FACTORS INFLUENCING THE ADOPTION OF ELECTRONIC HEALTH RECORDS IN PUBLIC HEALTH FACILITIES IN KISUMU COUNTY, KENYA
Keywords:
Adoption, Electronic Health Records. Public Health Facilities, Kisumu CountyAbstract
Purpose: The purpose of the research study was to determine the factors influencing the adoption of electronic health records in public health facilities in Kisumu County.
Methodology: The study adopted was cross-sectional design where it targeted 12 public hospitals with a sample size of 132 health care workers. Out of 132 health care workers who were sampled out from 12 public health facilities, 108 consented to take part in the study. Questionnaires with both structured and semi-structured questions were administered. Qualitative data was recorded, transcribed, coded then analyzed while quantitative data was coded and analyzed using Statistical Package for Social Sciences (SPSS) version 20. Descriptive statistics of frequencies and percentages were used to summarize the data while inferential statistics applied Chi-square to test for the association between the dependent and independent variables. A p value which was less or equal to 0.05 was considered significant.
Results: The study revealed that there was a significant statistical relationship between techno-organizational factors and existing EHR levels; Inadequate & non-functional EHR related infrastructure, weak internet connectivity and unstable power supply were the key technological factors while lack of adequate financial resources, inadequate training support by the hospital management, inadequate technical expertise, non-user involvement and lack of harmonized standard legal enforcement were the major organizational factors that contributed to low rate of EHR adoption. Individual factors had the least influence towards low rate of adoption. Two existing levels of EHR implementation were established; fully implemented and not implemented. Majority of the health facilities had not adopted the use of EHR system hence belonged to "˜not implemented level'. Therefore, adoption of EHR has not yet attained its maximum potential as it is still low and unevenly effected across public hospitals.
Unique Contribution to Theory, Practice and Policy: The study recommended that in a move towards universal health coverage, it is necessary for health facilities to streamline the techno-organizational structures that strengthen the adoption of health system projects like EHR towards the provision of improved and quality health services.
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References
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Bagozzi, R., Davis, F., and Warshaw, P., 1992, "˜Extrinsic and Intrinsic motivation to use computers in the work place', Journal of applied social psychology, 22(14), 1111-1132
Bates, D.W., and Gawande, A.A., 2003, "˜Improving Safety with Information Technology' N Engl J Med 348, 2526-2534.
Boonstra, A., Brekhuis, M., 2010, "˜Barriers to the acceptance of electronic medical records by physicians from systematic review to taxonomy and interventions', Viewed on 24 August 2016
Bedeley, R.T., and Palvia, P., 2014, "˜Study of the issues of E-Health in Developing Countries: The Case of Ghana', Twentieth Americas Conference on Information Systems.
Carter, J. H., 2006, Infrastructure and Supporting Technologies: What is Electronic Health Record, USA, American College of Physicians.
Chapli, B., Meloni, S., Esen, G., Jolayemi, T., Banigbe, B., and Adeola, J., 2015, "˜Scale-up of networked HIV treatment in Nigeria: Creation of an integrated electronic medical records system, International journal of Medical Information, 84, 58-68
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Cresswell, K., Morrison, Z., Crowe, S., Robertson, A., Sheikh, A., 2011, "˜Anything but engaged: user involvement in the context of a national electronic health record implementation', Journal of Informatics in Primary Care, 19, 191-206.
Des Roches, C.M., Worzala, C., Joshi M.S., Kralovec, P. D., and Jha, A.K., 2012, "˜Electronic Health Record Systems: Small, Nonteaching and Rural Hospitals Continue to be slow in adopting', 31(5), 1092-1099.
Ford, E. W., Menachemi, N., and Phillips, T.M., 2006, "˜Predicting the Adoption of Electronic Health Records by Physicians: When will Health care be paperless?' Journal of American Medical Informatics Association, 13(1), 106-112
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Jha, A.K., Bates, D.W., Jenter, C., Oray, E.J., Zheng, J., Cleary, P., and Simon, S.R., 2009, "˜Electronic Health Records: Use, barriers and satisfaction among physicians who care for black and Hispanic patients', Journal of Evaluation in clinical Practice, 15, 153-163.
