Barriers to the Adoption of Electronic Medical Record System in Ethiopia: A Systematic Review (Preprint)

BACKGROUND Electronic Medical Records (EMRs) have been an important tool in improving patient safety, improving the quality of health care, and increasing health efficiency. Various countries have gone through the local application of EMRs to various health care organizations in national implementation and integration of EMRs. Ethiopia lags far behind in this regard, as only a few hospitals have implemented EMR. OBJECTIVE This study aimed to identify barriers to the adoption of EMRs in Ethiopia through systematic literature reviews. METHODS We searched for relevant articles using three search engines (PubMed, Semantic Scholar, and Google Scholar). The search method focuses on peer-reviewed, empirical studies conducted in Ethiopia. The final set that met the inclusion criteria was nine studies. The authors extracted, analysed, and summarized empirical results related to EMR barriers in these studies. RESULTS This systematic review identified the following 19 barriers to EMR adoption: lack of EMR training, lack of access to computers, lack of computer literacy, lack of knowledge of EMR, lack of technical assistance, lack of EMR manual, negative attitude with EMR, limited internet access, lack of management support, electric power interruption, lack of perceived system quality, lack of perceived information quality, user resistance to change, the complexity of the system, performance expectancy, effort expectancy, social influence, lack of IT qualification, and lack of confidence with computer typing ability. CONCLUSIONS The most common barriers identified in the literature are: lack of EMR training, limited computer access, lack of computer literacy, lack of EMR knowledge, lack of technical support, and absence of an EMR manual. These six barriers alone contain 56.8% of the barriers reported in the literature. As this study summarizes the available evidence regarding barriers to the adoption of EMR in Ethiopia, future research will build on the current evidence and will focus on building an appropriate framework for EMR adoption in Ethiopia.