Organizational and health professional readiness for the implementation of electronic medical record system: an implication for the current EMR implementation in northwest Ethiopia

Factors Influencing Health Professionals' Attitudes Towards Electronic Medical Record Implementation in Ethiopian Hospitals: Insights from a Cross-Sectional Study (2023) (Preprint).. [DOI: 10.2196/preprints.63135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

BACKGROUND

Despite Ethiopia's keen interest in adopting Electronic Medical Record (EMR) systems, the acceptance rate remains low, primarily due to health professionals' attitudes towards new technology. Understanding the factors influencing these attitudes is crucial for successful EMR implementation. This study aimed to evaluate health professionals' attitudes and associated factors towards EMR implementation in Ethiopian hospitals in 2023.

OBJECTIVE

To assess the attitudes of health professionals towards the implementation of Electronic Medical Record (EMR) systems in Ethiopian hospitals and identify the factors associated with their attitudes.

METHODS

Multicenter cross-sectional study was conducted in piloted hospitals in Ethiopia from April 30 to May 15, 2023. A systematic random sampling technique was used to select 397 participants from the three selected hospitals. Data were collected through a self-administered questionnaire, cleaned, coded, inputted into EpiData software (version 4.6), and analyzed using SPSS version 25. Binary logistic regression analysis was performed, with a significance level of p < 0.05 and adjusted odds ratios with 95% confidence intervals used to identify associated factors.

RESULTS

A total of 382 health professionals participated, yielding a response rate of 96.2%. Among the respondents, 184(48.2%) had a favorable attitude towards the implementation of the EMR system. In multivariate analysis, factors significantly associated with attitude included age ≤ 29 years (Adjusted Odds Ratios (AOR): 3.05; 95% CI: 1.58, 5.9), computer literacy (AOR: 2.66; 95% CI: 1.16-6.09), training on the EMR system (AOR: 2.87; 95% CI: 1.80-4.56)) and health professionals’ knowledge of EMR (AOR: 1.8; 95% CI: 1.10-2.96).

CONCLUSIONS

Nearly half of the respondents displayed low attitudes towards EMR implementation. Age, knowledge, computer literacy, and training access were significantly associated with attitudes towards the EMR systems. Enhancing health professionals’ attitudes and integrating tailored training within the healthcare system are crucial for advancing EMR utilization.

Electronic medical record systems data use in decision-making and associated factors among health managers at public primary health facilities, Dodoma region: a cross-sectional analytical study

Background

Tanzania has shown some improvements in the adoption of electronic medical record (EMR) systems in public health facilities; however, the rate of utilization of data generated from EMRs among health managers is not well documented. This study aims to assess the use of electronic medical record systems data in decision-making among health managers at public primary health facilities in Dodoma Region, Central Tanzania.

Methods

A facility-based quantitative cross-sectional analytical study was conducted among 308 randomly selected health managers. A self-administered questionnaire supplemented with documentary review was used. Descriptive summary statistics and bivariable and multivariable logistic regression analyses (crude and adjusted odds ratios) were used. A P-value of <0.05 was used to declare statistically significant associations.

Results

Overall, more than a third (40.6%) of the health managers, that is 174 of the 308 included in the study, reported using data generated by EMR systems in decision-making. One-third (33.4%) of the health managers were adequately using data generated by EMR systems, of which 39.3% used data to support continuous quality improvement initiatives. Among the facilities visited, only nine (30%) had good documented EMR systems data use. Access to computers [adjusted odds ratio (AOR) = 4.72, 95% confidence interval (CI): 1.65, 13.48, p-value (p) = 0.004] and discussions on EMRs during meetings (AOR = 2.77, 95% CI: 1.01, 7.58, p = 0.047) were independent predictors of EMR system data use. Those who reported having EMR systems in all working areas were seven times more likely to use EMR system data (AOR = 7.23, 95% CI: 3.15, 16.59, p = 0.001). The respondents with good perceived EMR system information quality were more likely to use EMR system data (AOR = 2.84, 95% CI: 1.50, 5.39, p = 0.001) than those with poor perception. Furthermore, health managers who had excellent knowledge of computers and data use had higher odds of using EMR system data (AOR = 1.84, 95% CI: 3.38, 10.13, p = 0.001) compared with their counterparts.

