Effectiveness of EHR systems on decision support in primary healthcare: a technology acceptance model 3 perspective.

IF 1.7 4区医学 Q3 HEALTH POLICY & SERVICES Journal of Health Organization and Management Pub Date : 2024-11-01 DOI:10.1108/JHOM-07-2024-0296

Augustino Mwogosi, Stephen Kibusi

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Abstract

Purpose: This study aims to evaluate healthcare practitioners' perceptions of electronic health record (EHR) systems and their effectiveness in supporting clinical decision-making in Tanzanian Primary Healthcare (PHC) facilities.

Design/methodology/approach: A mixed-methods approach was employed, combining quantitative data from structured questionnaires and qualitative insights from open-ended responses. The study was conducted in the Dodoma region of Tanzania, focusing on a diverse representation of PHC facilities, including district hospitals, health centres and dispensaries. Data were analysed using multiple linear regression for quantitative data, and thematic analysis was applied to qualitative responses.

Findings: The results revealed that while EHR systems are widely used in Tanzanian PHC facilities, their impact on clinical decision-making remains limited. Only a moderate portion of practitioners perceived EHR systems as effective in decision support, and frequent system use was negatively correlated with user satisfaction. Challenges such as inadequate training and support, system crashes, slow performance and poor usability and integration into clinical workflows were significant barriers to effectively utilising EHR systems.

Originality/value: This study contributes to the limited literature on EHR system implementation in low-resource settings, specifically Tanzania, by focusing on decision-support features within EHR systems. The findings offer valuable insights for healthcare policymakers, system designers and practitioners to optimise EHR implementation and improve healthcare outcomes in resource-constrained environments.

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电子病历系统对基层医疗决策支持的效果：技术接受模型 3 的视角。

目的：本研究旨在评估坦桑尼亚初级医疗保健（PHC）机构中医疗从业人员对电子健康记录（EHR）系统的看法及其在支持临床决策方面的有效性：采用混合方法，将结构化问卷中的定量数据与开放式回答中的定性见解相结合。这项研究在坦桑尼亚多多马地区进行，重点关注各种初级保健设施，包括地区医院、保健中心和药房。对定量数据采用多元线性回归分析，对定性回答采用专题分析：结果显示，虽然电子病历系统在坦桑尼亚初级保健设施中得到了广泛应用，但其对临床决策的影响仍然有限。只有相当一部分从业人员认为电子病历系统在决策支持方面是有效的，系统的频繁使用与用户满意度呈负相关。培训和支持不足、系统崩溃、性能缓慢、可用性差以及与临床工作流程的整合等挑战是有效利用电子病历系统的重大障碍：本研究通过关注电子病历系统中的决策支持功能，为有关在低资源环境（特别是坦桑尼亚）实施电子病历系统的有限文献做出了贡献。研究结果为医疗政策制定者、系统设计者和从业人员在资源有限的环境中优化电子病历系统的实施和改善医疗效果提供了宝贵的见解。

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来源期刊

Journal of Health Organization and Management HEALTH POLICY & SERVICES-

CiteScore

3.20

自引率

7.10%

发文量

期刊介绍： ■International health and international organizations ■Organisational behaviour, governance, management and leadership ■The inter-relationship of health and public sector services ■Theories and practices of management and leadership in health and related organizations ■Emotion in health care organizations ■Management education and training ■Industrial relations and human resource theory and management. As the demands on the health care industry both polarize and intensify, effective management of financial and human resources, the restructuring of organizations and the handling of market forces are increasingly important areas for the industry to address.