Organizational and health professional readiness for the implementation of electronic medical record system: an implication for the current EMR implementation in northwest Ethiopia.

OBJECTIVE: The WHO developed a manual outlining the preliminary organizational and health professionals' readiness to implement electronic medical records (EMR). On the other hand, the readiness assessment in Ethiopia only includes the evaluation of health professionals, leaving out organisational readiness components. As a result, this research aimed to determine health professionals' and organizational readiness to implement EMR at a specialized teaching hospital. METHODS: An institutional-based cross-sectional study design was conducted among 423 health professionals and 54 managers. Self-administered and pretested questionnaires were used to collect data. Binary logistic regression analysis was used to identify factors associated with health professionals' readiness for EMR implementation. An OR with a 95% CI and p<0.05 was used to determine the strength of the association and the statistical significance, respectively. RESULTS: In this study, 53.7% management capacity, 33.3% finance and budget capacity, 42.6% operational capacity, 37.0% technology capability and 53.7% organisational alignment among the five dimensions evaluated to assess an organisation's readiness to implement an EMR system. Of 411 health professionals in this study, 173 (42.1%) with (95 CI 37.3% to 46.8%) were ready to implement an EMR system at the hospital. Sex (AOR 2.69, 95% CI 1.73 to 4.18), basic computer training (AOR 1.59, 95% CI 1.02 to 2.46), knowledge of EMR (AOR 1.88, 95% CI 1.19 to 2.97) and attitudes towards EMR (AOR 1.65, 95% CI 1.05 to 2.59) were significantly associated with health professionals' readiness towards EMR system implementation. CONCLUSIONS: Findings showed that most dimensions of organizational readiness for EMR implementation were below 50%. This study also revealed a lower level of EMR implementation readiness among health professionals compared with previous research studies' results. To improve organisational readiness to implement an electronic medical record system, a focus on management capability, financial and budget capability, operational capability, technical capability and organisational alignment was crucial. Likewise, having basic computer training, giving special attention to female health professionals and improving health professionals' knowledge of and attitudes towards EMR could help improve the readiness level of health professionals for implementing an EMR system.

Health professionals' knowledge and attitude towards patient confidentiality and associated factors in a resource-limited setting: a cross-sectional study.

BACKGROUND: Respecting patients' confidentiality is an ethical and legal responsibility for health professionals and the cornerstone of care excellence. This study aims to assess health professionals' knowledge, attitudes, and associated factors towards patients' confidentiality in a resource-limited setting. METHODS: Institutional based cross-sectional study was conducted among 423 health professionals. Stratified sampling methods were used to select the participants, and a structured self-administer questionnaire was used for data collection. The data was entered using Epi-data version 4.6 and analyzed using SPSS, version 25. Bi-variable and multivariable binary logistic regression analyses were used to measure the association between the dependent and independent variables. Odds ratio with 95% confidence intervals and P value was calculated to determine the strength of association and to evaluate statistical significance. RESULT: Out of 410 participants, about 59.8% with [95% CI (54.8-68.8%)] and 49.5% with [95% CI (44.5-54.5%)] had good knowledge and favorable attitude towards patents confidentiality respectively. Being male (AOR = 1.63, 95% CI [1.03-2.59]), taking training on medical ethics (AOR = 1.73, 95% CI = [1.11-2.70]), facing ethical dilemmas (AOR = 3.07, 95% CI [1.07-8.79]) were significantly associated factors for health professional knowledge towards patients' confidentiality. Likewise, taking training on medical ethics (AOR = 2.30, 95% CI [1.42-3.72]), having direct contact with the patients (AOR = 3.06, 95% CI [1.12-8.34]), visiting more patient (AOR = 4.38, 95% CI [2.46-7.80]), and facing ethical dilemma (AOR = 3.56, 95% CI [1.23-10.26]) were significant factors associated with attitude of health professionals towards patient confidentiality. CONCLUSION: The findings of this study revealed that health professionals have a limited attitude towards patient confidentiality but have relatively good knowledge. Providing a continuing medical ethics training package for health workers before joining the hospital and in between the working time could be recommended to enhance health professionals' knowledge and attitude towards patient confidentiality.