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Introduction
Healthcare systems worldwide are implementing ICT to improve access to healthcare and the effectiveness and efficiency of health systems.1 Electronic medical record (EMR) systems are used in many countries’ healthcare systems. An EMR is a computer-based system that collects and stores a person’s medical information.2 3 EMR systems can collect longitudinal data from patients, retrieve patient history and provide doctors with access to evidence-based decision-making tools. EMR systems are used for patient registration, medication and drug prescriptions, pharmaceutical activity record keeping, laboratory results and all patient healthcare information during each visit.4 5
The WHO developed a manual outlining the preliminary organisational and health professional readiness for implementing an EMR system.6 According to the WHO outline, successful implementation and maintenance of EMR result from the organisation’s and end users’ predetermined readiness.6 Globally, more than half of EMR projects face sustainability issues. Especially in low-income and middle-income countries, the adoption of EMR systems is far lower than expected. Evidence shows that only 35% of lower-middle-income and 15% of low-income countries have implemented national electronic health record systems.7 A factor contributing to the low adoption rate of EMR systems is that implementers in low-income and middle-income countries fail to properly assess organisational and staff readiness for EMR system implementation and use.8 Before implementing EMRs, it is critical to understand the medical community’s managerial readiness and digital literacy. This is because once the implementer is aware of the problems, everyone can work together to keep the implementation moving forward.
In developed countries, evidence reported the assessment of organisational9 10 and healthcare provider readiness to adopt EMR.11–13 On the other hand, there is a lack of preimplementation assessment in low-income countries, particularly in sub-Saharan Africa, which has been blamed for the failure of those EMR implementation projects. Evidence suggested that low-income nations did not conduct organisational or health professional readiness evaluations before implementing the EMR, and that no efforts were made to ensure the implementation’s effectiveness.14 Furthermore, the readiness assessment in this setting includes only the evaluation of health professionals, leaving out organisational readiness, which is a cornerstone to successfully implementing EMR systems.15–17 As readiness is a multidimensional and multilevel construct, it should consist of individual and organisational dimensions. Organisational readiness is a well-known factor influencing EMR implementation success. The areas of focus for organisational readiness for implementing EMR are management capacity, finance and budget capacity, operational capacity, technology capacity and organisational alignment.18
In Ethiopia, studies have been conducted to assess the readiness of health professionals for EMR adoption.19–21 Sociodemographic characteristics, knowledge, attitude and practice of health professionals on EMR, computer training, and computer literacy determine the readiness of health professionals.20–23
In the past many years, Ethiopia has made efforts to implement EMR systems at various public health facilities. However, the implementation efforts have been unsuccessful in all but a few health facilities. In recent years, however, Ethiopia has made remarkable achievements in the implementation of health information systems, including the District Health Information System, Electronic Community Health Information System, Electronic Logistics Management Information System, Electronic Public Health Emergency Management System and EMR system.24
Currently, the Ministry of Health is facilitating and supporting the implementation of EMR systems that meet the Ethiopian Electronic Health Record (EHR) standard. One of the EMR systems deployed in various public health facilities in Ethiopia, including the University of Gondar Comprehensive and Specialised Hospital, is the Bahmni system. The system is a global open EMR tool that provides end-to-end automation of health facility services.25
Understanding the readiness level could help to identify gaps and take remedial actions before and during EMR system implementation. Therefore, this research aimed to determine health professionals’ and organisational readiness to implement EMR at the University of Gondar specialised hospital. The findings of this study will provide implementers and health managers with baseline information about organisational and health professional readiness levels before launching a costly implementation.
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