Investigating challenges to electronic medical record systems adoption : a case of Coast Province General Hospital

Abstract

Background: The recent worldwide focus on healthcare quality improvement, cost containment and enhanced patient experience has led to increased need for adoption of Electronic Medical Record systems (EMR).This would significantly reduce clinician workload and medical errors while saving the institution major expenses. Kenya is globally acclaimed as a leader for its Information Communication Telecommunications (ICT) innovations such as M-PESA.Yet compared to developed nations, Kenya has a long way to go on EMR systems adoption. This paper thus examines the potential challenges as perceived by user groups, to EMR systems adoption in a public hospital and suggests possible interventions to the said challenges. Methodology: A descriptive survey research design was used. A sample size of 141 was used out of a population of 473 employees working at the Coast Province General Hospital (CPGH). Stratified random sampling technique was used based on categories of staff establishment .Data was collected using structured questionnaires and analyzed using SPSS version 20 and Microsoft Excel 2007. Results: The study findings indicate that financial, technical and time constraints are among the challenges to EMR adoption at CPGH with change process as a mediating factor. The respondents strongly agreed that lack of proper leadership, lack of stakeholder involvement, resistance to changing the traditional way of working and lack of motivating factors were among the impediments to adopting this change. EMR systems adoption requires extensive commitment to system administration, control, maintenance, and support in order to keep it working effectively and efficiently. High initial costs, ongoing maintenance costs and uncertain return on investment were highlighted as key financial barriers. Lack of the infrastructure and skills among the user groups, presumed complexity and lack of customizability were some of the technical barriers voiced. Time to learn the system; time to enter data and time to convert the records was perceived to have an effect on workflow and workload. Conclusions: The policy makers thus need to budget for EMR adoption expenses, put measures to train staff, communicate the shared vision through stakeholder involvement, and have monitoring and evaluation strategy in place. The process of EMR adoption should be treated as a change project, and led by implementers or change managers. The quality of change management plays an important role in the success of EMR adoption. The findings from this study will be shared with the hospital administration for consideration in policy formulation, decision making, research and development and in addressing the said challenges.