Jimoh, L., Pate, M.A., and Schulman, K.A., 2012, "˜A model for the adoption of ICT by health workers in Africa', International Journal of Medical Information, 81, 773-781
Johnson, C.M., Johnson, D., Crowley, K., Culbertson, H., Rippen, H.E., Damico, D.J., Plaisant, C., Zayas-Caban, T., 2011, EHR Usability Toolkit: A background Report on Usability and Electronic Health Records Prepared for: Agency for Healthcare Research and Quality U.S.
Kanyua, N.H., 2015, "˜Factors influencing the adoption of ICT in Public hospitals in Nairobi', Master's Thesis, Department of Extra-Mural Studies, University of Nairobi.
Khan, S.Z., Shahidi, Z., Hedstrom, K., and Andersson, A., 2012, "˜Hopes and Fears in Implementation of Electronic Health Records in Bangladesh', The Electronic Journal of Information systems in Developing Countries, 54.
Klosek, J., 2014, "˜Exploring the Barriers to the More Widespread Adoption of Electronic Health Records', Notre Dame Journal of Law, Ethics & Public Policy, 25 (2), 11.
Kumar, S., Aldrich, K., 2010, "˜Overcoming barriers to electronic medical Records (EMR) implementation in US healthcare system: a Comparative Study', Health Informatics Journal, 16, 306-318
Ludwick, D., and Doucette, J., 2009, "˜Adopting Electronic Medical Records in Primary Care: Lessons learned from health information systems implementation experience in seven countries', International Journal of medical Informatics, 78 (1), 22-31.
Luna, D., Almerares, A., Mayan, J.C., Gonzalez de Quiros, F., Otero, C., 2014, "˜Going Beyond Pilot Practices to Sustainable Implementations: A review of the current Challenges', Journal of Health Informatics in Developing Countries, 20, 3-10.
Marques, A., Oliveira, T., Dias, S.S., and Martins, M.F.O., 2011, "˜Medical Record System Adoption in European Hospitals', Electronic Journal of Information Systems Evaluation, 14(1), 89-99.
Meade, B., Buckley, D., and Boland, M., 2009, "˜What Factors Affect the use of Electronic Patient Records by Irish GPS', International journal of Medical informatics, 78(8), 551-558.
Menachemi, N., and Collum, T.H., 2011, "˜Benefits and Drawbacks of electronic Health Record systems', Risk management and Healthcare Policy, 4, 47-55, accessed from http://doi.org/10.2147/RMHP.S12985.
Menachemi, N., Langley, A., and Brooks, R. G., 2007, "˜The use of information technologies among rural and urban physicians in Florida', Journal of Medical Systems, 31, 483-488,
Menachemi, N., Matthews, M.C., Ford, E.W., and Brooks, R.G., 2007, "˜The Influence of Payer Mix on Electronic Health Record Adoption by Physicians', Health Care Management Review, 32(2), 111-118.
Menachemi, N., Powers, T., Au, D.W., and Brooks, R.G., 2009, "˜Predictors of Physician satisfaction among electronic health records system users.
Muga, R., Kizito, P., Mbayah, M., and Gakuruh, 2004, "˜Overview of Health System in Kenya', Ministry of Health Report, 2, 13-27.
Muhammad, A., Emmert, C., McAlpine, A.D., Tarn, J.M., and Islam, K.N., 2011, "˜Electronic Health Records (EHR) Implementation and Post Implementation Challenges', Transactions of the International Conference on Health Information Technology Advancement, Accessed from http://scholarworks.wmich.edu/ichita_transactions/7
Najaftorkaman, M., Ghapanchi, A.H., Talaei-Khoei, A., and Ray, P., 2014, "˜A Taxonomy of Antecedents to User Adoption of Health Information Systems: A synthesis of Thirty Years of Research', Journal of the Association for Information Science and Technology, 2318.
