Factors Associated With Adoption of Electronic Medical Record System among Healthcare Providers in Kirehe District Health Facilities, Rwanda

Purpose: The goal of this study is to determine the factors associated with adoption of EMR system among healthcare providers in Kirehe District health facilities. The study intends to answer a series of research questions about determining the level of EMR use among healthcare service providers, evaluation of the perception of healthcare providers towards medical care using EMR and the assessment of factors associated with the adoption of EMR system among healthcare providers in Kirehe District Health Facilities. Methodology: The researcher used a cross sectional study design with quantitative approach. Thus, the researcher used census method, which involved the whole target population in the study as a sample size since the numbers of medical personnel in Kirehe District are manageable in terms of time and economy. The researcher used a questionnaire to collect data in this study. Chi-square test was used to assess the association between EMR system adoption and independent variables. The multivariable analysis was applied to identify factors associated with the EMR system adoption by considering the AOR, 95% and p-value less than 0. 05. Tables and Figure were also used to present the data. Findings: The study findings showed that 25.8% of study participants had low, 36.0% had moderate while 38.2% had high levels of EMR use in Kirehe District Health Facilities. The percentage of adoption of EMR system at health facility was 38.2. Findings revealed that most of the study participants (86.8%) said they prefer using EMR rather than paper-based medical records. A big number (78.7%) of study participants believed that the quality of care is improved when using EMR. A lot of study participants (50.0%) strongly agreed that decisions about patient care are quickly taken based on electronic data. During the record of patient’s data, most of the study participants (55.1%) agreed that errors are reduced while using EMR system. A big number of study participants (53.7%) strongly agreed that EMR system makes easy the generation of reports as it is automated and strongly agreed (57.4%) that the reports from the EMR system are accurate. Most of study participants (65.4%) strongly agreed that recording patient’s data using EMR system saves time. A lot of study participants (95.6%) said that EMR use has a positive impact on patient care provision. Perception on reporting facilitation (easy generation of reports), EMR work use experience, data-driven decision-making and quality of internet were significantly associated with EMR system adoption among clinicians in Kirehe District Health Facilities. Clinicians who strongly agreed that EMR system eases reports generation were more likely to adopt the EMR system use (AOR=3.14, 95%CI: 1.128–6.023, p<0.001) compared to those who strongly disagreed. Clinicians who have used EMR system between 1 to 3 years were more likely to adopt EMR system use (AOR=4.23, 95% CI: 1.309–8.003, p=0.021) compared to those who have used the system for a period of less than 1 year. Clinicians who strongly agreed that EMR system supports in quick data-driven decision-making to improve patient’s care were more likely to adopt the EMR system use (AOR=5.61, 95%CI: 1.829–11.864, p=0.022) compared to those who strongly disagreed. Clinicians who said that the quality of internet at the health facility was good during working hours were more likely to adopt EMR system use (AOR: 4.29, 95%CI: 1.005-7.879, p=0.002) compared to those who reported that the internet was unreliable. Unique Contribution to Theory, Practice and Policy: The study should implicate the need for a holistic approach which combines technology (IT, modern infrastructure), people (capacity building and successful adoption), policy and planning that support sustainability of EMR usage to fully realize benefits of EMR in improving patient care and health data management in Kirehe district.