Electronic medical record (EMR) pre-deployment assessment for adoption readiness, acceptability, and associated factors at Hiwot Fana comprehensive specialized university hospital

Low-income countries struggled to launch large-scale EMR systems and the adoption and use of EMR is still in its embryonic stage. Hiwot Fana comprehensive specialized university hospital in collaboration with the Ethiopian ministry of health, Digital Health Activity (DHA), USAID grant under Capacity Building and Mentorship Project (CBMP) at Haramaya University designed and planned to deploy EMR. This study therefore aimed to assess electronic medical record pre-deployment adoption readiness, acceptability and associated factors. A cross-sectional study was conducted at Hiwot Fana Comprehensive Specialized University Hospital from May 14-May 30, 2023 among 407 healthcare providers and 13 hospital management. Standardized tools to assess technology adoption was used. Data was collected using Kobo Toolbox and transferred to Stata version 16.0 for analysis. Simple descriptive analysis and composite scores were computed for readiness and acceptability. Variables having a p-value of < 0.2 in the bivariable analysis were included in the multivariable logistic regression analysis to identify factors associated with EMR adoption readiness. All statistical values with p-value less than 0.05 were declared to be significant. A total of 407 health workers and 13 case team leaders were involved in this study. Overall, 52.58% healthcare providers were ready to adopt EMR system of which 50.37% had core readiness (dissatisfaction with paper records and need for electronic medical records) whereas 57.25% had engagement readiness (potential benefits and willingness to accept EMR and concern about negative impact of EMR). In multivariable logistic regression male sex, good computer literacy level, good knowledge and favourable attitude towards EMR were positively associated with readiness to adopt EM whereas direct engagement with patient care was negatively associated with EMR adoption readiness. This study established low or unsatisfactory readiness and acceptability of EMR deployment both by the healthcare providers and organizational level. Strong leadership support, targeted capacity building to address staff with low digital literacy levels prior to implementation of an electronic medical record system is very critical. Moreover, assessment of needs, providing and managing financial resources, and setting standards should be highest priority.