily received and stored in electronic devices.
The question is whether there will be any need for record managers if document users can search
data warehouses to retrieve electronic records themselves? The answer to this question can have a
tremendous impact on the future viability of the profession of records management. Will the work
of record managers be performed by the computer in the future and will there be any need for
paper records? Electronic document management software allows organizations to create, store,
and disposing of records in a paperless manner, potentially precluding the need to send a copy to a
records centre.

All these technologies could reduce the need for records managers in service organizations. For
records managers to secure their jobs, they must have the same computing skills as document
creators and computer systems managers. Huffman, E.K, (1994) further indicates that information
management professionals can influence these changes by identifying them and their impact on the

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future of records management. It would be critical to distinguish between records management
business activities that can be easily automated, and records management business activities that
can be only partially automated, as well as those records management activities that can probably
never be automated successfully. Obviously, records managers who develop their skills in regard
to activities that are unlikely to be automated will be in demand professionally for some time to
come.

2.2 Extent to Which Records Management Contribute To Performance

Rapid growth in records management awareness is gaining recognition from both public and
private sectors as the most reliable method of managing an organization’s flow of information. It
has been accepted as management of people’s daily activities for future reference. Organizations
are increasingly acknowledging the fact that efficient control of recorded information leads to
effective management which, in turn, means that information is more easily retrievable, readily
identifiable and economically managed (Benfell P. 2002).

Records management services provide the corporate memory of an organization. They document
an organization’s accountability, preserve the evidence of an organization’s activities, enable
timely access to current administrative information and ensure that records of archival value are
marked for preservation at the time of creation and not inadvertently destroyed.

Records management is a fundamental and core activity of any organization’s handling of records.
The motive behind records management’s existence is to assist organizations in making the right
decisions about which records to keep and how to keep them. In other According to the Republic
of National Records and Archives Act (2001), records management exists in order to help
organizations to classify records so that they can be easily retrievable. Furthermore, it remains the
purpose of records management’s existence to assist organizations in deciding which records to
destroy. Records management in an organization is driven by a number of factors such as
responsibility, accountability, legal obligations and transparency.

All public organizations should practice accountability through submission of records such as
annual reports, business plans, financial statements etc. They are therefore responsible for
whatever results emanate from their records. Mismanagement of funds is easily picked up from
review of an organization’s records.

According to Kathleen M. and Eichenwald S. (2002), the aims of records management should
further include:
 Formulation of policies, procedures and standards for handling records.

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 Development of classification systems and retention schedules.
 Creation, usage and keeping track of records in the office.
 Finding ways to store records as cheaply and efficiently as possible.
 Protection records that need to be kept and disposal of records that are no longer of value to the
organization. Since records exist in any organization, they need to be managed from their
creation to their disposal. Regardless of the medium on which they are created and stored, they
document decisions and activities, and provide evidence of transactions in support of everyday
business.

2.3 Impact of Electronic Record Management on Performance

Electronic records management was introduced as a solution to manual records management.

Technological advances are radically changing the discipline of records management. Information
management professionals can influence these changes by identifying them and their impact on the
future of records management. Records managers are also advised to enhance relationships with
their counterparts in the field of information technology and explain to them the role of records
management in the entire information management process (Huffman, E.K, 1994).

The information revolution has radically changed the way most organizations work. The benefits
of electronic information systems, such as improved retrieval of information, quicker and cheaper
communication and the ability to reuse information, have changed the nature of both work and
record-keeping within organizations. Today, documents are created through computer by sending
e-mails, doing electronic banking transactions and preparing articles on personal computers or
laptops (Benfell P. 2002).

Corporate information has moved from paper memoranda and letters, to e-mail messages. Today,
reports, books, leaflets and publications of governmental agencies are more likely to be accessed
through websites. The impact of technology on organizations and records management is not a
new phenomenon. For example, the introduction of the telegraph, typewriter and the telephone
fundamentally altered the way business was done and records were kept. The advent of the
computer altered record-keeping even more. However, the unique and fragile nature of electronic
data demands a re-evaluation of the way governmental bodies manage records.

