Abstract:
Introduction: Despite the rapid growth in the information technology, use of electronic
medical records in health care is lagging behind. Its adoption rate is still low and its
implementation is not consistent across healthcare facilities in resource limited settings. There
is limited study conducted on electronic health records implementation status, specifically
factors associated with electronic health record use by health professionals in Dire Dawa city
administration.
Objective of the study: The aims of this study was to assess electronic medical record
implementation status, data quality and factors associated with electronic medical record use
in urban public health facilities in Dire Dawa city administration from April 7- May 7/2019.
Methods: An institution based cross-sectional study, supplemented with an exploratory
qualitative approach was used. All urban public health facilities were included for the
assessment of electronic medical record implementation status and data quality. Simple random
sampling technique was used to select 446 health professionals for the assessment of factors
associated with electronic medical records use. Data was entered into epidata 3.1 version and
analyzed using Stata version 14.1. Variables having a p-value of <0.2 in the bivariate analysis
were included into multivariate logistic regression analysis. All statistical value with p-value
less than 0.05 was declared to be significant. An in-depth interview was thematically analyzed
using ATLAS.ti version 7.5.4 software.
Result: Electronic medical record implementation was 11.18% at health centers and 22.96%
at hospitals. Only 26.6% of health professionals were using electronic medical record at the
time of the study. Work experience less than 7 years (AOR=2.23; 95%CI-[1.15-4.31]),
discussing on EMR in any meeting (AOR=14.47; 95%CI-[5.58-37.57]), presence of EMR
manual (AOR=3.10 95%CI-[1.28-7.38]), participants good attitude on electronic medical
system quality (AOR=11.15; 95%CI-[4.90-25.36]) and service quality (AOR=8.02; 95%CI-
[4.09-15.72]) were significantly associated with electronic medical record use.
Conclusion: Electronic health record implementation at facilities level and utilization by health
professionals is low. Presence of EMR manual and health professionals perceived system
quality on EMR are factors strongly associated with EMR use. Improving awareness, providing
supplies and training are important interventions to improve the electronic medical record
system use by health professionals.
