Factors influencing adoption of electronic medical record systems in public health facilities in Kenya: a case of Nakuru county.

Abstract

Adoption of the information systems deployed at healthcare facilities by physicians is important in achieving intended effects of the systems, but many systems face adoption barriers. This study sought to explore factors that influence the adoption of Electronic Medical Record systems, years after its deployment in the provision of health services in Kenya by focusing on public health care facilities in Nakuru County. Electronic Medical Records assists in collecting and storage of patient’s data which can be retrieved in summary form to give a brief overview of the patient’s medical history. Electronic Medical Records applications can be able to show completeness; provide better ordering for searching and retrieving, and provide validity checks for data quality, research and especially decision support. The objectives of this study are; to determine the extent to which Capacity influences the adoption of Electronic Medical Record systems in public health facilities in Nakuru County, to examine the extent to which Infrastructure influences the adoption of Electronic Medical Record systems in public health facilities in Nakuru County, to assess the extent to which User Perception influences the adoption of Electronic Medical Record systems in public health facilities in Nakuru County and to establish the extent to which Workload influences the adoption of Electronic Medical Record systems in public health facilities in Nakuru County. Descriptive survey research design was adopted because it gives a description of the current state of affairs as it exists at present and describes "what exists" involving asking questions of why, where and when. The target population was all the public health facilities in Nakuru County where Electronic Medical Record systems has been deployed but not implemented. Therefore, Census was adopted in gathering the information from all the health facilities in the target population. To choose the participants from each health facility, purposive random sampling was applied which is a type of non-probability sampling (sometimes known as judgmental, selective or subjective sampling) which focuses on particular characteristics of a population that are of interest, thus, the sample size for this study was all the facilities in the target population. Based on theories from the Technology Acceptance Model (TAM), a conceptual framework for the adoption of Electronic Medical Record systems in healthcare facilities was developed. Questionnaires were dropped for the respondent to fill at their own convenient time. The study collected data with the use of a structured questionnaire and the data were coded, entered and analysed using descriptive statistics (frequencies, percentages, mean and coefficient of variation) with the aid of Statistical Packages for Social Sciences (SPSS) computer software. The results were presented in tables. The study was successful in addressing the study objectives and answering the research questions. It was established that Capacity, User Perception and Workload had an influence in the adoption of EMR. Following the findings the study recommends ICT curriculum be included in medical courses as this will give the medical practitioners ownership and confidence to use the technology, having a follow-up mentorship after the first formal training and finally having sufficient health care providers to meet the need of the ever increasing number of patient.