Processes and procedures created to meet the needs of record-keeping in the paper environment do
not apply equally to electronic records. The purpose of technology is to make easier, more
efficient, and less costly to handling information. High technology devices such as computers,
optical character readers, fax machines, and laser printers should be looked at no differently than

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filing equipment, and should therefore, be obtained only to fulfil a specified need (Johns Merida,
2002).

2.5 Challenges of Keeping and Managing Electronic Records

According to (Huffman, E.K, 1994) becoming involved with the management of electronic records
provides a number of new opportunities and challenges.

Changes in Software and Hardware: Frequent changes in software and hardware create greater
pressure on archival institutions because preservation of digital archival collections centres on the
interim mechanism for storing the digital information, migrating to new form and providing long-
term access. One of the greatest issues facing the longevity of digital collections in developing
countries is not only the storage media deterioration, but the problem of rapidly changing storage
devices.

Inadequate Funding: Digital projects are expensive. Digitization of records requires enormous
funding due to frequent hardware and software upgrades, and increasing cost of subscription to
electronic databases, this makes them to be easily by information seekers globally.

Computer Phobia: Due to inadequate skills in information technology, many traditional

librarians, record keepers and archivists are conservatives and have phobia for computers. Because
of generation gaps between the new and old professionals, computers are perceived as a threat to
their status as experts. Thus, they find it difficult to cope or measure up with the requirements of
the electronic/digital age, and are at the same time too reluctant to jettison the old practices for new
one. Successful application of information handling technologies in developing countries requires
an ability to overcome staff and personal resistance to such innovation.

Technical Expertise: One of the biggest challenges to preservation and conservation of hospital
records in developing countries is educating the record keepers in hospital community on the best
ways to handle hospital records. This challenge is exacerbated by the fact that preservation of
records is not at the center of most medical science curricula. Added to this is the fact that
inadequate technical expertise is prevalent in many African countries (Adeyemi, 2012).

Also, there is shortage of personnel/human capital. Those few librarians that possess basic
knowledge in computer science and its applications work in archives and record units, hence the
consequent frequent break down of ICT facilities and disruption of services in digitized record
units. In many countries, human resources with appropriate skills, competences and attitude are not
readily available to initiate, implement and sustain digitization project, and most states are still
lagging behind in technological and telecommunications infrastructure.
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Inadequate Technology Infrastructures: Frequent power outage constitute serious bottleneck to
digitization. This has the effects in damaging digital/ ICT equipment and where there is a standby
electric generator, the cost of running them is prohibitive. Most developing countries do not have
adequate and reliable supply of electricity which consequently makes it impossible to maintain a
conducive and sustainable technological environment suitable for digitization projects.

Technological Obsolescence: The continuous changes in computer hardware and software cause
technological obsolescence which is a threat to digitization and record preservation. It causes the
loss of the means to access to information in digital form. Technological obsolescence is caused by
continuous upgrade of operating system, programming language application and storage media.
Hence, Alegbeleye (2009) suggested that digital archives should be transcribed every ten to twenty
years to ensure that they will not become technologically obsolete.

Lack of Legislation/Policy: Legislators in most developing countries are neither aware of, nor
conversant with the requirements of digital preservation and for that reason; they either ignore or
inadequately cover digital preservation issues. The Internet links is also a challenge to digitization
because of copyright legislation. The copyrights of software needed to access digital files, and the
right to copy for preservation has not been adequately articulated in most national legislation, and
if permission for digitization cannot be obtained, digitization of such materials should not proceed.

