Factors influencing Adoption of Electronic Medical Records in Government Hospitals of Sri Lanka

Authors

  • Maheesa Dayananda  Senior Project Manager (Digital Health), Information and Communication Technology Agency of Sri Lanka

DOI:

https://doi.org/10.32628/CSEIT206624

Keywords:

Electronic Medical Records, Digital Health, Adoption, Sri Lanka

Abstract

Electronic medical records (EMR) is a popular topic in the literature with the increasing use of EMR in both developed and developing countries. It supports to achieve health sector goals including but not limited to; improved quality, efficiency, cost reduction and patients’ safety and contributes to the sustainable development goal “ensure healthy lives and wellbeing for all at all ages”. Developing countries like Sri Lanka have a critical requirement of having innovative solutions to improve health outcomes while controlling the cost. EMR identified as a better solution to fulfil this requirement. However, it is questionable whether the rate of adoption is at a satisfactory level compared to the importance and benefits of the EMR. This study aimed at identifying critical success and failure factors in adopting EMR in Sri Lanka and propose strategies for successful adoption. Both primary and secondary data were used for the study. The study focused on experience of forty Government hospitals where the EMR systems established under the Digital Health Project, Sri Lanka. Primary data were collected from the health professionals and the regional project officers of Information and Communication Technology Agency of Sri Lanka who managed and coordinated the EMR implementation process in the hospitals. Focus group discussions (FGD), key informant interviews (KII) were mainly used as data collection tools. Further, the research papers published in peer-reviewed journals were reviewed. During the study, twenty-six factors that influence the success and failure of EMR adoption were identified. These factors were categorized and analyzed under six themes – i.e., human factors, technical factors, organizational factors, financial factors, legal factors and change management factors. The most influential category of factors was human factors. Even though the EMR implementation involves applying technology in the health sector, ‘people’ factor should not be forgotten. Ideally, the future EMR implementations should be based on the lessons learnt and best practices of the previous projects in order to achieve successful adoption and to avoid waste of resources.

