Empowering child health: Harnessing machine learning to predict acute respiratory infections in Ethiopian under-fives using demographic and health survey insights.

BACKGROUND: A dearth of studies showed that infectious diseases cause the majority of deaths among under-five children. Worldwide, Acute Respiratory Infection (ARI) continues to be the second most frequent cause of illness and mortality among children under the age of five. The paramount disease burden in developing nations, including Ethiopia, is still ARI. OBJECTIVE: This study aims to determine the magnitude and predictors of ARI among under-five children in Ethiopia using used state of the art machine learning algorithms. METHODS: Data for this study were derived from the 2016 Ethiopian Demographic and Health Survey. To predict the determinants of acute respiratory infections, we performed several experiments on ten machine learning algorithms (random forests, decision trees, support vector machines, Naïve Bayes, and K-nearest neighbors, Lasso regression, GBoost, XGboost), including one classic logistic regression model and an ensemble of the best performing models. The prediction ability of each machine-learning model was assessed using receiver operating characteristic curves, precision-recall curves, and classification metrics. RESULTS: The total ARI prevalence rate among 9501 under-five children in Ethiopia was 7.2%, according to the findings of the study. The overall performance of the ensemble model of SVM, GBoost, and XGBoost showed an improved performance in classifying ARI cases with an accuracy of 86%, a sensitivity of 84.6%, and an AUC-ROC of 0.87. The highest performing predictive model (the ensemble model) showed that the child's age, history of diarrhea, wealth index, type of toilet, mother's educational level, number of living children, mother's occupation, and type of fuel they used were an important predicting factor for acute respiratory infection among under-five children. CONCLUSION: The intricate web of factors contributing to ARI among under-five children was identified using an advanced machine learning algorithm. The child's age, history of diarrhea, wealth index, and type of toilet were among the top factors identified using the ensemble model that registered a performance of 86% accuracy. This study stands as a testament to the potential of advanced data-driven methodologies in unraveling the complexities of ARI in low-income settings.

Acceptance of electronic medical records and associated factor among physicians working in University of Gondar comprehensive specialized hospital: A cross-sectional study.

Objective: Electronic Medical Records (EMRs) are digitalized medical record systems that collect, store, and display patient data. It is individual patient clinical information electronically gathered and made instantly available to all physicians in the healthcare chain, assisting in the delivery of coherent and consistent care. However, the acceptance of the electronic medical record status of physicians in Ethiopia is limitedly known due to knowledge, attitude, and computer skill gaps. This study aims to assess the acceptance of electronic medical records and associated factors among physicians working in Ethiopia. Methods: A cross-sectional study was conducted among physicians working in Gondar Comprehensive Specialized Hospital. A total of 205 physicians were included. Data were collected through a self-administered structured questionnaire. Descriptive and Logistic regression were conducted. Result: A one hundred ninety-eight participants returned the questionnaire from the total yielding a response rate of 96.6%. The proportion of those who have good acceptance for EMR was 72.2% and about 48.5%, 78.3%, and 59.6%, were sufficient computer skills, Good knowledge, and a favorable attitude toward EMR respectively. Age ≤ 30 years (AOR = 0.13 (0.02, 0.57), working experience AOR = 0.15 (0.04, 0.54), working department AOR = 0.09 (0.01, 0.90), good computer skills AOR = 8.42 (6.45, 16.02), Good knowledge AOR = 5.21 (1.22, 12.28), and favorable attitude AOR = 15.24 (12.06, 25.94) were significantly associated towards EMR acceptance. Conclusion: Generally, in this study, physicians' acceptance of electronic medical records was good. Age, year of experience, working department, good computer skills, good knowledge, and favorable attitude were significantly associated with physicians' acceptance of the electronic medical record. Improving computer skills, enhancing positive attitudes, and increasing the knowledge of the health care professionals are vital interventions to enhance and improve the acceptance of EMR system in the study area.

The effect of capacity building evidence-based medicine training on its implementation among healthcare professionals in Southwest Ethiopia: a controlled quasi-experimental outcome evaluation.

