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卢旺达1型糖尿病管理电子病历系统早期采用情况的定性探索

A qualitative exploration of the early adoption of an electronic medical record system for type 1 diabetes management in Rwanda.

作者信息

Bille Nathalie, Christensen Dirk Lund, Byberg Stine, Gishoma Crispin, Villadsen Sarah Fredsted, Calopietro Michael

机构信息

Department of Digital Health Solutions, World Diabetes Foundation, Bagsvaerd, Denmark.

Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark.

出版信息

Digit Health. 2025 Jan 9;11:20552076241311057. doi: 10.1177/20552076241311057. eCollection 2025 Jan-Dec.

Abstract

BACKGROUND

Delivering adequate quality care remains a challenge in many low-and middle-income countries (LMICs), especially for people living with type 1 diabetes (T1D), requiring a complex treatment regimen. Digital health solutions, including electronic medical record (EMR) systems, have shown potential to improve delivery and quality of care but still require a successful implementation.

OBJECTIVE

To analyze the adoption of a newly implemented EMR system in Rwanda from the perspectives of individuals with T1D, health care providers, and experts.

STUDY DESIGN

A qualitative study was conducted using the Diffusion of Innovation (DoI) theory to guide the focus of the analysis. A data triangulation strategy was used to gain multi-dimensional insights, involving in-depth interviews and participant observations with T1D individuals, EMR system users, and experts (with varying levels of acquaintance with the EMR system). Experiences of early adoption of the EMR system were explored through thematic analysis guided by the DoI theory.

RESULTS

In general, all the participant groups had a positive attitude towards the EMR system, believed to increase the likelihood of a successful implementation. The system was described as user-friendly and improved workflows, data quality, and patient care. The main concerns to successful adoption were related to the maintenance and long-term sustainability of the system.

CONCLUSION

The EMR system showed great potential, was valued by users, and was positively believed to have potential to improve care and outcomes for patients. However, sustainability aspects must not be overlooked when assessing the adoption and use of an EMR system.

摘要

背景

在许多低收入和中等收入国家(LMICs),提供足够质量的护理仍然是一项挑战,特别是对于1型糖尿病(T1D)患者而言,他们需要复杂的治疗方案。包括电子病历(EMR)系统在内的数字健康解决方案已显示出改善护理提供和质量的潜力,但仍需要成功实施。

目的

从T1D患者、医疗保健提供者和专家的角度分析卢旺达新实施的EMR系统的采用情况。

研究设计

采用定性研究,运用创新扩散(DoI)理论指导分析重点。使用数据三角测量策略以获得多维度见解,包括对T1D患者、EMR系统用户和专家(对EMR系统的熟悉程度不同)进行深入访谈和参与观察。通过DoI理论指导的主题分析探索EMR系统早期采用的经验。

结果

总体而言,所有参与组对EMR系统持积极态度,认为这增加了成功实施的可能性。该系统被描述为用户友好型,改善了工作流程、数据质量和患者护理。成功采用的主要担忧与系统的维护和长期可持续性有关。

结论

EMR系统显示出巨大潜力,受到用户重视,并且被积极认为有潜力改善患者的护理和结局。然而,在评估EMR系统的采用和使用时,可持续性方面绝不能被忽视。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/820e/11719426/114a6489f460/10.1177_20552076241311057-fig1.jpg

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