# Exploring the Health Information Management System of Kuwait: Lessons and Opportunities
## 4 Discussion
However, policies regarding the storage, retention and disposal of medical records require uniformity across all healthcare settings and accreditation by authorized bodies, perhaps by the National Accreditation Program for Hospitals (NAPH) in collaboration with the MoH. Finally, our study examined the problems in the existing medical records management system. As per our findings, the top six problems were missing medical records, lack of storage facilities, slow retrieval of records, duplication of patient's medical files, lack of supply of forms or files, and lack of technical expertise of the staff. These problems can be solved by implementing an EHR system that would provide quantitative benefits, which would help save time and cost; qualitative benefits, which would ensure data accuracy, easy accessibility, and efficient transfer of information; and strategic benefits, which would enable health research and policymaking [34]. Moreover, the overall negative impact of the COVID-19 pandemic in Kuwait necessitates the need for targeted interventions through the provision of accessible and acceptable services using health information tools [35, 36]. The socio-economic status of Kuwait allows a sedentary lifestyle and a high-caloric diet, causing a rise in non-communicable diseases (NCDs), such as hypertension and diabetes [13, 15]. Kuwait's current healthcare system cannot sustain the growing burden of NCDs, making healthcare reform efforts, such as better-quality healthcare and reduced costs, a top priority. In order to achieve these milestones, it is of paramount importance that the healthcare system of Kuwait adopts effective health information technology, such as EHRs [37]. The aforementioned factors, along with the study results, clearly depict that the HIMS practiced in hospitals of Kuwait call for an urgent intervention for the improvement of medical records [32, 38]. To reap the clinically-relevant benefits of the medical record system, healthcare settings must ensure the documentation of complete, accurate, timely, accessible, safe, secure, and legible medical records [29, 30]. Certain accreditation practices must be implemented to establish a baseline for the required minimum expectations, if not superior quality [26]. The ripple effect of this will eventually lead to improved quality of care in Kuwait hospitals. Considering the study findings, the MoH and the NCHI must lead HIM practices in Kuwait hospitals by establishing, enforcing, and monitoring national and international standards, guidelines, and policies for the medical record management system, based on previously published literature. Moreover, the NCHI should institutionalize a robust mechanism to monitor adherence to the established national policies and guidelines in Kuwait healthcare settings. Communication channels or networks between NCHI and satellite HIM departments in various hospitals must be improved to facilitate a smooth and continuous exchange of reports and guidelines. Furthermore, corrective measures should be developed when there is incompliance with national policies and procedures. Finally, we believe that hospitals must invest in extensive training and providing mentorship to professionals in their medical record departments on the important aspects of information management to reap benefits [37]. Moreover, a clear hierarchy must be maintained in these departments, and knowledgeable individuals must be hired to strengthen the workforce. Our study has several strengths. Since it was a mixed-methods study, it applied both quantitative and qualitative methodology, providing a better understanding of research problems than either of the approach alone. This is an up-to-date study and, to our knowledge, is the first study addressing the existing medical records management system of Kuwait, which is an invaluable addition to the limited body of work in this field. However, this study is limited because it lacks questions related to other health information management operations, such as quality of documentation.