Implementation challenges and perception of care providers on Electronic Medical Records at St. Paul’s and Ayder Hospitals, Ethiopia

Abstract

Background In resources constrained settings, effectively implemented Electronic Medical Record systems have numerous benefits over paper-based record keeping. This system was implemented in the 2009 Gregorian Calendar in the two Ethiopian territory hospitals, Ayder and St. Paul’s. The pilot implementation and similar re-deployment efforts done in 2014 and 2017 Gregorian Calendar failed at St. Paul's. This study aimed to assess the current status, identify challenges, success factors and perception of health care providers to the system to inform on future roll-outs and scale-up plans. Methods A cross sectional study design with quantitative and qualitative methods was employed. A survey was administered October to December 2019 using a structured questionnaire. A total of 240 health care providers participated in the study based on a stratified random sampling technique. An interview was conducted with a total of 10 persons that include IT experts and higher managements of the hospital. Descriptive statistics were employed to summarize the survey data using SPSS V.21. Qualitative data were thematically presented. Results St. Paul’s hospital predominantly practiced the manual medical recording system. The majority of respondents (30.6%) declared that a lack of training and follow up, lack of management commitment, poor network infrastructure and hardware/software-related issues were challenges and contributed to EMR system failure at St. Paul’s. Results from the qualitative data attested to the above results. The system is found well-functioning at Ayder, and the majority of respondents (38%) noted that lack of training and follow-up was the most piercing challenge. As per the qualitative findings, ICT infrastructure, availability of equipment, incentive mechanisms, and management commitment are mentioned as supportive for successful implementation. At both hospitals, 70 to 95% of participants hold favorable perceptions and are willing to use the system. Conclusion Assessing the readiness of the hospital, selecting and acquiring standard and certified EMR systems, provision of adequate logistic requirements including equipment and supplies, and upgrading the hospital ICT infrastructure will allow sustainable deployment of an EMR system.

Digital Nursing Technology to Achieve Job Satisfaction: A Systematic Review

“…In addition, they also recorded injuries related to posture and duration of time required to complete electronic forms on bedside touch screens, and negative comments contradicted by observational data [21]. Similarly, the statement by Leenan et al that there is still dissatisfaction in the use of electronic devices such as alarms due to system malfunctions, alarm frequency and dissonance with nurse measurements [22], and also found the low acceptance in the implementation of information systems, lack of training and support as inhibiting factors [23], [24]. However, positive perceptions are found in the use of management information systems and alarms, where electronic systems are very useful and easy to be used by nurses since they are efficient in storing patient data [22], [23].…”

“…This study discovered that there were 10 articles on ICT in nursing services such as the use of EHR [23], [24], [29]. It also includes HIT, ICT or implementing E-Health, and PAEHR [27], [19], [26], [20], [31], implementation of a novel electronic bedside nursing chart [21], while digital technology is also related to technology [30].…”

Electronic medical record implementation in a large healthcare system from a leadership perspective

“…In the USA, the Meaningful Use (MU) program was established to facilitate nationwide adoption of EMRs, and resulted in a steep increase in EMR implementation, leading to > 90% of hospitals using a government-certified EMR [ 3 ]. Globally, EMR implementation is also increasing, albeit to varying degrees across different countries [ 5 , 6 ]. The widespread of EMR implementation has exposed several challenges [ 3 ].…”

Satisfied or not satisfied? Electronic health records system implementation in Ghana: Health leaders’ perspective

“…Various studies from developed countries have revealed that EHR, has many benefits, such as having the ability to reduce waiting times, keeping safe records of past medical events, as well as easy accessibility of patient data during referrals [ 5 , 14 , 15 , 24 ]. However, it is the extent of the quality of the electronic health records that determines the fast access to patient information thereby facilitating health care provider communication, health care continuity and improved quality of care [ 4 , 11 , 20 ].…”

“…Despite the benefits stated by many authors, some facilities are not enjoying these benefits because of some barriers or challenges as enumerated by some studies regarding the use of EHR [ 5 , 9 , 13 , 23 ]. These include inadequate computer skills, limited or non-available tools, limited funding, lack of technical basis, security and privacy issues, lack of technical expertise and, changes in workflow.…”