Conclusions

The findings of this study indicate that utilization of EMR system data in decision-making among health managers was optimal. It was found that training in itself is insufficient to improve use of EMR, which points to more organizational aspects of work routine as a challenge. Hence, a comprehensive approach that addresses these factors is essential for maximizing EMR system data use in decision-making.

Optimising scale-up for public health impact: a multimethod implementation science research protocol to improve infant health outcomes in Ethiopia

INTRODUCTION

Child mortality rates remain high in sub-Saharan Africa, including Ethiopia. We are conducting a cluster randomised control trial in the Gondar zone of the Amhara region to determine the impact of pairing Orthodox priests with community health workers, known locally as the Health Development Army (HDA), on newborns' nutritional status, early illness identification and treatment, and vaccination completeness.Ensuring intervention efficacy with scientific rigour is essential, but there are often delays in adopting evidence into policy and programmes. Here, we present a protocol for conducting parallel implementation research alongside an efficacy study to understand intervention implementability and scalability. This will help develop a scale-up strategy for effective elements of the intervention to ensure rapid implementation at scale.

METHODS AND ANALYSIS

We will conduct a stakeholder analysis of key implementation stakeholders and readiness surveys to assess their readiness to scale up the intervention. We will conduct semistructured interviews and focus group discussions with stakeholders, including HDA members, health workers, Orthodox priests, and caregivers, to determine the core intervention elements that need to be scaled, barriers and facilitators to scaling up the intervention in diverse sociocultural settings, as well as the human and technical requirements for national and regional implementation. Finally, to determine the financial resources necessary for sustaining and scaling the intervention, we will conduct activity-based costing to estimate implementation costs from the provider's perspective.

ETHICS AND DISSEMINATION

The study received approval from the University of Gondar Institutional Review Board (approval no: VP/RTT/05/1030/2022) and the University of Washington Human Subjects Division (approval no: STUDY00015369). Participants will consent to participate. Results will be disseminated through workshops with stakeholders, local community meetings, presentations at local and international conferences, and journal publications. The study will provide evidence for factors to consider in developing a scale-up strategy to integrate the intervention into routine health system practices.

Health professionals' readiness to implement electronic medical record system in Gamo zone public hospitals, southern Ethiopia: an institution based cross-sectional study

BACKGROUND

The adoption of Electronic Medical Records (EMR) by the healthcare sector can improve patient care and safety, facilitate structured research, and effectively plan, monitor, and assess disease. EMR adoptions in low-income countries like Ethiopia were delayed and failing more frequently, despite their critical necessity. The most popular way to solve the issue is to evaluate user preparedness prior to the adoption of EMR. However, little is known regarding the EMR readiness of healthcare professionals in this study setting. Therefore, the objective of this study was to assess the readiness and factors associated with health professional readiness toward EMR in Gamo Zone, Ethiopia.

METHODS

An institution-based cross-sectional survey was conducted by using a pretested self-administered questionnaire on 416 study participants at public hospital hospitals in southern Ethiopia. STAT version 14 software was used to conduct the analysis after the data was entered using Epi-data version 3.2. A binary logistic regression model was fitted to identify factors associated with readiness. Finally, the results were interpreted using an adjusted odds ratio (AOR) with a 95% confidence interval (CI) and p-value less than 0.05.

RESULTS

A total of 400 participants enrolled in the study, with a response rate of 97.1%. A total of 65.25% (n = 261) [95% CI: 0.60, 0.69] participants had overall readiness, 68.75% (n = 275) [95% CI: 0.64, 0.73] had engagement readiness, and (69.75%) (n = 279) [95% CI: 0.65, 0.74] had core EMR readiness. Computer skills (AOR: 3.06; 95% CI: 1.49-6.29), EMR training (AOR: 2.00; 95% CI: 1.06-3.67), good EMR knowledge (AOR: 2.021; 95% CI: 1.19-3.39), and favorable attitude (AOR: 3.00; 95% CI: 1.76-4.97) were factors significantly associated with EMR readiness.

CONCLUSION

Although it was deemed insufficient, more than half of the respondents indicated a satisfactory level of overall readiness for the adoption of EMR. Moreover, having computer skills, having EMR training, good EMR knowledge, and favorable EMR attitude were all significantly and positively related to EMR readiness.