Njoroge, C., 2014, "˜Factors influencing adoption of electronic health record systems in small private health facilities', Master's Thesis, Department of Extra-Mural Studies, University of Nairobi.
Odekunle, F.F., Odekunle, R.O., and Shankar, S., 2017, "˜Why Sub-Saharan African lags in electronic health record adoption and possible strategies to increase its adoption in this region', International Journal of Health Sciences, 11(4)59-64
Ohemeng-Dapaah, S., Pronyk, P., Akosa, E., Nemser, B., and Kanter, A., 2010, "˜Combining vital events registration, verbal autopsy and Electronic Medical Records in rural Ghana for improved health services delivery', Health Technology Information, 160, 416-420.
Oluoch, T., Santas, X., Kwaro, D., Were, M., Biondich, P., and Bailey, C., 2012, "˜The effect of electronic medical record based clinical decision support on HIV care in resource-constrained settings', A systematic review, International Journal of Medical Information, 81, 83-92.
Oyeyemi, S.O., and Wynn, R., 2014, "˜Giving cell phones to pregnant women and improving services may increase primary health facility utilization: a case study of Nigerian project', Reproductive Health, 11(1), 8.
Palvia, P., Lowe, K., Nemati, H., and Jacks, T., 2012, "˜information technology issues in healthcare: hospital CEO and CIO perspectives', Communications of the Associations for Information Systems, 30(19), 293-312.
Pantuvo, J.S., Naguib, R., and Wickramasinghe, N., 2011, "˜Towards implementing a national wide electronic health record System in Nigeria', International Journal of Health care delivery reform initiatives, 3, 39-55.
Pettigrew, A. M., Woodman, R. W., & Cameron, K. S., 2001, "˜Studying organizational change and development: Challenges for future research', Academy of management journal, 44 (4), 697-713.
Qureshi, Q.A., Shah, B., Najeebullah, Kundi, G.M., Nawaz, A., Miankhel, A.K., Chrishti, K.A., Qureshi, N.A., 2013, "˜Infrastructure Barriers to e-health implementation in Developing Countries', European Journal of Sustainable Development, 2 (1), 163-170
Randeree, E., 2007, "˜Exploring Physician adoption of EMRs: A multi-case analysis', Journal of Medical Systems, 31, 489-496.
Schmid, I.K., and Syarstab, B.L., 2002, "˜nurse -physician Communication and Quality of Drug use in Swedish nursing homes', social science medical journal, 54(12), 1767-1777.
Simon, S.R., McCarthy, M.L., Kaushal, R., Jenter, C.A., Volk, L.A., Poon, E.G., Yee, K.C., Oray, E.J., Williams, D.H., Bates, D.W., 2008, "˜Electronic health records: which practices have them, and how are clinicians using them?', Journal of Evaluation in Clinical Practice, 14, 43-47
Sinha, P.S.G., Bendale, P., Mantri, M., Dande, A., 2013, Electronic Health Records: Standards, Coding systems, Frameworks and Infrastructures, Wiley-IEEE Press.
Singh, B., and Muthuswamy P., 2013, "˜Factors influencing the adoption of electronic health records by nurses'. World Applied Sciences Journal, 28 (11), 1531-1535
Sood, S.P., Nwabueze, S.N., Mbarika, V.W.A., Prakash, N., Chatterjee,S., Ray,P., and Mishra, S., 2008, "˜electronic medical records: a review comparing the challenges in developed and developing countries', Hawaii International Conference on System Sciences, Proceedings of the 41st Annual, 248-248.
Sun, Z., 2013, "˜User Involvement in System Development Process', International Conference on Computer Science and Electronics Engineering, Department of Information Science and Technology, Tianjin University of Finance and Economics.
