Does the integrated electronic medical record system have a positive adoption in community hospital settings?

Background: In developing nations, there is limited research evidence and an information gap in the adoption of Integrated Electronic Medical Record System (EMRs). This study aimed to evaluate the adoption of recently integrated EMRs in community hospitals in Nepal. 

Methods: Two community hospitals with integrated EMRs were purposively selected. Both hospitals used the Bahmni EMRs, an open-source platform designed for low-resource settings that integrates clinical, laboratory, pharmacy, and administrative functions. Among the total of 165 EMRs users, 121 successfully participated in this quantitative study from September 05 to October 23, 2022. The study utilized the technology acceptance model to assess the attitudes towards the adoption of integrated EMRs, based on EMRs usage duration, system capability, learning acceptability, and users’ behavioral intentions. 

Results: The mean scores for attitudes toward EMRs, EMRs learning acceptability and users’ behavioral intention to use EMRs were 46.55 ± 7.9, 33.41 ± 5.9, and 36.61 ± 5.7, respectively. Participants with postgraduate education (vs. undergraduate and high school) and those working in the laboratory and administration departments (vs. OPD, pharmacy and IPD) had higher mean scores for attitude and learning acceptability (P < 0.01). Increased duration of EMRs use, (B, 0.81, CI: 0.61–1.15, P < 0.001), increased EMRs system capability (B, 0.43; CI: 0.21–0.73, P = 0.001), increased EMRs learning acceptability (B, 0.71; CI: 0.50–0.94, P < 0.001), and increased EMRs users’ behavioral intentions (B, 0.51; CI: 0.35–0.67, P < 0.001) significantly increased the attitudes toward the use of EMRs. 

Conclusion: The adoption of integrated EMRs was positive. Integrated EMRs could improve the quality and efficiency of healthcare services with low-cost resources. Therefore, central and local healthcare systems must prioritize the expansion of integrated EMRs across multiple community hospitals and healthcare centers. 

Clinical trial number: Not applicable.