Electronic Medical Record Utilization, Determinant Factors and Barriers Among healthcare Providers at Selected Health Facilities in Addis Ababa, Ethiopia

Abstract

Background: Electronic medical record (EMR) is a longitudinal collection of patient information that can be created and managed by authorized clinicians. In developing nations, the adoption of EMR is extremely slow, and the fundamental barriers are not addressed. Despite the effort to digitize the health system in Ethiopia, evidence shows that the progress of utilizing EMR is very slow, with only limited individuals utilizing the system over ten years since its inception. Therefore, this study aims to assess the utilization of EMR and its determinants among healthcare providers in Addis Ababa.
Method: A mixed study design was conducted, enrolling 367 healthcare providers and 12 key informants at selected health facilities in Addis Ababa from May to August 2020. A multi-stage sampling technique was used to identify participants. STATA version 15 was used to analyze quantitative data, while Atlas.ti was used to manage qualitative data. Descriptive statistical summary measures were used to describe variables. Stepwise logistic regression was used to select variables. Variables with a p-value of less than 0.05 in the multivariable logistic regression model were considered statistically significant.
Result: A total of 353 respondents, mainly nurses (48.2%) and physicians (11.6%), were enrolled, yielding a response rate of 96.2%. The overall rate of EMR utilization was 68.5% (95% CI = 63.7, 73.4). EMR utilization was significantly associated with access to EMR training (AOR, 5.8; 95% CI = 1.6, 20.7), age (AOR, 0.37; 95% CI = 0.1, 0.9), type of health institution (AOR, 7.17, 95 % CI=3.2, 16.2), being pharmacists (AOR=9.61, 95% CI=1.97, 46.8) and having a favorable attitude (AOR, 2.3; 95% CI = 1.2, 4.5). On the other hand, qualitative exploration revealed that power fluctuation, shortage of EMR administrators, absences of guidelines, and vendor phase-out were hindering the utilization of EMR.
Conclusion: The utilization of EMR was found to be relatively low, owing to lack of EMR training, age, being a pharmacist, the attitude of healthcare professionals and type of health institution. The absence of clear EMR guidelines, phase-out of vendors, and power fluctuation hinders EMR utilization and needs intervention. We recommend periodic training, deploying EMR admins and making the EMR interface friendly. Furthermore, a strict binding agreement and clear phase-out strategy with EMR vendors are recommended.