Factors influencing Adoption of Electronic Medical Records in Government Hospitals of Sri Lanka

Abstract

Electronic medical records (EMR) is a popular topic in the literature with the increasing use of EMR in both developed and developing countries. It supports to achieve health sector goals including but not limited to; improved quality, efficiency, cost reduction and patients’ safety and contributes to the sustainable development goal “ensure healthy lives and wellbeing for all at all ages”. Developing countries like Sri Lanka have a critical requirement of having innovative solutions to improve health outcomes while controlling the cost. EMR identified as a better solution to fulfil this requirement. However, it is questionable whether the rate of adoption is at a satisfactory level compared to the importance and benefits of the EMR. This study aimed at identifying critical success and failure factors in adopting EMR in Sri Lanka and propose strategies for successful adoption. Both primary and secondary data were used for the study. The study focused on experience of forty Government hospitals where the EMR systems established under the Digital Health Project, Sri Lanka. Primary data were collected from the health professionals and the regional project officers of Information and Communication Technology Agency of Sri Lanka who managed and coordinated the EMR implementation process in the hospitals. Focus group discussions (FGD), key informant interviews (KII) were mainly used as data collection tools. Further, the research papers published in peer-reviewed journals were reviewed. During the study, twenty-six factors that influence the success and failure of EMR adoption were identified. These factors were categorized and analyzed under six themes – i.e., human factors, technical factors, organizational factors, financial factors, legal factors and change management factors. The most influential category of factors was human factors. Even though the EMR implementation involves applying technology in the health sector, ‘people’ factor should not be forgotten. Ideally, the future EMR implementations should be based on the lessons learnt and best practices of the previous projects in order to achieve successful adoption and to avoid waste of resources.