Forhad Hossain

Objective Research over the past decade has extensively covered the benefits of electronic health records in developing countries. Yet, the specific impact of their limited access on doctors’ workload and clinical decision-making, particularly in Bangladesh, remains underexplored. This study investigates current patients’ medical history storage mechanisms and associated challenges. It explores how doctors in Bangladesh obtain and review patients’ past medical histories, identifying the challenges they face. Additionally, it examines whether limited access to digital health records is an obstacle in clinical decision-making and explores factors influencing doctors’ willingness to adopt electronic health record systems in such contexts. Method An online cross-sectional survey of 105 doctors with Bachelor of Medicine, Bachelor of Surgery/Bachelor of Dental Surgery (MBBS/BDS) degrees and at least 2 years of experience was conducted, covering (a) personal information, (b) workload, (c) patient history challenges, and (d) decision-making. Results Out of 105 participants, 51.4% of them use paper-based methods with 56% facing challenges, versus 20% using digital methods. Most (94.3%) interview patients directly, and 80.9% are interested in a web-based, comprehensive medical history system. An ordinal regression model identified that the physicians’ disciplines, workload, and efficiency level of the current workplace in facilitating patient history-taking variables significantly affected willingness to adopt the described electronic health record in the survey. Conclusion Doctors in Bangladesh encounter significant challenges related to workload and clinical decision-making, largely attributed to restricted access to patients’ past medical histories. Despite the prevalent use of paper-based records, there is a notable willingness among these medical professionals to embrace electronic health record systems, indicating a potential shift towards more efficient healthcare practices in the region.

A doctor needs to know the patients’ medical history to investigate the root cause of symptoms. Traditionally it is done by a questionnaire at the clinic’s reception desk, or the doctor asks a series of questions to obtain a relevant medical history. An incomplete or wrong medical history affects the doctor’s decision. The challenge for a busy doctor is to obtain all the relevant medical history in a short period of time accurately and without missing any important history. Affordable clinics employ an assistant or junior doctor to sort out all the paper-based medical history and mark the important points. It increases doctors’ work performance by saving doctors time and making room for consulting more patients. But not all the small clinics can afford such assistants. This paper lists the technical requirements to develop a personal medical history visualization tool to increase doctors’ productivity.