An analysis of the adoption of electronic health records in primary healthcare

Abstract

Background: The challenges faced by the public healthcare system in developing countries such as South Africa (SA) have promulgated the use of Electronic Health Records (EHR) in primary healthcare facilities. This is due to the operational as well as administrative efficiencies offered by EHR. Objective: This study seeks to understand if the efficiencies of EHR are being realised, under what circumstances, to what extent and assess the perceived barriers to adoption of EHR. Literature gap: The implementation of EHR is still in the pilot phase and literature sources are available for adoption and implementation in other countries however, the resource challenges that plague SA may require different/ alternative solutions to guide implementation. Currently there is no published literature available regarding the adoption of EHRs in the public primary healthcare sector. Moreover, there is a need to scale up EHR in primary healthcare clinics, learning from evidence-based mechanisms to increase the positive impact created by technology in improving healthcare systems. Methodology: The research investigated the end-user experiences of adopting EHRs and the perspectives of subject matter experts (SMEs) on the best practices for implementation of EHR. A qualitative exploratory study was undertaken; 16 interviews were conducted, which were broken up as follows: eight interviews with end-users of EHR in three primary healthcare facilities and eight SMEs from five companies were conducted to obtain insights in and validate the alignment of SME and end-user perspectives. Results and Conclusion The importance of the interview results is that it led to the re-arrangement of change management models to streamline the adoption of electronic health record implementation in primary healthcare facilities. Key areas of improvement for implementers and SMEs were identified. There is potential to transform primary healthcare administration if the key drivers of adoption in primary healthcare are identified and improvements in that regard could lead to quicker adoption and assimilation of technologies like EHR.