BACKGROUND: Evidence-based medicine (EBM) bridges research and clinical practice to enhance medical knowledge and improve patient care. However, clinical decisions in many African countries don't base on the best available scientific evidence. Hence, this study aimed to determine the effect of training interventions on background knowledge and awareness of EBM sources, attitude, competence, and practice of EBM among healthcare professionals. METHOD: We designed a controlled group quasi-experimental pre-post test study to evaluate the effect of capacity-building EBM training. A total of 192 healthcare professionals were recruited in the study (96 from the intervention and 96 from the control group). We used a difference-in-differences (DID) analysis to determine the effect of the training. Along the way, we used a fixed effect panel-data regression model to assess variables that could affect healthcare professionals' practice of EBM. The cut point to determine the significant effect of EBM training on healthcare professionals' background knowledge and awareness of EBM sources, attitude, and competence was at a P-value < 0.05. RESULT: The DID estimator showed a significant net change of 8.0%, 17.1%, and 11.4% at P < 0.01 on attitude, competence, and practice of EBM, respectively, whereas no significant increment in the background knowledge and awareness of EBM sources. The fixed effect regression model showed that the attitude [OR = 2.288, 95% CI: (1.049, 4.989)], competence [OR = 4.174, 95% CI: 1.984, 8.780)], technical support [OR = 2.222, 95% CI: (1.043, 3.401)], and internet access [OR = 1.984, 95% CI: (1.073, 4.048)] were significantly affected EBM practice. CONCLUSION: The capacity-building training improved attitude, competence, and EBM practice. Policymakers, government, and other concerned bodies recommended focusing on a well-designed training strategy to enhance the attitude, competence, and practice towards EBM among healthcare professionals. It was also recommended to enhance internet access and set mechanisms to provide technical support at health facilities.

eHealth literacy and its associated factors in Ethiopia: Systematic review and meta-analysis.

INTRODUCTION: Electronic health has the potential benefit to the health system by improving health service quality efficiency effectiveness and reducing the cost of care. Having good e-health literacy level is considered essential for improving healthcare delivery and quality of care as well as empowers caregivers and patients to influence control care decisions. Many studies have done on eHealth literacy and its determinants among adults, however, inconsistent findings from those studies were found. Therefore, this study was conducted to determine the pooled magnitude of eHealth literacy and to identify associated factors among adults in Ethiopia through systematic review and meta-analysis. METHOD: Search of PubMed, Scopus, and web of science, and Google Scholar was conducted to find out relevant articles published from January 2028 to 2022. The Newcastle-Ottawa scale tool was used to assess the quality of included studies. Two reviewers extracted the data independently by using standard extraction formats and exported in to Stata version11 for meta-analysis. The degree of heterogeneity between studies was measured using I2 statistics. The publication bias between studies also checked by using egger test. The pooled magnitude of eHealth literacy was performed using fixed effect model. RESULT: After go through 138 studies, five studies with total participants of 1758 were included in this systematic review and Meta-analysis. The pooled estimate of eHealth literacy in Ethiopia was found 59.39% (95%CI: 47.10-71.68). Perceived usefulness (AOR = 2.46; 95% CI: 1.36, 3.12),educational status(AOR = 2.28; 95% CI: 1.11, 4.68), internet access (AOR = 2.35; 95% CI: 1.67, 3.30), knowledge on electronic health information sources(AOR = 2.60; 95% CI: 1.78, 3.78), electronic health information sources utilization (AOR = 2.55; 95%CI: 1.85, 3.52), gender (AOR = 1.82; 95% CI: 1.38, 2.41) were identified significant predictors of e-health literacy. CONCLUSION AND RECOMMENDATION: This systematic review and meta-analysis found that more than half of study participants were eHealth literate. This finding recommends that creating awareness about importance of eHealth usefulness and capacity building to enhance and encouraging to use electronic sources and availability of internet has para amount to solution to increase eHealth literacy level of study participants.

Health Information Technologies in a Resource-Limited Setting: Knowledge, Attitude, and Practice of Health Professionals.

The use of health information technology significantly enhances patient outcomes. As a result, policymakers from developing countries have placed strong emphasis on formulating eHealth policies and initiatives. However, there have not been many successful deployments to show for. The role of individual factors in the successful implementation of these technologies is indispensable. Therefore, this study assesses healthcare professionals' knowledge, attitudes, and practice of health information technology. An institution-based cross-sectional study was conducted at the University of Gondar Comprehensive Specialized Hospital from November 15 to December 29, 2020. A structured, self-administered questionnaire was used to collect data. Student's t-test was used to learn if there were any significant differences in practice habits between participants with and without previous information technology-related training. In addition, first-order partial correlation was conducted to identify the relationship of knowledge and attitude with practice. A total of 347 health professionals responded to the questionnaire, yielding an 87.2% response rate. Most health professionals are not aware of how to use health information technologies. Notably, practice levels were low and needed prompt action from responsible authorities. Previous training did not work very well to improve the practice levels of health professionals. However, the positive attitude of these professionals encourages policymakers and implementers to engage closely.

