Users’ perception on factors contributing to electronic medical records systems use: a focus group discussion study in healthcare facilities setting in Kenya

Abstract

Background Electronic medical records systems (EMRs) adoption in healthcare to facilitate work processes have become common in many countries. Although EMRs are associated with quality patient care, patient safety, and cost reduction, their adoption rates are comparatively low. Understanding factors associated with the use of the implemented EMRs are critical for advancing successful implementations and scale-up sustainable initiatives. The aim of this study was to explore end users’ perceptions and experiences on factors facilitating and hindering EMRs use in healthcare facilities in Kenya, a low- and middle-income country. Methods Two focus group discussions were conducted with EMRs users (n = 20) each representing a healthcare facility determined by the performance of the EMRs implementation. Content analysis was performed on the transcribed data and relevant themes derived. Results Six thematic categories for both facilitators and barriers emerged, and these related to (1) system functionalities; (2) training; (3) technical support; (4) human factors; (5) infrastructure, and (6) EMRs operation mode. The identified facilitators included: easiness of use and learning of the system complemented by EMRs upgrades, efficiency of EMRs in patient data management, responsive information technology (IT) and collegial support, and user training. The identified barriers included: frequent power blackouts, inadequate computers, retrospective data entry EMRs operation mode, lack of continuous training on system upgrades, and delayed IT support. Conclusions Users generally believed that the EMRs improved the work process, with multiple factors identified as facilitators and barriers to their use. Most users perceived system functionalities and training as motivators to EMRs use, while infrastructural issues posed as the greatest barrier. No specific EMRs use facilitators and/or barriers could be attributed to facility performance levels. Continuous evaluations are necessary to assess improvements of the identified factors as well as determine emerging issues.

Electronic medical record systems data use in decision-making and associated factors among health managers at public primary health facilities, Dodoma region: a cross-sectional analytical study

“…This is congruent with a study conducted in Ayder Hospital in Ethiopia in which 95% of the units were using the EMR system; hence, EMR use was higher ( 37 ). Another study conducted in Kenya revealed that EMR use was not adequate due to infrastructure challenges ( 38 ). In addition, another study revealed that the availability of health information system resources, such as EMR systems, organizational structure, and training, potentially influences data use ( 34 ).…”

Evaluating the Impact of a Digital Hospital Information Management System on the Operational and Financial Performance of Health Facilities in Kenya

“…This may be linked to the comparatively higher allocation of resources for digital HIMS in these higher-level facilities (26). In addition, the staff in these facilities are more familiar with sophisticated equipment and hence will be more likely to accept new technologies such as digital HIMS as demonstrated by Philomena et al (34). Level 2 facilities were the least represented and this may be linked to fewer resources for IT infrastructure making it difficult to afford or sustain these systems.…”

“…Also, Waithera et al demonstrated that an EHR system used in a level 5 referral hospital increased staff productivity, improved clinical decisions, and enhanced accountability for funds and resources (33). Despite these benefits, a focus group discussion done by Ngugi et al with digital HIMS users in a health facility pointed out that infrastructural and technical issues posed an important barrier (34). Elephant Healthcare (EH) is a UK-based health technology company that has developed a digital HIMS and is currently being deployed in SSA and Asia (35).…”

Digital Nursing Technology to Achieve Job Satisfaction: A Systematic Review

“…In addition, they also recorded injuries related to posture and duration of time required to complete electronic forms on bedside touch screens, and negative comments contradicted by observational data [21]. Similarly, the statement by Leenan et al that there is still dissatisfaction in the use of electronic devices such as alarms due to system malfunctions, alarm frequency and dissonance with nurse measurements [22], and also found the low acceptance in the implementation of information systems, lack of training and support as inhibiting factors [23], [24]. However, positive perceptions are found in the use of management information systems and alarms, where electronic systems are very useful and easy to be used by nurses since they are efficient in storing patient data [22], [23].…”

“…This study discovered that there were 10 articles on ICT in nursing services such as the use of EHR [23], [24], [29]. It also includes HIT, ICT or implementing E-Health, and PAEHR [27], [19], [26], [20], [31], implementation of a novel electronic bedside nursing chart [21], while digital technology is also related to technology [30].…”