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揭示坦桑尼亚初级卫生保健中电子健康记录实施以提供有效决策支持的障碍:来自从业者的见解。

Unveiling barriers to EHR implementation for effective decision support in tanzanian primary healthcare: Insights from practitioners.

机构信息

Department of Information Systems and Technology, University of Dodoma, Dodoma, Tanzania.

Department of Public Health and Community Nursing, University of Dodoma, Dodoma, Tanzania.

出版信息

Health Informatics J. 2024 Oct-Dec;30(4):14604582241304698. doi: 10.1177/14604582241304698.

Abstract

This study investigates the barriers to implementing electronic health records (EHR) systems for decision support in Tanzanian primary healthcare (PHC) facilities and proposes strategies to address these challenges. A qualitative, inductive approach was used, guided by the Diffusion of Innovations (DOI) theory, the Technology Acceptance Model (TAM), and the Sociotechnical Systems theory. Using snowball sampling, data were collected from 14 participants through semi-structured interviews in Dodoma, Tanzania. Thematic analysis identified key barriers. Critical barriers to EHR implementation include lack of leadership support, poor network infrastructure, increased workload, and resistance to technology due to concerns over professional autonomy. Technical challenges, such as system downtime and lack of skilled personnel, hinder EHR use, resulting in inefficiencies and incomplete system adoption, negatively affecting patient outcomes. This study offers unique insights into barriers to EHR adoption in Tanzanian PHC facilities. Grounded in multiple theoretical frameworks, the findings contribute to health informatics discourse in low-resource settings and provide practical recommendations for improving EHR implementation. The study's implications are relevant for policymakers, healthcare leaders, and IT developers in similar contexts.

摘要

本研究旨在探讨坦桑尼亚初级卫生保健(PHC)设施实施电子健康记录(EHR)系统以提供决策支持的障碍,并提出应对这些挑战的策略。研究采用了定性、归纳的方法,以创新扩散理论(DOI)、技术接受模型(TAM)和社会技术系统理论为指导。通过滚雪球抽样,在坦桑尼亚多多马通过半结构化访谈收集了来自 14 名参与者的数据。主题分析确定了关键障碍。EHR 实施的关键障碍包括缺乏领导力支持、网络基础设施差、工作量增加以及由于对专业自主权的担忧而对技术的抵制。技术挑战,如系统停机和缺乏熟练人员,阻碍了 EHR 的使用,导致效率低下和系统采用不完整,对患者的治疗效果产生负面影响。本研究深入探讨了坦桑尼亚 PHC 设施采用 EHR 的障碍,为低资源环境下的健康信息学研究提供了独特的见解,并为改善 EHR 的实施提供了实际建议。该研究对类似背景下的政策制定者、医疗保健领导者和 IT 开发人员具有重要意义。

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