References

  1. A. Boonstra and M. Broekhuis, “Barriers to accept EMR,” BMC Health Serv. Res., vol. 10, no. 231, 2010.
  2. S. P. Sood et al., “Electronic medical records: A review comparing the challenges in developed and developing countries,” Proc. Annu. Hawaii Int. Conf. Syst. Sci., pp. 1–10, 2008, doi: 10.1109/HICSS.2008.141.
  3. R. R. Shield, R. E. Goldman, D. A. Anthony, N. Wang, R. J. Doyle, and J. Borkan, “Gradual electronic health record implementation: New insights on physician and patient adaptation,” Ann. Fam. Med., vol. 8, no. 4, pp. 316–326, 2010, doi: 10.1370/afm.1136.
  4. Global Digital Health Index (GDHI), “About the Global Digital Health Index,” 2020. https://www.digitalhealthindex.org (accessed Nov. 22, 2020).
  5. J. D. Piette et al., “Impacts of e-health on the outcomes of care in low- and middle-income countries: where do we go from here?,” Bull. World Health Organ., vol. 90, no. 5, pp. 365–372, 2012, doi: 10.2471/BLT.11.099069.
  6. S. Rathnayake and R. Hewapathirana, “Impact of Electronic Health Records in Sri Lanka : Case Study of Four Government Hospitals .,” 2015, Online]. Available: https://s3.amazonaws.com/academia.edu.documents/38725595/IMPACT_OF_ELECTRONIC_HEALTH_RECORD_IN_SRI_LANKA_IEEE_final_v.3.pdf?AWSAccessKeyId=AKIAIWOWYYGZ2Y53UL3A&Expires=1509778654&Signature=vXxafXOZjgNOsrGG3l5ZNwuynCU%3D&response-content-disposition=inline.
  7. D. Pole, “Computerization of Clinical Records in Out-patient Departments of Sri Lankan Hospitals,” Sri Lanka J. Bio-Medical Informatics, vol. 1, no. 4, p. 200, 2010, doi: 10.4038/sljbmi.v1i4.2235.
  8. T. Jeyakodi and D. Herath, “Acceptance and Use of Electronic Medical Records in Sri Lanka,” Sci. Res. J., vol. IV, no. I, pp. 1–5, 2016, Online]. Available: www.scirj.org.
  9. K. Sarathchandra and S. Rathnayake, “Implementation challenges and Research Gaps of Electronic Medical Records (EMR) in Public Sector Hospitals of Sri Lanka,” Int. J. Sci. Res. Publ., vol. 9, no. 7, p. p9124, 2019, doi: 10.29322/ijsrp.9.07.2019.p9124.
  10. Ministry of Health Nutrition and Indigenous Medicine, “The National Policy on Health Information,” 2017. Online]. Available: http://www.health.gov.lk/moh_final/english/public/elfinder/files/publications/publishpolicy/NationalPolicyonHealthInformation.pdf.
  11. Ministry of Health, “National Digital Health Guidelines & Standards 2.0,” 2020. Online]. Available: http://www.health.gov.lk/moh_final/english/public/elfinder/files/publications/list_publi/NDHGS v2.pdf.
  12. K. Mendis et al., “Cloud-Based Open Source Primary Care Electronic Patient Record System for Sri Lankan Citizens,” 2019 Natl. Inf. Technol. Conf. NITC 2019, pp. 8–10, 2019, doi: 10.1109/NITC48475.2019.9114518.
  13. ICTA, “Digital Health Project,” Official Website ICTA, 2020. https://www.icta.lk/projects/digital-health/#1447655280990-9ce25279-b127ffac-1feb (accessed Nov. 22, 2020).
  14. K. Häyrinen, K. Saranto, and P. Nykänen, “Definition, structure, content, use and impacts of electronic health records: A review of the research literature,” Int. J. Med. Inform., vol. 77, no. 5, pp. 291–304, 2008, doi: 10.1016/j.ijmedinf.2007.09.001.
  15. L. G. Yamamoto and A. N. G. A. Khan, “Challenges of electronic medical record implementation in the Emergency Department,” Pediatr. Emerg. Care, vol. 22, no. 3, pp. 184–194, 2006, doi: 10.1097/01.pec.0000203821.02045.69.
  16. R. Wong and E. H. Bradley, “Developing patient registration and medical records management system in Ethiopia,” Int. J. Qual. Heal. Care, vol. 21, no. 4, pp. 253–258, 2009, doi: 10.1093/intqhc/mzp026.
  17. M. Top and Ö. Gider, “Nurses’ views on electronic medical records (EMR) in turkey: An analysis according to use, quality and user satisfaction,” J. Med. Syst., vol. 36, no. 3, pp. 1979–1988, 2012, doi: 10.1007/s10916-011-9657-6.
  18. M. Khalifa, “Barriers to health information systems and electronic medical records implementation a field study of Saudi Arabian hospitals,” Procedia Comput. Sci., vol. 21, pp. 335–342, 2013, doi: 10.1016/j.procs.2013.09.044.
  19. G. B. Cline and J. M. Luiz, “Information technology systems in public sector health facilities in developing countries: The case of South Africa,” BMC Medical Informatics and Decision Making, 2013. http://www.biomedcentral.com/1472-6947/13/13.
  20. M. Greiver, J. Barnsley, R. H. Glazier, R. Moineddin, and B. J. Harvey, “Implementation of electronic medical records: Theory-informed qualitative study,” Can. Fam. Physician, vol. 57, no. 10, pp. 390–397, 2011.
  21. M. I. Merhi, “A process model leading to successful implementation of electronic health record systems,” Int. J. Electron. Healthc., vol. 8, no. 2–4, pp. 185–201, 2015, doi: 10.1504/IJEH.2015.075355.
  22. J. W. Lian, D. C. Yen, and Y. T. Wang, “An exploratory study to understand the critical factors affecting the decision to adopt cloud computing in Taiwan hospital,” Int. J. Inf. Manage., vol. 34, no. 1, pp. 28–36, 2014, doi: 10.1016/j.ijinfomgt.2013.09.004.
  23. I. Muslimin, S. P. Hadi, and E. Nugroho, “An Evaluation Model Using Perceived User Technology Organization Fit Variable for Evaluating the Success of Information Systems,” Sci. J. Informatics, vol. 4, no. 2, pp. 86–94, 2017, doi: 10.15294/sji.v4i2.12012.
  24. F. Fritz, B. Tilahun, and M. Dugas, “Success criteria for electronic medical record implementations in low-resource settings: A systematic review,” J. Am. Med. Informatics Assoc., vol. 22, no. 2, pp. 479–488, 2015, doi: 10.1093/jamia/ocu038.
  25. J. Brender, E. Ammenwerth, P. Nykänen, and J. Talmon, “Factors influencing success and failure of Health Informatics systems: A pilot Delphi study,” Methods Inf. Med., vol. 45, no. 1, pp. 125–136, 2006, doi: 10.1055/s-0038-1634049.
  26. ICTA, “Enabling Legal Environment,” Official Website ICTA, 2020. https://www.icta.lk/act/ (accessed Nov. 29, 2020).

IInternational Journal of Scientific Research in Computer Science, Engineering and Information Technology

Downloads

Published

2020-12-30

Issue

Volume 6, Issue 6, November-December-2020

Section

Research Articles

License

Copyright (c) IJSRCSEIT

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite

[1]
Maheesa Dayananda, " Factors influencing Adoption of Electronic Medical Records in Government Hospitals of Sri Lanka" International Journal of Scientific Research in Computer Science, Engineering and Information Technology(IJSRCSEIT), ISSN : 2456-3307, Volume 6, Issue 6, pp.190-199, November-December-2020. Available at doi : https://doi.org/10.32628/CSEIT206624