Electronic ordering performance and user experience in public health facilities in Kampala

Abstract

Background: Errors in ordering, late order submissions, lack of capacity to make accurate orders and long lead times have been cited as some of the reasons for stock outs of medicines and health supplies in health facilities in Uganda. Electronic logistic management systems with focus on electronic ordering has been implemented as one of the ways to solve these issues. Evaluating the performance of these digitalisation efforts, particularly in terms of timely order submission, order refill rate, lead time reduction and order adjustments, is crucial for successful implementation. Objective: To assess electronic ordering performance and user experience in public health facilities in Kampala. Methods: A cross sectional study employing collection of both quantitative and qualitative data collection approaches was used. Records of the orders, invoices and goods received notes of the 12 health facilities that had electronic ordering implemented were studied. The respondents responsible for the electronic orders in these health facilities were also interviewed. Two tools were used in collecting the data that is a checklist and an in-depth interview guide. Quantitative data was analyzed using the t test in STATA 14. Qualitative data was analyzed using thematic analysis aided by Atlas ti version 7. Ethical considerations were addressed prior to commencement of this study. Results: Timely order submission for the order cycles had an overall significant change after implementation of electronic ordering with a p-value of 0.01.The average Order refill rate for the cycles increased from 70.55% to 77.5%(p=0.28) after implementation of electronic ordering. Additionally, average adjustments decreased from 15.5% to 9.2 %( p=0.50) but the overall lead time increased from 47 days to 72 days (p=0.14) for facilities using the six-cycle ordering system. Timely deliveries increased from 5% to 22% post implementation of online ordering. Users revealed the online system’s flexibility, accountability, error correction and time-saving capabilities while also challenges like downtime, connectivity issues and inflexibility in order quantity adjustments. Conclusion: Implementation of an electronic ordering system has improved ordering performance with a significant improvement in timely order submission. Users of the system were most notably satisfied with the systems capability for remote usage and eased ordering modules but however still faced some challenges.