Organizational levels’ involvement in electronic health system adoption in Nairobi: a case study of Radiant Group of Hospitals

Abstract

Kenya has experienced a notable increase in uptake of eHealth interventions since the first initiative documented in 2001. But there is limited knowledge on factors influencing the adoption process of locally produced eHealth systems. EHealth adoption enhances quality of life by improving quality of health service delivery, promoting access and cost containment through modern technology. Despite its benefits eHealth still has high failure rate of more than 40 percent. Studies have shown that a vast amount of eHealth adoption fail during implementation phase. Other studies in Kenya revealed a gap of inadequate involvement between strategic management and system end-users in the adoption of Electronic Health Record (EHR) systems. The purpose of this study was to investigate how the involvement of all organizational levels influence the adoption of EHR system through a two-dimension framework that integrates the adoption process and intra-organizational levels. The main objective of the study was to explore the effectiveness of all organizational levels’ involvement in the adoption of a locally developed EHR system in Kenyan context. The study focused on adoption stages of investment, implementation, and utilization. The study was conducted at Radiant Group of Hospitals by examining processes that occurred during the adoption of a locally produced EHR system. A case study design was used for the study. A qualitative approach was adopted to provide in-depth understanding of circumstances relating to how the different levels in the organization perceived the EHR system adoption process. The sample size of the study was 15 comprising of: four of strategic personnel, five operations personnel and six frontline personnel. The collected data was entered and analysed using Nvivo Pro 11. The results from the study indicated that involvement of all organization level in EHR investment decision can positively influence success of EHR adoption as this promotes end-user’s ownership of the system. Organizations need to take their time in planning adequately and in choosing the right vendor. Successful Implementation relies mainly on adequate training of frontline level plus training of trainers (TOTs), availability of IT supporting infrastructures as well as a supportive IT team and vendors. The system is likely to be used effectively if perceived useful in easing and aiding one’s duties. Individual computer or IT skills and supportive superiors also plays a great role in system usability.