2.6 The Effects of Technological Advancement on Records Management

It is a well-known fact that the information revolution has radically changed the way most
organizations work. The benefits of electronic information systems, such as improved retrieval of
information, quicker and cheaper communication and the ability to reuse information, have
changed the nature of both work and record-keeping within organizations. Corporate information
has moved from paper memoranda and letters, to e-mail messages. Reports, books, leaflets and
publications of organizations are now more likely to be accessed through websites. A shared folder
on an organization’s intranet replaces the correspondence file, and relational database systems
replace paper forms and case files (Benfell P. 2002).
We live in a changed and changing world, with challenges facing those who manage
organizational information. Thoughts about the future of information and records management
must include the realities of high-speed communication around the world, a global economy, and
the accelerating adoption of internationally authoritative standards, such as International Standards
Organization (ISO) and Uganda Bureau of Standards (UBS). The effects they will have on records
management in the future will pose serious challenges to organizations and the profession
worldwide. With the proliferation of electronic documents, records management programs is in the

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midst of a software evaluation which will allow the safekeeping and control of electronic
information whether it be e-mail, spreadsheets, or a word processed document created by anyone
within the organization. This will ensure that all records, regardless of their format, are created and
protected.

2.7 Strategic Role of Records Management

According to the National Records and Archives Act 2001, the strategic role of records
managements based on the following reasons:

To control the creation and accumulation of records: Despite decades of using various non-paper
storage media, the amount of paper in offices continues to escalate. An effective records
management program addresses both creation control and records retention, thus stabilizing the
growth of records in all formats.

To reduce operating costs: Although filing equipment, space in offices and staffing to maintain
organized filing system cost money, the cost eventually is much higher if an organization does not
have a record management program in place. Misplaced files could cost an organization more
money to create new files.

To improve efficiency and productivity: Time spent searching for missing records is non-
productive. A well-defined and operated filing system with an effective index can facilitate
retrieval and delivery of information to users as quickly as they need it.

To assimilate new records management technologies. A good records management program

provides an organization with the capability to assimilate new technologies and take advantage of
their benefits.

To minimize litigation and risks: Organizations implement records management programs in order
to reduce the risks associated with litigation and potential penalties.

To ensure regulatory compliance: The only way an organization can be reasonably sure that it fully
complies with laws and regulations is by operating within a good record management program
which takes responsibility for regulatory compliance. Failure to comply with laws and regulations
could result in severe fines, penalties or other legal consequences.

To safeguard vital information: Every organization, public or private, needs a comprehensive

program for protecting its vital records and information from catastrophe or disaster, because every
organization is vulnerable to losses.

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To support management’s decision-making process: In today’s organizational environment, the
first manager to access relevant data wins, either by making the decision ahead of the competition,
or making a better, more informed decision. A records management programme Can help ensure
that managers have the information they need when they need it.

To preserve organizational memory: An organization’s files contain its institutional memory which
is created with a view to future management decisions and planning.

To foster professionalism in an organization: An office with papers lying all over gives the
impression of a poor working environment. This may discourage customers and result in less of
income.

2.4 Relationships between automation of records and organizational performance

Organizations in the new era must be applicant advanced computer systems and information
technology and media and the future belongs to those who considered with accurately recognition
of advantages and disadvantages of these systems are to be critical and learn from the experience
of others without having to pay the costs of that experience again.

Access to computers and advance information technology and media generating growing
momentum and momentum has the effect that each unit of time that would be saved from the
previous unit makes it more valuable. Thus, there is a positive feedback loop is created that
accelerates acceleration (Roshan, 2005).

Computer expanding in recent decades is major changes in the intelligence system of the invention
from printing machine in the fifteenth century or even the invention of writing. Parallel with this
extraordinary change, expand networks and new media that is equally amazing and its job is move
knowledge and constituent elements i.e. the data and information. What managers do at different
levels and always move in the space, decisions can be considered as data collection and process.

Today, the growth of records management technologies, this organizational arrangement is

shifting. Records managers are expected to involve themselves actively in information technology
forums. However, the introduction of electronic records also had a major impact on the way
records management is viewed. The link between records management and IT has not been
addressed clearly yet. In the past, records management was not technology-driven. The pressure of
technological change in organization, eventually forced the records management section to
consider repositioning itself within the electronic organization’s infrastructure (Johns Merida,
2002).

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The strategic role of records management in an organization also improved as IT started to share
functional goals with records management. The following section therefore aims at addressing the
strategic role of records management in an organization. The rapid rise of the Internet and
company Intranets has created a particular demand among businesses to put a far greater
proportion of their business documents online, either for external or internal use.

