Department of Information Systems and Technology, The University of Dodoma, Dodoma City, United Republic of Tanzania.
Department of Public Health, The University of Dodoma, Dodoma City, United Republic of Tanzania.
J Health Organ Manag. 2024 Nov 1;ahead-of-print(ahead-of-print):310-333. doi: 10.1108/JHOM-07-2024-0296.
This study aims to evaluate healthcare practitioners' perceptions of electronic health record (EHR) systems and their effectiveness in supporting clinical decision-making in Tanzanian Primary Healthcare (PHC) facilities.
DESIGN/METHODOLOGY/APPROACH: A mixed-methods approach was employed, combining quantitative data from structured questionnaires and qualitative insights from open-ended responses. The study was conducted in the Dodoma region of Tanzania, focusing on a diverse representation of PHC facilities, including district hospitals, health centres and dispensaries. Data were analysed using multiple linear regression for quantitative data, and thematic analysis was applied to qualitative responses.
The results revealed that while EHR systems are widely used in Tanzanian PHC facilities, their impact on clinical decision-making remains limited. Only a moderate portion of practitioners perceived EHR systems as effective in decision support, and frequent system use was negatively correlated with user satisfaction. Challenges such as inadequate training and support, system crashes, slow performance and poor usability and integration into clinical workflows were significant barriers to effectively utilising EHR systems.
ORIGINALITY/VALUE: This study contributes to the limited literature on EHR system implementation in low-resource settings, specifically Tanzania, by focusing on decision-support features within EHR systems. The findings offer valuable insights for healthcare policymakers, system designers and practitioners to optimise EHR implementation and improve healthcare outcomes in resource-constrained environments.
本研究旨在评估医疗保健从业者对电子健康记录（EHR）系统的看法，以及这些系统在支持坦桑尼亚初级医疗保健（PHC）设施中的临床决策方面的有效性。
设计/方法/方法：采用混合方法，结合来自结构化问卷的定量数据和来自开放式回答的定性见解。该研究在坦桑尼亚多多马地区进行，重点关注 PHC 设施的多样化代表性，包括地区医院、卫生中心和诊所。使用多元线性回归对定量数据进行分析，对定性反应进行主题分析。
结果表明，尽管 EHR 系统在坦桑尼亚 PHC 设施中广泛使用，但它们对临床决策的影响仍然有限。只有一部分从业者认为 EHR 系统在决策支持方面是有效的，并且系统的频繁使用与用户满意度呈负相关。培训和支持不足、系统崩溃、性能缓慢以及可用性和与临床工作流程的集成差等挑战，是有效利用 EHR 系统的重大障碍。
原创性/价值：本研究通过关注 EHR 系统中的决策支持功能，为资源有限环境中 EHR 系统实施的有限文献做出了贡献，特别是在坦桑尼亚。研究结果为医疗保健政策制定者、系统设计者和从业者提供了有价值的见解，以优化 EHR 的实施，并在资源有限的环境中改善医疗保健结果。
