The Diffusion of Electronic Medical Record Towards Universal Health Care at the Outpatient Department in Selected Public Health Facilities in Kenya.
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Date
2025-01
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Kenyatta University
Abstract
Healthcare organizations are increasingly adopting electronic Medical Records(EMR) as a means to enhance their services and mitigate rising costs associated with the pursuit of Universal Health Care. The diffusion of EMR in public health facilities has become a pivotal aspect of modern healthcare systems globally. There is a significant increase in countries with significant diffusion of EMR, with over half of WHO Member States now having an EMR framework that aligns with UHC objectives. In Kenya, the diffusion of EMR in public healthcare facilities has exhibited a comparatively slow pace of adoption. The problem of slow diffusion has arisen as a notable barrier within the healthcare industry in Kenya. The current investigation was guided by the diffusion of innovations theory which seeks to explain how, why and at what rate new ideas and technology spread. The principal objective of this study was to evaluate the extent of EMR diffusion in Nyeri County Referral Hospital, Thika Sub County Hospital, and Mbagathi Sub County Hospital. The study utilized a hospital based descriptive design, incorporating simple random and proportionate sampling techniques. The study's target population comprised health records and information officers, physicians, nurses, administrators, and other personnel directly engaged in the utilization of electronic medical records (EMR). A sample size of 285 participants was chosen for the study. The process of data collection encompassed the utilization of a meticulously designed questionnaire and the conduction of Key Informant Interviews (KIIs). The data was subjected to analysis using SPSS version 26.0. At least 160 (56.1%) of health facilities partially adopted electronic medical record between different departments, however, the diffusion varied with functions with the registration of patients being the most EMR reliant services, which was reported by 65.7% of the respondents. Working experience ( =15.301; df 3; p=0.018), lack of training ( =10.919; df 4; p=0.031), lack of effective leadership ( =8.062; df 4; p=0.041), adequacy of technical skills on IT systems ( =11.508; df 4; p=0.025), level of computer literacy ( =6.562; df 4; p=0.044), understanding of working with EMR system (p=0.0001), assigning EMR security privileges to staff (p=0.046), and lack of adequate infrastructure ( =7.879; df 2; p=0.046) were affecting diffusion of EMR. Additionally, inadequate sources of funding ( =9.186; df 2; p=0.017), lack of technical personnel to install and operate EMR technology resources ( =8.615; df 2; p=0.042), the consistency rate of internet connection (bandwidth) ( =14.882; df 2; p=0.005), lack of training new hospital staff on EMR usage & operations ( =8.170; df 1;p=0.019), lack of technical personnel to install and operate EMR technology ( =10.071; df 1; p=0.015), absence of computer skills amongst health care staff ( =7.404; df 1; p=0.038), and inadequate internet bandwidth ( =9.504; df 1; p=0.032) were affecting diffusion of EMR. Thus, the hospital management should improve the diffusion of EMR from one department to another, more training should be undertaken, and the county governments should strengthen organizational resources to support information use.
Description
A Thesis Submitted in Partial Fulfilment of the Requirements for the Award of the Degree of Master of Science in Health Information Management in the School of Public Health and Applied Human Science of Kenyatta University, January 2025.
Supervisor
1. George O. Otieno
2. Keneth Rucha