This has given rise to a new trend in records and document management systems, i.e. web-based
records and document management. A Web application integrated with an organization’s records
and document management system enables end-users to search, track and request corporate records
and documents at any time of the day or night and from any location through the web enabled
desktop computer. Integrating records management with portal technology allows end-users to
search seamlessly not only the wider Web environment and corporate database, but also corporate
records (Benfell P. 2002).

2.4.1 Conclusion

Records management is closely becoming an IT function and not an administrative function.

Technological progress and the unsettling changes it produces will require significant attention to
records management education. Information technology skills are therefore of the utmost
importance to the end-users in order to guarantee their positive reaction to records. Lack of IT
skills would affect end-users’ access to records in general negatively. Apart from IT skills,
organizations should also ensure that employees are equipped with relevant IT equipment. Keeping
up with technological advancement in records management is of critical importance in dealing
with electronic records management to enhance performance and service delivery. When preparing
to store records, it is important to ensure that the format of the document is one that will last for its
entire useful life (Benfell P. 2002).

CHAPTER THREE: METHODOLOGY

3.0 Introduction

This chapter outlines the methods adopted in order to answer the research questions detailed in

chapter one. It looks at the research design, research population, sampling techniques, data

17
collection instruments and procedure of data collection, mode of data analysis and presentation as

well as ethical consideration and limitations of the study.

3.1 Research Design

The researcher will use a descriptive case study design. According to Amin (2005), case studies
emphasize detailed contextual analysis of a limited number of events or conditions and their
relationships. This method is suitable for this kind of study because it specific and its findings can
be generalized in other similar facilities. Both qualitative and quantitative data collected were used
during the data collection.

3.2 Research Population

The researcher will focus on health record keeping and management specifically in matters dealing
with medical care and health centre management at Soroti Regional Referral Hospital. The health
centre has a total of 36 staff, 16 Officials from Orungo Sub County Local Government (LG),
which is the immediate government administrative authority of the health centre and 53 VHTs
attached to the health centre of whom will be the general population of the study.
Table 3.1 Population and Sample Size Table

Respondents Population Sample

Soroti Regional Referral Hospital staff 36 20
Orungo Sub County LG Officials 16 05
Village Health Team members 53 25
Total 441 50
Table 3.1: Population and Sample Size of the Study Source: Field

3.3 Sampling procedures

This study will use a technical of stratified random sampling method to determine a sample size of
50 respondents for this study.

3.4 Research Instruments

This study will use a structured questionnaire an interview schedule to gather primary data from
the respondents. The questionnaire will have both open-ended and close-ended questions.
Questionnaires are very important in gathering important information from a large number of
people. Key informant interviews will be used also to collect primary data from management of

18
the records department at Soroti Regional Referral Hospital. Secondary information will also be
gathered from the records of office bearers in the institution

3.5 Validity of Research Instrument

Content validity will be used to examine the validity of the questionnaire. This will be done by
getting an opinion from the lecturers on the content of the questionnaire, if the questionnaire is
able to answer questions relating to all the variables in the study

A pilot study will be conducted to test the validity of the questionnaires. This will enable the
researcher to test whether questions being posed will give the required responses and gauge on the
choice of design of questions asked, finding out whether they are logical, clear and easy to
understand. This will allow one to check if the variables can easily be processed and analyzed. The
pilot study will be carried out on a sampled 10% of the sampled respondents, and the results of the
pilot study will enable the researcher to revise or adjust the questions accordingly.

3.6 Reliability of Research Instrument

The reliability of the instrument will be undertaken using the test-retest method. The questionnaire
will be issued to the same respondent two times. After the first administrations of the
questionnaire, the research will wait for two weeks to elapse before administering the same
questionnaire to the same respondents. The scores on the two sets of measures will be correlated to
obtain an estimated coefficient of reliability. The researcher will then calculate a reliability
coefficient to indicate the relationship between the two sets of scores obtained.

