Factors influencing User Acceptance of Electronic Health Records Systems in Low Resource Settings: The Case of Ghana

Abstract

Background and Purpose: Electronic Health Records (EHR) Systems play in vital role in improving healthcare globally, particularly in low resource settings. Their adoption however remains challenging in developing countries although they have been shown empirically to be superior to traditional paper records. The Light wave Health Information Management System, an EHR, was deployed in the Tamale Teaching Hospital in December, 2020. Unfortunately, no evaluation has ever been done to ascertain staff attitudes and perceptions of the system. We investigated user acceptance and factors influencing user acceptance among healthcare workers in the Tamale Teaching Hospital, in Ghana.

Methods: A quantitative cross-sectional design was used to study 373 randomly selected health care workers. A Z-test for proportion was used to examine differences in staff attitudes pre- and post-implementation of the system. Further, logistic regression analysis was used to identify factors influencing acceptance of the system. 

Results: The study revealed a high acceptance rate (97%) with the application. We observed significant improvement in the overall positive attitude pre-implementation 65% compared with post-implementation 77% towards electronic health records system (z=-3.07; p-value=0.007; 95% C.I.-.19 - -.04). Predictors of user acceptance were workers with at least 20 years’ experience in computer use (OR=6.307, p=0.032), and being a medical doctor (OR=7.443, p=0.048). The study identified complex software interface, lack of dedicated power supply, poor internet connectivity, and inadequate training as key challenges to the acceptance of the system.  

Conclusions: To avoid dissatisfaction among workers, management should organize training sessions to improve computer skills, and make sufficient budgetary allocation for planned maintenance, stable power supply, and reliable internet connectivity.