Electronic Medical Record System Use and Determinants in Ethiopia: Systematic Review and Meta-Analysis.

BACKGROUND: The strategic plan of the Ethiopian Ministry of Health recommends an electronic medical record (EMR) system to enhance health care delivery and streamline data systems. However, only a few exhaustive systematic reviews and meta-analyses have been conducted on the degree of EMR use in Ethiopia and the factors influencing success. This will emphasize the factors that make EMR effective and increase awareness of its widespread use among future implementers in Ethiopia. OBJECTIVE: This study aims to determine the pooled estimate of EMR use and success determinants among health professionals in Ethiopia. METHODS: We developed a protocol and searched PubMed, Web of Sciences, African Journals OnLine, Embase, MEDLINE, and Scopus to identify relevant studies. To assess the quality of each included study, we used the Joanna Briggs Institute quality assessment tool using 9 criteria. The applicable data were extracted using Microsoft Excel 2019, and the data were then analyzed using Stata software (version 11; StataCorp). The presence of total heterogeneity across included studies was calculated using the index of heterogeneity I2 statistics. The pooled size of EMR use was estimated using a random effect model with a 95% CI. RESULTS: After reviewing 11,026 research papers, 5 papers with a combined total of 2439 health workers were included in the evaluation and meta-analysis. The pooled estimate of EMR usage in Ethiopia was 51.85% (95% CI 37.14%-66.55%). The subgroup study found that the northern Ethiopian region had the greatest EMR utilization rate (58.75%) and that higher (54.99%) utilization was also seen in publications published after 2016. Age groups <30 years, access to an EMR manual, EMR-related training, and managerial support were identified factors associated with EMR use among health workers. CONCLUSIONS: The use of EMR systems in Ethiopia is relatively low. Belonging to a young age group, accessing an EMR manual, receiving EMR-related training, and managerial support were identified as factors associated with EMR use among health workers. As a result, to increase the use of EMRs by health care providers, it is essential to provide management support and an EMR training program and make the EMR manual accessible to health professionals.

Myth and Misinformation on COVID-19 Vaccine: The Possible Impact on Vaccination Refusal Among People of Northeast Ethiopia: A Community-Based Research.

Background: To prevent the spread of COVID-19 and carry out a successful vaccination program especially in low-income countries, people must have faith on scientists and health experts. The most significant challenge to vaccination programs' efficacy is now regarded to be a lack of information and trust in immunization due to myths and misinformation spread in the community. Therefore, this study aimed to identify the myth and misconceptions that are propagated about the COVID-19 vaccine, the refusal rate of the vaccine and determine the factors associated with COVID-19 vaccine refusal. Methods: A community-based cross-sectional study was conducted from December 7 to January 25, 2022. Face-to-face interviews with a standardized questionnaire were used to collect data on the variables. Data were entered into the statistical tool Epi data version 3.1 and then exported to SPSS version 25 for analysis. Binary logistic regression, both bivariable and multivariable, was conducted. In the multivariable binary logistic regression model, the adjusted odds ratio with 95% confidence interval was used to declare statistically significant factors based on a p value less than 0.05. Results: Out of the total 574 respondents, 60.3% [95% CI (55.5, 64.2)] of them refused to take COVID-19 vaccine. In this study, respondent's age [AOR = 2.1 at 95% CI: (1.8, 4.9)], perception on COVID-19 vaccine [AOR = 3.0 at 95 CI: (1.9, 4.6)], eHealth literacy [AOR = 2.7 at 95% CI: (1.7, 4.1)], source of information about the vaccine [AOR = 2.9 at 95% CI: (1.9, 4.4)], computer literacy [AOR = 2.8 at 95 CI: (1.8, 4.2)] and frequency of internet use [AOR = 2.2 at 95 CI: (1.8, 5.3)] were identified as determinant factors for COVID-19 vaccine acceptance. Conclusion: Factors like eHealth literacy, source of information about the vaccine, frequency of internet use, respondent's perception about the vaccine and computer literacy were found to be determinant factors for COVID-19 vaccine acceptance.

eHealth Literacy and its Associated Factors Among Health Professionals During the COVID-19 Pandemic in Resource-Limited Settings: Cross-sectional Study.