Tang, P.C., 2003, "˜Key capabilities of an electronic health record system', accessed on from http://www.nap.edu/openbook/N1000427/html/index.html.
Tang, P.C., and McDonald, C.J., 2006, Electronic health record systems, Biomedical Informatics: Computer applications in health care and biomedicine, New York, Springer, 447-475.
Terry, A.L., Thorpe, C.F., Giles, G.G., Brown, J.B., Harris S.B., Reid, G.J., Thind, A., and Stewart, M., 2008, Implementing Electronic Health Records, Canadian Family Physicians, 54, 730-736
Venkatesh, V., and Davis, F., 1996, "˜A critical assessment of potential measurement biases in the technology acceptance model: Three experiments', International Journal of Human Computer Studies, 45(1), 19-45.
Vishwanath, A., and Scamurra, S.D., 2007, "˜Barriers to adoption of electronic healt records: using concept mapping to develop a comprehensive empirical model', Health Informatics Journal, 13, 119-134
Wagner, E. H., 2000, "˜The role of patient care teams in chronic disease management', Biomedical Journal, 320(7234), 569-572.
Williams, F., and Boren, S.A., 2008, "˜The role of electronic medical record in care delivery in developing countries', International journal of information management, 28, 503-507.
World Health Organization, 2006, E-Health tools and Services: Global Observatory for eHealth, World Health Organization
Akanbi, M., Ocheke, A., Agaba, P., Daniyam, C., Agaba, E., Okeke, E., and Ukoli, C., 2012, "˜Use of Electronic Health Records in Sub-Saharan Africa: progress and Challenges', Journal Med Trop, 14(1), 1-16.
Al-Aswad, A.M., Brownsell, S., Plammer, R., Nichol, J.P., & Altuwajiri, M.M., 2008, "˜Electronic-health in Saudi Arabia: Just around the corner', Saudi Med Journal, 29(2), 171-178.
Aldosari, B., and Abdul-Aziz, K.S., 2017, "˜Patients "˜safety in the era of EMR/EHR automation "˜Journal of health informatics, 9 (2017), 230-233
Angst, C.M., Agarwal, R., Sambamurthy, V., and Kelly, K., 2010, "˜Social Contagion and Information Technology Diffusion: The adoption of electronic Medical Records in US Hospitals', Management Science (56:8), 1219-1241.
Awokola, B.I., Abioye-Kuteyi, E.A., Otoru, O.O., Oyegbade, O.O., Awokola, and E.O., Awokola, O.A., 2012, Practical challenges of setting up an electronic medical record system in Nigeria tertiary hospital: The Wesley guild hospital experience', Middle East Journal of Family Medicine, 7, 37-42.
Bagozzi, R., Davis, F., and Warshaw, P., 1992, "˜Extrinsic and Intrinsic motivation to use computers in the work place', Journal of applied social psychology, 22(14), 1111-1132
Bates, D.W., and Gawande, A.A., 2003, "˜Improving Safety with Information Technology' N Engl J Med 348, 2526-2534.
Boonstra, A., Brekhuis, M., 2010, "˜Barriers to the acceptance of electronic medical records by physicians from systematic review to taxonomy and interventions', Viewed on 24 August 2016
Bedeley, R.T., and Palvia, P., 2014, "˜Study of the issues of E-Health in Developing Countries: The Case of Ghana', Twentieth Americas Conference on Information Systems.
Carter, J. H., 2006, Infrastructure and Supporting Technologies: What is Electronic Health Record, USA, American College of Physicians.
Chapli, B., Meloni, S., Esen, G., Jolayemi, T., Banigbe, B., and Adeola, J., 2015, "˜Scale-up of networked HIV treatment in Nigeria: Creation of an integrated electronic medical records system, International journal of Medical Information, 84, 58-68
Chebole, G.C., 2015, "˜Factors influencing adoption of electronic medical record systems in public health facilities in Kenya', Master's Thesis, Department of Extra-Mural Studies, University of Nairobi.
