Electronic medical records system user acceptance

Abstract

Access to quality healthcare in developing countries must be provided amidst a resource scarce environment and often only accessible to a fraction of the population. Health information technologies (HIT) are seen as a means to improve and increase access to quality healthcare with the South African National Health Insurance strategy requiring the use of electronic based systems as an integral part of the medical information system to help ensure the success of the strategy. One such electronic based system is electronic medical records (EMR). Various studies have recognized the positive influence EMR systems should have on the perceived efficiencies of healthcare professionals and also the positive influence change management as a science can have on the change process any company has to or need to make. This paper reports on the results of a study focusing on the challenges healthcare professionals face in accepting a new EMR system and also to test if change management as a scientific field of study can be used to facilitate the changeover process from a paper based record system to an EMR system. The scope of the study was limited to the human aspects of change management and perceived efficiency of healthcare professionals. Two South African medical institutions were approached with one in the process of implementing a new EMR system and the other at the initial stages of the deployment at the time of the study. A literature review of EMR systems and in-depth study of change management were done. A narrative inquiry was performed to determine if any principles of change management has been used to facilitate the changeover to the new system. The responses of the narratives survey were analysed and compared to known principles of change management taking into consideration the complexities of EMR systems and the resulting conflicts between using the existing system and changing over to a new system as well as the perceived change in efficiency. The challenges faced by successfully implementing new EMR systems are indeed vast. There do however seem to be a common theme in most of the challenges that ultimately converge on how users experience the system and thus their resistance to the new system. Less experienced user tend to resist the change due to a lack of understanding of the system with usability of the system playing a large role. Even experienced user will resist a system if they perceive the system to be ineffective in assisting them with their primary task. Thus, based on literature and confirmed in this case study, if adoption of EMR systems is the ultimate goal, the implementation thereof should be properly managed with strong leadership and political backing at the highest level. Adoption is also supported by keeping the end goal in mind with all stakeholders, especially leadership, at all times aware and responsive to whether the change is supporting or hindering organizational goals. In this regards change management as a science can possibly play an integral part in the ultimate acceptance of EMR systems.