BACKGROUND: The COVID-19 pandemic has wreaked havoc on health care systems and governments worldwide. Although eHealth literacy is acknowledged as a critical component of public health, it was overlooked during the pandemic. To assist patients and their families, health professionals should be knowledgeable about online health information resources and capable of evaluating relevant online information. In a resource-constrained situation, the level of eHealth literacy among health professionals is not well documented. OBJECTIVE: The aim of this study was to assess the eHealth literacy level and its associated factors among health professionals working in Amhara regional state teaching hospitals, Ethiopia. METHODS: A self-administered questionnaire was used in an institutional-based cross-sectional study design. Descriptive statistics were calculated to describe eHealth literacy statements and key variables using SPSS v.24. Bivariable and multivariable logistic regression models were fit to identify factors related to eHealth literacy. Variables with P<.05 were declared to be statistically significant predictors. RESULTS: A total of 383 participants completed and returned the questionnaire with a response rate of 90.5%. Health professionals demonstrated a moderate level of eHealth literacy (mean 29.21). Most of the professionals were aware of the available health resources located on the internet, and know how to search and locate these resources. However, they lack the ability to distinguish high-quality health resources from low-quality resources. Factors that were significantly associated with eHealth literacy were computer access, computer knowledge, perceived ease of use, and perceived usefulness of eHealth information resources. CONCLUSIONS: It is crucial to provide training and support to health care workers on how to find, interpret, and, most importantly, evaluate the quality of health information found on the internet to improve their eHealth literacy level. Further research is needed to explore the role of eHealth literacy in mitigating pandemics in developing countries.

Medical documentation practice and associated factors among health workers at private hospitals in the Amhara region, Ethiopia 2021.

INTRODUCTION: Medical documentation is an important part of the medical process as it is an essential way of communication within the health care system. However, medical documentation practice in the private sector is not well studied in Ethiopian context. The aim of this study was to assess the practice of medical documentation and its associated factors among health workers at private hospitals in the Amhara region, Ethiopia. METHOD: An institution-based cross-sectional quantitative study supplemented with a qualitative design was conducted among 419 health workers at the private hospitals in the Amhara Region, Ethiopia from March 29 to April 29 /2021. Data were collected using both a self-administered questionnaire and interview guide for quantitative and qualitative respectively. Data were entered using Epi data version 3.1 and analyzed using SPSS version 20. Descriptive statistics, Bi-variable, and multivariable logistic regression analysis were performed. In-depth interviews were conducted using semi-structured questionnaires with eight respondents to explore the challenges related to the practice of medical documentation. Respondent's response were analyzed using OpenCode version 4.03 thematically. RESULTS: Four hundred seven study participants returned the questionnaire. Nearly 50 % (47.2%) health workers had of good medical documentation practice. Health workers who received in-service training on medical documentation AOR = 2.77(95% CI: [1.49,5.14]), good knowledge AOR = 2.28 (95% CI: [1.34,3.89]), favorable attitude AOR = 1.78 (95%CI: [1.06,2.97]), strong motivation AOR = 3.49 (95% CI: [2.10,5.80]), available guide line formats AOR = 3.12 (95% CI: [1.41,6.84]), eHealth literacy AOR = 1.73(95% CI: [1.02,2.96]), younger age AOR = 2.64 (95% CI:[1.27,5.46]) were statistically associated with medical documentation. CONCLUSION: More than half of the medical services provided were not registered. Therefore, it is important to put extra efforts to improve documentation practice by providing planed trainings on standards of documentation to all health workers, creating positive attitudes and enhancing their knowledge by motivating them to develop a culture of information.

Physicians' Attitude towards Electronic Medical Record Systems: An Input for Future Implementers.