Cresswell, K., Morrison, Z., Crowe, S., Robertson, A., Sheikh, A., 2011, "˜Anything but engaged: user involvement in the context of a national electronic health record implementation', Journal of Informatics in Primary Care, 19, 191-206.
Des Roches, C.M., Worzala, C., Joshi M.S., Kralovec, P. D., and Jha, A.K., 2012, "˜Electronic Health Record Systems: Small, Nonteaching and Rural Hospitals Continue to be slow in adopting', 31(5), 1092-1099.
Ford, E. W., Menachemi, N., and Phillips, T.M., 2006, "˜Predicting the Adoption of Electronic Health Records by Physicians: When will Health care be paperless?' Journal of American Medical Informatics Association, 13(1), 106-112
Furukawa, M.F., King, J., and Patel, V., 2015, Physician attitudes on ease of use of EHR functionalities related to meaningful use
Gabbay, J., and LeMay, A., 2004, "˜Evidence based guidelines or collectively constructed "˜mindliness': Ethnographic study of Knowledge management in primary care', British Medical Journal, 329, 1013
Gaylin, D.S., Moiduddin, A., Mohamoud, S., Lundeen, K., Kelly, J.A., 2011, "˜Public Attitudes about Health Information Technology and its Relationship to Health care Quality, Costs and Privacy: Health Services Research', 920-938
Hasanain, R.A., Vallmuur, K., and Clark, M., 2015, "˜Electronic Medical Record System in Saudi Arabia: Knowledge and Preferences of Healthcare Professionals', Journal of Health Informatics in Developing Countries, 9 (1).
Hassibian, M.R., 2013, "˜Electronic Health Record Acceptance and Implementation in Developing Countries: Challenges and Barriers', Department of medical informatics, Mashhad University of Medical Sciences.
Hayrinen, K., Saranto, K., and Nykanen, P., 2008, "˜Definition, structure, content, use and impacts of electronic health records: A review of the research literature, 77(5), 291-304.
Jha, A.K., Bates, D.W., Jenter, C., Oray, E.J., Zheng, J., Cleary, P., and Simon, S.R., 2009, "˜Electronic Health Records: Use, barriers and satisfaction among physicians who care for black and Hispanic patients', Journal of Evaluation in clinical Practice, 15, 153-163.
Jimoh, L., Pate, M.A., and Schulman, K.A., 2012, "˜A model for the adoption of ICT by health workers in Africa', International Journal of Medical Information, 81, 773-781
Johnson, C.M., Johnson, D., Crowley, K., Culbertson, H., Rippen, H.E., Damico, D.J., Plaisant, C., Zayas-Caban, T., 2011, EHR Usability Toolkit: A background Report on Usability and Electronic Health Records Prepared for: Agency for Healthcare Research and Quality U.S.
Kanyua, N.H., 2015, "˜Factors influencing the adoption of ICT in Public hospitals in Nairobi', Master's Thesis, Department of Extra-Mural Studies, University of Nairobi.
Khan, S.Z., Shahidi, Z., Hedstrom, K., and Andersson, A., 2012, "˜Hopes and Fears in Implementation of Electronic Health Records in Bangladesh', The Electronic Journal of Information systems in Developing Countries, 54.
Klosek, J., 2014, "˜Exploring the Barriers to the More Widespread Adoption of Electronic Health Records', Notre Dame Journal of Law, Ethics & Public Policy, 25 (2), 11.
Kumar, S., Aldrich, K., 2010, "˜Overcoming barriers to electronic medical Records (EMR) implementation in US healthcare system: a Comparative Study', Health Informatics Journal, 16, 306-318
Ludwick, D., and Doucette, J., 2009, "˜Adopting Electronic Medical Records in Primary Care: Lessons learned from health information systems implementation experience in seven countries', International Journal of medical Informatics, 78 (1), 22-31.