3.7 Project Risks and Mitigation

Risk mitigation planning is the process of developing options and actions to enhance opportunities
and reduce threats to project objectives .Risk mitigation implementation is the process of executing
risk mitigation actions. Risk mitigation progress monitoring includes tracking identified risks,
identifying new risks, and evaluating risk process effectiveness throughout the project.

This researcher shall deal with any risks that may occur by acknowledging the existence of risks
that may occur, and make a deliberate decision to accept it without engaging in special efforts to
control it. Approval of project by the university and relevant authorities will be of use here, Adjust
program requirements or constraints to eliminate or reduce risks by a change in funding, schedule,
or technical requirements and Implement actions to minimize the impact or likelihood of any risks
that will occur. She will also monitor the environment for changes that affect the nature and/or the
impact of risks that may affect the study.

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3.8 Data Analysis
The purpose of data analysis will be to develop an understanding or interpretation that answers the
basic question of “what is going on here? The raw data collected will be coded under major
themes, analyzed and interpreted manually in order to attach meaning from the raw-data collected.
The descriptive approach was used for qualitative forms of data. The descriptive analysis was also
be used for qualitative forms of data. All the coded data under major themes will be placed
together to make a write-up

3.9 Ethical Considerations

Ethical considerations are important in ensuring a professional research and are non-intrusive in
accomplishing a research objective. For this study, the researcher will ask for permission to carry
out the study from relevant administrative management of Soroti Regional Referral Hospital. The
researcher will assure confidentiality to the respondents and confirm that the study is for the
purposes of accomplishing academic goals only. The researcher will also acknowledge all
additional sources of information from other scholars.

The researcher will seek permission from Stafford University Uganda campus in Soroti to conduct
academic research. A self developed questionnaire on the respondents and record any naturally
available data will be used in this study. The respondents consent will be sought, the research
procedure be explained, and confidentiality assured.

REFERENCES;

Adeyemi J (2012), Preservation of Medical Records and Referral Service. Onipanu, Lagos:
Topmost Pub.

Amin, M.E. (2005). Social Sciences Research: Concepts, Methodology and Analysis, Kampala:
Makerere University Publication
20
ARMA International (2009), Glossary of Records and Information Management Terms, ARMA
International

Benfell P (2002), Electronic Records Management: An Integrated Approach, London: Macmillan

Publishers Limited.

Government of Uganda, (2001), National Records and Archives, Act 2001, Kampala, Uganda

Harding M.K (1990), Introduction to Office Record Management, London, McGraw-Hill

Publishers.

Huffman, E.K. (1994), Electronic Records Management. 4th ed. Berwyn, IL: Physicians Record
Company

ISO 15489 (2001), Information and Documentation – Records Management, Part 2 Guidelines,
Inter Stand Org (ISO).

ISO 15489 (2001), Information and Documentation – Records Management, Part 1 General. Inter
Stand Org (ISO).

Johns Merida (2002), Health Information Management Technology: An Applied Approach.

Chicago: Sage Publication.

Kathleen M. and Eichenwald S. (2002) Records and Archives Management: Concepts, Principles
and Practice. Chicago: AHIMA.

Reinhold K. and Carl H. (1965), Data Processing and Management Information, London:
Macmillan Publishers Ltd.

APPENDIX I: LETTER OF INTRODUCTION;

Stafford University Uganda

Soroti Campus
Uganda.

Dear Respondent,

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RE: LETTER OF INTRODUCTION

I am Apio Jennifer a student of Stafford University Uganda pursuing Diploma in Records and
Archives Management. I am collecting information for academic research on the topic: The Effect
of Records and Archives Management on Electronic Records Performance in Health
Centres, A Case Study of Soroti Regional Referral Hospital in Amuria District of Uganda.

You have been picked to participate in this research study that will lead to findings and
recommendations which will hopefully enhance electronic health records management at the
government health facility.

This study is purely for academic purposes and the study findings will be used to develop
recommendations for improving performance of the Records department through good Electronic
Records Management practices at Soroti Regional Referral Hospital. I am kindly requesting you to
answer the questions below as sincerely as possible. Your honest answers and other comments are
important for the success of this study.

