Utilization, Determinants, and Prospects of Electronic Medical Records in Ethiopia

Abstract

Background. A lot of effort is being done in the electronic medical record (EMR) system. However, it has not been implemented and used at the expected scale for maximal effectiveness. There is limited evidence on the factors affecting the utilization of EMR in this particular context, which are critical for targeted strategies. Objective. To assess the magnitude and factors affecting the utilization of EMR among health professionals in eastern Ethiopia. Methods. An institutional-based cross-sectional study was conducted among randomly selected 412 health professionals from Harari and Dire Dawa, eastern Ethiopia, using a pretested self-administered questionnaire. The tool was developed from previous literature, and a pilot survey was done before the actual study. Bivariable and multivariable binary logistic regression were done to assess the relationship between an independent variable with EMR use. Crude and an adjusted odds ratio with a 95% confidence interval were reported. A $P$ value of less than 0.05 was used to declare a statistically significant association. Results. A total of 412 health professionals with a mean age of 29 years (±6.4 years) were included. A total of 229 (55.6%) and 300 (72.8%) of them had good knowledge and attitude towards the EMR, while 279 (67.7%) used the service (54% used it on a daily basis). About 272 (66%) of the respondents reported that they prefer EMRs to paper-based systems. Health professionals with more than five years of experience had two times higher odds of using the service ( $\text{AOR}=2.22$ ; 95% CI; 1.12-4.42) than early-career workers. Health professionals trained in EMR would use the service more ( $\text{AOR}=5.88$ ; 95% CI; 2.93-11.88) compared to those who did not take the training. In addition, having good knowledge ( $\text{AOR}=1.52$ ; 95% CI; 0.92-1.5) and a good attitude towards the EMR system ( $\text{AOR}=2.4$ ; 95% CI; 1.35-4.31) showed to use EMR as compared to counterparts. Conclusions. The utilization of EMR was found to be optimal. Age, work experience, knowledge, attitude, and training of professionals were positively associated with the use of the service in their facility.