Luna, D., Almerares, A., Mayan, J.C., Gonzalez de Quiros, F., Otero, C., 2014, "˜Going Beyond Pilot Practices to Sustainable Implementations: A review of the current Challenges', Journal of Health Informatics in Developing Countries, 20, 3-10.
Marques, A., Oliveira, T., Dias, S.S., and Martins, M.F.O., 2011, "˜Medical Record System Adoption in European Hospitals', Electronic Journal of Information Systems Evaluation, 14(1), 89-99.
Meade, B., Buckley, D., and Boland, M., 2009, "˜What Factors Affect the use of Electronic Patient Records by Irish GPS', International journal of Medical informatics, 78(8), 551-558.
Menachemi, N., and Collum, T.H., 2011, "˜Benefits and Drawbacks of electronic Health Record systems', Risk management and Healthcare Policy, 4, 47-55, accessed from http://doi.org/10.2147/RMHP.S12985.
Menachemi, N., Langley, A., and Brooks, R. G., 2007, "˜The use of information technologies among rural and urban physicians in Florida', Journal of Medical Systems, 31, 483-488,
Menachemi, N., Matthews, M.C., Ford, E.W., and Brooks, R.G., 2007, "˜The Influence of Payer Mix on Electronic Health Record Adoption by Physicians', Health Care Management Review, 32(2), 111-118.
Menachemi, N., Powers, T., Au, D.W., and Brooks, R.G., 2009, "˜Predictors of Physician satisfaction among electronic health records system users.
Muga, R., Kizito, P., Mbayah, M., and Gakuruh, 2004, "˜Overview of Health System in Kenya', Ministry of Health Report, 2, 13-27.
Muhammad, A., Emmert, C., McAlpine, A.D., Tarn, J.M., and Islam, K.N., 2011, "˜Electronic Health Records (EHR) Implementation and Post Implementation Challenges', Transactions of the International Conference on Health Information Technology Advancement, Accessed from http://scholarworks.wmich.edu/ichita_transactions/7
Najaftorkaman, M., Ghapanchi, A.H., Talaei-Khoei, A., and Ray, P., 2014, "˜A Taxonomy of Antecedents to User Adoption of Health Information Systems: A synthesis of Thirty Years of Research', Journal of the Association for Information Science and Technology, 2318.
Njoroge, C., 2014, "˜Factors influencing adoption of electronic health record systems in small private health facilities', Master's Thesis, Department of Extra-Mural Studies, University of Nairobi.
Odekunle, F.F., Odekunle, R.O., and Shankar, S., 2017, "˜Why Sub-Saharan African lags in electronic health record adoption and possible strategies to increase its adoption in this region', International Journal of Health Sciences, 11(4)59-64
Ohemeng-Dapaah, S., Pronyk, P., Akosa, E., Nemser, B., and Kanter, A., 2010, "˜Combining vital events registration, verbal autopsy and Electronic Medical Records in rural Ghana for improved health services delivery', Health Technology Information, 160, 416-420.
Oluoch, T., Santas, X., Kwaro, D., Were, M., Biondich, P., and Bailey, C., 2012, "˜The effect of electronic medical record based clinical decision support on HIV care in resource-constrained settings', A systematic review, International Journal of Medical Information, 81, 83-92.
Oyeyemi, S.O., and Wynn, R., 2014, "˜Giving cell phones to pregnant women and improving services may increase primary health facility utilization: a case study of Nigerian project', Reproductive Health, 11(1), 8.
Palvia, P., Lowe, K., Nemati, H., and Jacks, T., 2012, "˜information technology issues in healthcare: hospital CEO and CIO perspectives', Communications of the Associations for Information Systems, 30(19), 293-312.
Pantuvo, J.S., Naguib, R., and Wickramasinghe, N., 2011, "˜Towards implementing a national wide electronic health record System in Nigeria', International Journal of Health care delivery reform initiatives, 3, 39-55.
