Electronic Medical Record Utilization, its Determinant Factors and Barriers Among Health Care Providers at Selected Health Facilities in Addis Ababa, Ethiopia
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Date
2020-11
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Addis Abeba University
Abstract
Background: Electronic Medical Record (EMR) is a longitudinal collection of health-related information that can be created and managed by authorized clinicians. In Ethiopia, Electronic Medical Record is one part of the information revolution road map to transform the culture of data use. Limited studies have been conducted to determine the progress and determinants of utilization of Electronic Medical Record. The aim of this study is, therefore, to assess the current utilization of EMR and its determinant factors among health care professionals working in Ababa city administration, 2020.
Method: A mixed study design was used among 367 health care providers and 12 key-informants. Four government and three private health facilities were included. A multi-stage sampling technique was used. Data were entered by epi-data and analyzed by STATA version 15. Atlas.ti version 7 was used to manage qualitative data. An ethical clearance letter was obtained from Addis Ababa University.
Descriptive statistical summary measures were used to describe variables. Binary logistic regression with odds ratio and along with 95% confidence interval was used. Variables with a p-value of less than 0.25 were entered into the multivariable logistic analysis model. Finally, variables with a p-value of less than 0.05 were considered statistically significant.
Result: A total of 353 respondents participated, making the response rate of 96.2%. Most of the respondents (48.2%) were nurses, followed by physicians (11.6%). Overall, 68.6% (95% CI= 63.773.4%) of health care professionals
were utilizing the EMR system.Only 30.2% have received EMR training. Factors such as access to basic EMR training (AOR=5.8, 95% CI=1.6-20.7), a favorable attitude of health care providers (AOR=2.3, 95% CI=1.2-4.5), and user-friendly EMR interface (AOR=2.7, 95% CI=1.4-5.1) were positively associated with the use of EMR. However, individuals aged 35 & above were 66.4% less likely to use EMR than individuals aged 23-28.
Key informants mentioned; power fluctuation, shortage of capable EMR administrator, phase-out of vendors, absence of guidelines and policies, shortage of equipment and legal issues as major barriers to utilize EMR.
Conclusion: EMR utilization by health care professionals from private health facilities was better than government facilities. Overall utilization of EMR was low.
The finding suggests that access to basic EMR training, the attitude of health care providers and the EMR interface were affecting the use of EMR.
Besides, absence of clear EMR guidelines, power and connection fluctuation hinders EMR utilization and needs intervention. We recommend periodic training for professionals and make the EMR interface friendly.
There should be clear guidelines on how to use EMR, strict binding agreement, and clear phase-out strategy when giving EMR implementation for NGO EMR vendors.
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Keywords
EMR, Health Care Providers, Health Facility, Ethiopia