Tolera Abebe, Oljira Lamessa, Dingeta Tariku, Abera Admas, Roba Hirbo Shore
School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
Front Digit Health. 2022 Aug 23;4:935945. doi: 10.3389/fdgth.2022.935945. eCollection 2022.
Despite the significant benefits of digital health technologies (ITs), developing countries are lagging behind their developed counterparts in the adoption of electronic medical records (EMRs) in a healthcare setting. EMRs have long been considered essential elements in improving the quality of healthcare. However, the rate of utilization of EMRs among healthcare providers still remains low, particularly in developing countries.
This study aimed at exploring EMR use and its determinants among healthcare providers at public health facilities in Dire Dawa, eastern Ethiopia.
A quantitative cross-sectional study was conducted among 402 health professionals working at public health facilities supplemented with an exploratory qualitative study in Dire Dawa, Ethiopia. Descriptive summary statistics and binary and multivariable logistic regression analysis were used to explore the determinant factors of EMR use, while qualitative data were thematically analyzed.
Overall, about a quarter (26.6%) of health professionals were using electronic medical records. A work experience of 6 years or less [adjusted odds ratio (AOR) = 2.23; 95% confidence interval (CI): [1.15-4.31]], a discussion on EMR (AOR = 14.47; 95% CI: [5.58-7.57]), the presence of an EMR manual (AOR = 3.10; 95% CI: [1.28-7.38]), and a positive attitude toward the EMR system (AOR = 11.15; 95% CI: [4.90-25.36]) and service quality (AOR = 8.02; 95% CI: [4.09-15.72]) were independent determinants of EMR use. Poor collaboration among stakeholders and dependence on the software programs of NGOs were the main challenges cited by key informants.
The findings of this study indicate that EMR use by health professionals in the study area is very low. Several organizational, technical, and behavioral factors were identified for this low utilization. Therefore, there is a need to leverage EMRs through continuous technical support and commitment to enhance its use, which has the potential to improve health service performance. Developing locally applicable EMR software should be considered.
尽管数字健康技术（IT）有显著益处，但在医疗环境中采用电子病历（EMR）方面，发展中国家落后于发达国家。长期以来，电子病历一直被视为提高医疗质量的关键要素。然而，医疗服务提供者中电子病历的使用率仍然很低，尤其是在发展中国家。
本研究旨在探索埃塞俄比亚东部迪雷达瓦公共卫生机构中医疗服务提供者对电子病历的使用情况及其决定因素。
对在公共卫生机构工作的402名卫生专业人员进行了定量横断面研究，并在埃塞俄比亚的迪雷达瓦进行了探索性定性研究。使用描述性汇总统计以及二元和多变量逻辑回归分析来探索电子病历使用的决定因素，同时对定性数据进行主题分析。
总体而言，约四分之一（26.6%）的卫生专业人员在使用电子病历。6年及以下的工作经验[调整后的优势比（AOR）=2.23；95%置信区间（CI）：[1.15 - 4.31]]、关于电子病历的讨论（AOR = 14.47；95% CI：[5.58 - 7.57]）、有电子病历手册（AOR = 3.10；95% CI：[1.28 - 7.38]）、对电子病历系统的积极态度（AOR = 11.15；95% CI：[4.90 - 25.36]）以及对服务质量的积极态度（AOR = 8.02；95% CI：[4.09 - 15.72]）是电子病历使用的独立决定因素。关键信息提供者提到的主要挑战是利益相关者之间协作不佳以及依赖非政府组织的软件程序。
本研究结果表明，研究区域内卫生专业人员对电子病历的使用率非常低。已确定导致这种低使用率的几个组织、技术和行为因素。因此，有必要通过持续的技术支持和努力来利用电子病历以提高其使用率，这有可能改善卫生服务绩效。应考虑开发适用于当地的电子病历软件。