Pettigrew, A. M., Woodman, R. W., & Cameron, K. S., 2001, "˜Studying organizational change and development: Challenges for future research', Academy of management journal, 44 (4), 697-713.
Qureshi, Q.A., Shah, B., Najeebullah, Kundi, G.M., Nawaz, A., Miankhel, A.K., Chrishti, K.A., Qureshi, N.A., 2013, "˜Infrastructure Barriers to e-health implementation in Developing Countries', European Journal of Sustainable Development, 2 (1), 163-170
Randeree, E., 2007, "˜Exploring Physician adoption of EMRs: A multi-case analysis', Journal of Medical Systems, 31, 489-496.
Schmid, I.K., and Syarstab, B.L., 2002, "˜nurse -physician Communication and Quality of Drug use in Swedish nursing homes', social science medical journal, 54(12), 1767-1777.
Simon, S.R., McCarthy, M.L., Kaushal, R., Jenter, C.A., Volk, L.A., Poon, E.G., Yee, K.C., Oray, E.J., Williams, D.H., Bates, D.W., 2008, "˜Electronic health records: which practices have them, and how are clinicians using them?', Journal of Evaluation in Clinical Practice, 14, 43-47
Sinha, P.S.G., Bendale, P., Mantri, M., Dande, A., 2013, Electronic Health Records: Standards, Coding systems, Frameworks and Infrastructures, Wiley-IEEE Press.
Singh, B., and Muthuswamy P., 2013, "˜Factors influencing the adoption of electronic health records by nurses'. World Applied Sciences Journal, 28 (11), 1531-1535
Sood, S.P., Nwabueze, S.N., Mbarika, V.W.A., Prakash, N., Chatterjee,S., Ray,P., and Mishra, S., 2008, "˜electronic medical records: a review comparing the challenges in developed and developing countries', Hawaii International Conference on System Sciences, Proceedings of the 41st Annual, 248-248.
Sun, Z., 2013, "˜User Involvement in System Development Process', International Conference on Computer Science and Electronics Engineering, Department of Information Science and Technology, Tianjin University of Finance and Economics.
Tang, P.C., 2003, "˜Key capabilities of an electronic health record system', accessed on from http://www.nap.edu/openbook/N1000427/html/index.html.
Tang, P.C., and McDonald, C.J., 2006, Electronic health record systems, Biomedical Informatics: Computer applications in health care and biomedicine, New York, Springer, 447-475.
Terry, A.L., Thorpe, C.F., Giles, G.G., Brown, J.B., Harris S.B., Reid, G.J., Thind, A., and Stewart, M., 2008, Implementing Electronic Health Records, Canadian Family Physicians, 54, 730-736
Venkatesh, V., and Davis, F., 1996, "˜A critical assessment of potential measurement biases in the technology acceptance model: Three experiments', International Journal of Human Computer Studies, 45(1), 19-45.
Vishwanath, A., and Scamurra, S.D., 2007, "˜Barriers to adoption of electronic healt records: using concept mapping to develop a comprehensive empirical model', Health Informatics Journal, 13, 119-134
Wagner, E. H., 2000, "˜The role of patient care teams in chronic disease management', Biomedical Journal, 320(7234), 569-572.
Williams, F., and Boren, S.A., 2008, "˜The role of electronic medical record in care delivery in developing countries', International journal of information management, 28, 503-507.
World Health Organization, 2006, E-Health tools and Services: Global Observatory for eHealth, World Health Organization
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Published
2019-02-07
How to Cite
Isemeck, C. S., Ngure, P. K., Kariuki, M. J., & Muchene, M. O. (2019). FACTORS INFLUENCING THE ADOPTION OF ELECTRONIC HEALTH RECORDS IN PUBLIC HEALTH FACILITIES IN KISUMU COUNTY, KENYA. Journal of Health, Medicine and Nursing, 4(1), 74 – 101. Retrieved from https://iprjb.org/journals/index.php/JHMN/article/view/826
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