FACTORS INFLUENCING THE ADOPTION OF ELECTRONIC HEALTH RECORDS IN PUBLIC HEALTH FACILITIES IN KISUMU COUNTY, KENYA

1.0 INTRODUCTION 1.1 Background to the Study Electronic health records (EHRs) are the fundamental building blocks of any national health information system (Castro, 2009). A country with low acceptance of health systems implementation is bound to have poor quality of healthcare services and low economic growth, as productivity of citizens might be greatly affected when they fall sick and are not attended to as required. However, influenced by government policies to begin using new technologies, reception and adoption of health systems has allowed the process of technology diffusion to commence which ultimately determines the rate of change of productivity (Hall and Khan, 2002). As such, many countries including developing countries have realized that EHR can be considered as good solution for them to overcome most of their problems in healthcare delivery services (Hassibian, 2013). However, serious problems continue to be experienced. Certain hospital cultures tend to resist technological changes which result to low adoption and use of technology, yet effective diffusion requires user acceptance. Resistance by users to transform from an existing health system to a new system such as from paper based health record (PBHR) to EHR system (Peansupap and Walker, 2005) is among the list of complex issues that various researchers have attempted to document. Multiple factors have attributed to low rate of adoption (Al-Aswad et al, 2013) which may range from individual, organizational to technological factors such as human skills, organizational structures, training, user confidence, culture, technical infrastructure, financial resources and coordination (Heeks, 2006; Jihaet al, 2009; Boonstra, 2014; I-TECH, 2015) among others. Several studies have also recognized that, despite the ever increasing interest in EHR implementation, the rate of adoption still remains low in many developing countries (Ajami et al, 2011; Njoroge, 2014; Chebole, 2015). 1.2 Problem Statement Manual PBHR system has been used for a long time to store large files of patient data (Njoroge, 2014). This has not been an efficient way to record and store data since there are many disadvantages associated: loss of cards, loss of files, untraceable file and time wasted trying to retrieve files. However, with the use of new technology in every walk of life, more hospitals are considering the use of EHR system in place of PBHR (Thakkar et al, 2006). EHR has distinct advantages over paper records which include: enabled access to medical records from remote locations, improved speed and ease of retrieval of records, avenues to flag abnormal results and the elimination of hand written prescriptions, which reduces the occurrence of prescription errors, greater work efficiency and streamlined workflow (Ohemeng et al, 2010; Gaylin et