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埃塞俄比亚亚的斯亚贝巴医疗服务提供者采用电子病历的障碍与促进因素

Barriers and facilitators of the electronic medical record adoption among healthcare providers in Addis Ababa, Ethiopia.

作者信息

Bekele Tadesse Alemu, Gezie Lemma Derseh, Willems Herman, Metzger Jonathan, Abere Biruhtesfa, Seyoum Blen, Abraham Loko, Wendrad Naod, Meressa Selamawit, Desta Bethel, Bogale Tariku Nigatu

机构信息

JSI Research and Training Institute Inc., Addis Ababa, Ethiopia.

University of Gondar, Gondar, Amhara, Ethiopia.

出版信息

Digit Health. 2024 Dec 10;10:20552076241301946. doi: 10.1177/20552076241301946. eCollection 2024 Jan-Dec.

Abstract

INTRODUCTION

An electronic medical record (EMR) can enhance the quality of care and patient outcomes. Ethiopia started the implementation of EMR in 2013. However, its adoption among healthcare providers has been low. Thus, this study explored the barriers and facilitators of EMR adoption among healthcare providers in Addis Ababa, Ethiopia.

METHODS

A descriptive-phenomenological approach was used. Data were collected from one hospital and three health centers from 5-13 June, 2023, that implemented the EMR. A total of 25 EMR users (physicians, health officers, pharmacists, nurses, laboratory technologists, radiology technicians) were included in the key informant interviews. The interviews were audio-recorded, transcribed verbatim, translated to English, and exported to OpenCode 4.03 software for analysis. Thematic analysis was applied to analyze, summarize, and present the data.

RESULTS

Healthcare providers reported barriers operating at three levels: individual, technological, and organizational. Individual barriers included lack of digital literacy, technical knowledge, skill; motivation; and favorable attitude. Technological barriers included lack of infrastructure including computers, networks, and reliable power supply; and software-related challenges such as system downtime, lack of interoperability, comprehensiveness, and decision support systems; and system security and privacy concerns. Organizational barriers included poor quality of training, lack of follow-up, supervision and technical support; poor leadership commitment; lack of incentives and motivation; and staff turnover and workload. Perceived benefits of the system, such as ease of access to quality data, improved quality of care and work efficiency; availability of onsite technical support; presence of information technology supplies; and feedback from supervisors, were identified as facilitators of EMR adoption.

CONCLUSION

The study identified different barriers and facilitators to the adoption of the EMR. The health system should prioritize strategies to address technological, individual, and organizational factors influencing the successful adoption of the EMR to support the delivery of quality care and improve patient outcomes.

摘要

引言

电子病历(EMR)可以提高医疗质量和患者治疗效果。埃塞俄比亚于2013年开始实施电子病历。然而,医疗服务提供者对其采用率一直很低。因此,本研究探讨了埃塞俄比亚亚的斯亚贝巴医疗服务提供者采用电子病历的障碍和促进因素。

方法

采用描述性现象学方法。于2023年6月5日至13日从一家医院和三个实施电子病历的健康中心收集数据。关键 informant 访谈共纳入了25名电子病历用户(医生、卫生官员、药剂师、护士、实验室技术人员、放射技术人员)。访谈进行了录音,逐字转录,翻译成英文,并导出到OpenCode 4.03软件进行分析。采用主题分析来分析、总结和呈现数据。

结果

医疗服务提供者报告了在三个层面存在障碍:个人层面、技术层面和组织层面。个人障碍包括缺乏数字素养、技术知识、技能;积极性;以及积极的态度。技术障碍包括缺乏包括计算机、网络和可靠电源在内的基础设施;以及与软件相关的挑战,如系统停机、缺乏互操作性、全面性和决策支持系统;以及系统安全和隐私问题。组织障碍包括培训质量差、缺乏跟进、监督和技术支持;领导承诺不足;缺乏激励措施和动力;以及人员流动和工作量。该系统的感知益处,如易于获取高质量数据、提高医疗质量和工作效率;现场技术支持的可用性;信息技术用品的存在;以及上级的反馈,被确定为电子病历采用的促进因素。

结论

该研究确定了电子病历采用的不同障碍和促进因素。卫生系统应优先制定战略,以解决影响电子病历成功采用的技术、个人和组织因素,以支持提供高质量医疗服务并改善患者治疗效果。

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