BACKGROUND: Electronic medical record (EMR) systems offer the potential to improve health care quality by allowing physicians real-time access to patient healthcare information. The endorsement and usage of EMRs by physicians have a significant influence on other user groups in the healthcare system. As a result, the purpose of this study was to examine physicians' attitudes regarding EMRs and identify the elements that may influence their attitudes. METHOD: An institutional-based cross-sectional study design supplemented with a qualitative study was conducted from March 1 to April 30, 2018, among a total of 403 physicians. A self-administered questionnaire was used to collect quantitative data. The validity of the prediction bounds for the dependent variable and the validity of the confidence intervals and P values for the parameters were measured with a value of less than 0.05 and 95 percent of confidence interval. For the supplementary qualitative study, data were collected using semistructured in-depth interviews from 11 key informants, and the data were analyzed using thematic analysis. RESULT: Physicians' computer literacy (CI: 0.264, 0.713; P: 0001) and computer access at work (CI: 0.141, 0.533, P: 0.001) were shown to be favorable predictors of their attitude towards EMR system adoption. Another conclusion from this study was the inverse relationship between physicians' prior EMR experience and their attitude about the system (CI: -0.517, -0.121; P: 0.002). CONCLUSION: According to the findings of this study, physicians' attitudes regarding EMR were found moderate in the studied region. There was a favorable relationship between computer ownership, computer literacy, lack of EMR experience, participation in EMR training, and attitude towards EMR. Improving the aforementioned elements is critical to improving physicians' attitudes regarding EMR.

Electronic Health-Information Resource Utilization and Its Associated Factors among Health Professionals in Amhara Regional State Teaching Hospitals, Ethiopia.

BACKGROUND: With the rapid advancement and growth of computer and networking technologies, there is also significant growth in the availability and use of various types of electronic information resources. The availability of health information provides confidence for health professionals in clinical decision-making and improves practical skills and attitudes to care. Due to limited studies, the extent of health professionals' electronic health-information resource (EHIR) utilization at specialized teaching hospitals in Amhara regional state is not known. This study aimed to assess the level of EHIRutilization and identify associated factors among health professionals at teaching hospitals in Amhara, Ethiopia. METHODS: An institution-based cross-sectional study was conducted among health professionals working at specialized teaching hospitals in Amhara from February 23 to May 10, 2020. Data were collected using a self-administered questionnaire. Descriptive analysis was used to describe the utilization of EHIRs. Bivariate and multivariate logistic regression analyses were applied to identify which factors were associated with EHIR use. RESULTS: A total of 383 (93.6% response rate) participants responded by completing the questionnaire, and 70.8% (271 of 383) of study participants used EHIRs. eHealth literacy (AOR 1.90, 95% CI 1.03-3.54), Internet access (AOR 1.97, 95% CI 1.06-3.67), computer literacy (AOR 1.9, 95% CI 1.68-5.76), information-searching skills (AOR 1.89, 95% CI 1.05-3.39), and computer access in the working area (AOR 2.50, 95% CI 1.55-5.54) were factors significantly associated with utilization of EHIRs. CONCLUSION: Nearly three-quarters of the health professionals utilized EHIRs. However, most reported that they encountered problems while they were using those resources. For better utilization levels, giving training in the area of electronic information-resource use, increasing awareness of health professionals about available resources, and improving Internet and computer access in each hospital are recommended.

Information Seeking on Covid-19 Pandemic: Care Providers' Experience at the University of Gondar Teaching Hospital, Northwest of Ethiopia.

BACKGROUND: During the pandemic, information is inevitable and important, and having knowledge on pertinent information is very crucial for health-care professionals in order to deliver sustainable and quality health services to their clients, and to combat the virus. Therefore, the aim of this study was to assess the health-care providers' information seeking behavior on COVID-19 pandemic. METHODS: A descriptive cross-sectional study had conducted among 291 respondents. The participant's characteristics were presented using frequency and percentage. The association between the independent and dependent variables was explained using chi-squared test. RESULTS: Out of the 291 respondents, 207 (71.1%) of them had sought information on COVID-19 pandemic. The association between the gender and educational status with the outcome variable was found insignificant. Age (χ2=10.6, P=0.011), respondent's working unit (χ2=33.7, P<0.001), profession (χ2=12.7, P=0.013), taking computer training (χ2=17.44, P=0.000), computer access at work place (χ2=7.28, P=0.007), internet access at work place (χ2=22.2, P<0.001), and frequency of internet use (χ2=17.63, P<0.001) were found significant with COVID-19 information seeking. CONCLUSION: Information seeking behavior was positively associated with computer access, computer training, internet access and frequency of use. Therefore, comprehensive package is required to build the capacity of care providers on computer-related skills. Besides, institutions need to have internet and computer access.