All answers shall be treated as highly confidential as possible.

Thank You,

APIO JENIFFER
0779 037723

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APPENDIX II: QUESTIONNAIRE;

Instruction: Please tick () appropriate choice against the variable

SECTION A: BACKGROUND INFORMATION

01. Position:________________________________________________
02. Designation: Senior Staff Junior Staff
03. Highest Level of Education attained. (Tick where appropriate)
a. O’level b. A’level c. Certificate d. Diploma
e. Bachelors f. Masters g. PhD h. Other _________
04. How Long Have you worked with Orungo H/C III?
a. Below 1 year b. 1-3 years c. 3-5 years d. Over 5 years
05. Have you been trained on records/archives management or studying towards, a professional
records management or related qualification?
Yes No
06. If yes, which areas have you been trained on?
a. creation, capture and receipt of records e. storage and maintenance
b. records life cycle f. access, usage and tracking
c. electronic records g. disposition
d. paper records g. any other (specify) _____________
07. Do you use Electronic Records Management System (ERMS) to manage records?
Yes No
08. If yes, how long have you been using ERMS?
a. Below 1 year b. 1-3 years c. 3-5 years d. Over 5 years

SECTION B: PERFORMANCE ASSESSMENT AND OPPORTUNITIES FOR

ELECTRONIC RECORDS MANAGEMENT

This section assesses how health records management impacts electronic records performance
at Soroti Regional Referral Hospital. Please tick () appropriate choice against the variable.

To a small To a large
No. Instructions Not at all
extent extent
01 All staff understand usage of electronic records

02 High administrative controls and policies are in place

to support electronic records management

03 Staff at Orungo H/C III often use electronic records in

their day-to-day operations

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 To a small To a large
No. Instructions Not at all
extent extent
Staff understand that electronic records are important
04 towards their performance to achieve good service
delivery

05 Health records management has helped Orungo H/C

III to achieve its objectives?
06 What is the level of operation of electronic records at
Orungo H/C III

a. very easy c. easy

07 How easy is it to create, use, access and store
b. fairly easy d. not easy
electronic records at Orungo H/C III
Would you prefer electronic records management to Yes
08
manual paper records management No
a. faster service delivery
What accrued benefits do you see as a result of b. better job performance
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electronic records management at Orungo H/C III c. easy accountability
d. minimized duplication

In general, which of the following statements best a. I am very satisfied

10 describes your opinion on electronic records effect on b. I am more or less satisfied
your performance and service delivery c. I am not satisfied

SECTION B: CHALLENGES

01 What challenges do you face in the electronic records management

a. financial b. human resources c. technical expertise
d. resistance to change e. inadequate documentation

02 How are these challenges being addressed?

_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________

03 How long does it take to address the identified challenges?

a. 1 day b. 2-3 days c. 3-5 days d. 1 week e. Over 1 week

04 Would you recommend electronic records management to other government health

facilities? Yes No
Thank You For Your Time And Cooperation.
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APPENDIX III: WORK PLAN;

DATE ACTIVITY PERSON RESPONSIBLE

October - December 2017 Developing research topic and Researcher and Supervisor
approval
September 2018 Proposal writing. Developing Researcher and Supervisor
research instruments, and
Approval
November 2018 Proposal review and Pilot Researcher and Supervisor
Testing of tools
November 2018 Data collection Researcher
December 2018 Data processing and Analysis Researcher
January 2019 Report writing Researcher and Supervisor
January 2019 Final report submission Researcher and Supervisor

APPENDIX IV: BUDGET ESTIMATES;

No. ITEM Quantity Cost/Unit Total cost

1. Stationery 02 reams 20,000 40,000
2. Printing and Binding 03 reports 100,000 300,000
3. Communication N/A 100,000
4. Transport N/A 250,000
5. Upkeep 10 days 20,000 200,000
6. Data Analysis N/A 300,000
7. Miscellaneous N/A 300,000 300,000
TOTAL 1,490,000

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