Adoption of electronic medical records in developing countries—A multi-state study of the Nigerian healthcare system

Abstract

Electronic medical records (EMR) are extensively used in developed countries to manage patient records and facilitate consultations and follow-up of treatment. This has resulted in centralised databases where different services and clinicians can quickly access patient data to support healthcare delivery. However, adoption and usage of EMR in developing countries is not common and, in most cases, non-existent. Clinicians are dependent on patients keeping their own records manually with no centralised database to manage and control the patient medical history. The key objective of this study was to investigate the propensity of clinicians and senior management personnel in healthcare facilities to adopt EMR and evaluate the contextual factors that impact or impede adoption. Using Davis's technology adoption model extended with other factors, this study determined if contextual or situational factors are associated with barriers that impede adoption of EMRs in developing countries. Using a cross-sectional quantitative research approach, a questionnaire was designed to collect data across four states in the Niger Delta region of Nigeria. Stratified random sampling was used to select healthcare facilities that participated in the survey and selection of respondents from each healthcare facility. Data was collected by trained research assistants and a total of 1,177 valid responses were received and analysed using factor analysis and multiple regression analysis. The results from the analysis show that usefulness, critical success factors, awareness and relative advantage significantly influence clinicians' intention to adopt EMRs. Surprisingly, infrastructure availability was not statistically significant. Meanwhile, risk and data security both negatively influence adoption, indicating that user perception of risk and safety of their data decreases their propensity to adopt EMRs. The results from this study suggests that usefulness and anticipated success factors in facilitating operations within healthcare facilities have a great influence on user adoption of EMRs. Awareness, training and education of users on the effectiveness of EMRs and their usefulness will increase adoption. The results will be beneficial in helping government and healthcare leaders formulate policies that will guide and support adoption of EMR. Other policy recommendations and suggestions for future research were also proffered.

Analysis of Readiness For Implementation of Electronic Medical Records Using DOQ-IT Method

“…Assessment of organizational alignment in RME development is obtained from the total score of the culture, leadership and strategy components. Assessment of organizational capacity in developing electronic medical records is obtained from the total score of information management components, clinical and administrative staff, training, accountability process workflow, finance and budget, IT management support and information technology infrastructure [19], [20].…”

Hambatan Penerimaan Rekap Medis Elektronik Catatan Oleh Dokter: Tinjauan Sistematis

“…Menurut (Kumari et al, 2023), Tingkat adopsi yang lambat menunjukkan bahwa resistensi di antara Dokter harus kuat karena dokter adalah kelompok pengguna garis depan utama EMR. Apakah atau tidak mereka mendukung dan menggunakan EMR akan memiliki pengaruh besar pada kelompok pengguna lain dalam praktik medis, seperti perawat dan staf administrasi (Akwaowo et al, 2022). Akibatnya, dokter memiliki dampak besar pada tingkat adopsi secara keseluruhan EMR (Roberts et al, 2023).…”

Impact of electronic medical records on healthcare delivery in Nigeria: A Review

“…The impact of the introduction of the EMRs has not been well studied. Most of the published literature have been perspective papers and reviews [4][5][6], case studies describing the practical experiences of hospitals setting up EMRs [7][8][9][10], primary studies exploring the barriers hindering their adoption [1,[11][12][13][14][15] and studies leveraging EMRs for research [16][17][18][19]. Several primary studies have however assessed the impact of EMRs on patient-relevant outcomes [8,[20][21][22][23][24][25], but no reviews have synthesized the evidence from them.…”

“…Electronic medical records (EMRs) are extensively used in developed countries but their adoption in developing countries has been slow [1]. According to a survey conducted by the World Health Organization, 114 countries are presently developing national electronic medical record systems due to an increasing awareness that a more robust health information technology (HIT) system is essential for delivering superior healthcare at reduced expenses [2].…”