The Applicability of the Modified Technology Acceptance Model (TAM) on the Sustainable Adoption of eHealth Systems in Resource-Limited Settings.

BACKGROUND: The implementation of eHealth systems with a trial-and-error approach is very expensive and unsuccessful. So, this study aims to examine the constructs and relationships of the modified technology acceptance model (TAM) to determine whether it can be applied to assess health professional's behavioral intention to adopt eHealth systems in resource-limited settings or not. METHODS: The institutional-based cross-sectional study design was conducted among a total of 384 healthcare professionals in referral hospitals of Amhara regional state, Ethiopia. Self-administered questionnaire was used to collect the data, and the data were entered using Epi-info version 7 and the descriptive data were analyzed using SPSS version 25. Structural equation modeling, using AMOS 22, was also applied to describe and validate the degree of relationships between variables. RESULTS: The findings of the structural equation modeling (SEM) indicate that perceived usefulness has a significant influence on attitude (ß =0.298, P<0.01) and intention to use eHealth (ß =0.387, P<0.01). Perceived ease of use has significant influence on perceived usefulness (ß=0.385, P<0.05) and attitude (ß=0.347, P<0.05) and intention to use eHealth (ß=0.339, P<0.01). Technical infrastructure has significant influence on attitude (ß =0.412, P<0.01) and intention to use eHealth (ß =0.355, P<0.01). The staffs IT experience has a significant influence on perceived usefulness (ß =0.595, P<0.01) and attitude (ß =0.267, P<0.05), but the effect of IT experience on the intention to use eHealth was not significant. Among all the constructs, healthcare professionals attitude towards eHealth showed the strongest effect on the intention to use eHealth systems (ß = 0.52, P<0.01). CONCLUSION: Overall, this model describes 56.2% of the variance in behavioral intention to use eHealth systems. Therefore, the implementers should give priority in enhancing the organizations technical infrastructure, staff's IT skill, and their attitude towards eHealth by giving continuous support.

Intention to use electronic medical record and its predictors among health care providers at referral hospitals, north-West Ethiopia, 2019: using unified theory of acceptance and use technology 2(UTAUT2) model.

BACKGROUND: Electronic Medical Records (EMRs) are systems to store patient information like medical histories, test results, and medications electronically. It helps to give quality service by improving data handling and communication in healthcare setting. EMR implementation in developing countries is increasing exponentially. But, only few of them are successfully implemented. Intention to use EMRs by health care provider is crucial for successful implementation and adoption of EMRs. However, intention of health care providers to use EMR in Ethiopia is unknown. OBJECTIVE: The aim of this study was to assess health care provider's intention to use and its predictors towards Electronic Medical Record systems at three referral hospitals in north-west, Ethiopia, 2019. METHODS: Institutional based cross-sectional explanatory study design was conducted from March to September among 420 health care providers working at three referral hospitals in north-west Ethiopia. Data were analyzed using structural equation model (SEM). Simple and multiple SEM were used to assess the determinants of health care providers intention to use EMRs. Critical ratio and standardized coefficients were used to measure the association of dependent and independent variables, 95% confidence intervals and P-value were calculated to evaluate statistical significance. Qualitative data was analyzed using thematic analysis. RESULT: The mean age of the study subjects was 32.4 years ±8.3 SD. More than two-third 293(69.8%) of the participants were male. Among 420 health care providers, only 167 (39.8%) were scored above the mean of intention to use EMRs. Factors positively associated with intention to use EMRs were performance expectancy (ß = 0.39, p < 0.001), effort expectancy (ß = 0.24,p < 0.001),social influence (ß = 0.18,p < 0.001),facilitating condition (ß = 0.23,p < 0.001), and computer literacy (ß = 0.08,p < 0.001). Performance expectancy was highly associated with intention to use EMRs. CONCLUSION: Generally, about 40 % of health care providers were scored above the mean of intention to use EMRs. Performance expectancy played a major role in determining health care providers' intention to use EMRs. The intention of health care providers to use EMRs was attributed by social influence, facilitating condition in the organization, effort expectancy, performance expectancy and computer literacy. Therefore, identifying necessary prerequisites before the actual implementation of EMRs will help to improve the implementation status.