title: Health Professionals' readiness to implement electronic medical record system at three hospitals in Ethiopia: a cross sectional study.
abstract: BACKGROUND
  Electronic medical record systems are being implemented in many countries to support healthcare services. However, its adoption rate remains low, especially in developing countries due to technological, financial, and organizational factors. There is lack of solid evidence and empirical research regarding the pre implementation readiness of healthcare providers. The aim of this study is to assess health professionals' readiness and to identify factors that affect the acceptance and use of electronic medical recording system in the pre implementation phase at hospitals of North Gondar Zone, Ethiopia.
  
  
  METHODS
  An institution based cross-sectional quantitative study was conducted on 606 study participants from January to July 2013 at 3 hospitals in northwest Ethiopia. A pretested self-administered questionnaire was used to collect the required data. The data were entered using the Epi-Info version 3.5.1 software and analyzed using SPSS version 16 software. Descriptive statistics, bi-variate, and multi-variate logistic regression analyses were used to describe the study objectives and assess the determinants of health professionals' readiness for the system. Odds ratio at 95% CI was used to describe the association between the study and the outcome variables.
  
  
  RESULTS
  Out of 606 study participants only 328 (54.1%) were found ready to use the electronic medical recording system according to our criteria assessment. The majority of the study participants, 432 (71.3%) and 331(54.6%) had good knowledge and attitude for EMR system, respectively. Gender (AOR = 1.87, 95% CI: [1.26, 2.78]), attitude (AOR = 1.56, 95% CI: [1.03, 2.49]), knowledge (AOR = 2.12, 95% CI: [1.32, 3.56]), and computer literacy (AOR =1.64, 95% CI: [0.99, 2.68]) were significantly associated with the readiness for EMR system.
  
  
  CONCLUSIONS
  In this study, the overall health professionals' readiness for electronic medical record system and utilization was 54.1% and 46.5%, respectively. Gender, knowledge, attitude, and computer related skills were the determinants of the presence of a relatively low readiness and utilization of the system. Increasing awareness, knowledge, and skills of healthcare professionals on EMR system before system implementation is necessary to increase its adoption.
authors.affiliation: Department of Health informatics, Teda Health Science College, Gondar, Ethiopia. senafekeshb@yahoo.com.
authors.forename: Senafekesh
authors.initials: S
authors.lastname: Biruk
authors.affiliation: Department of Health informatics, University of Gondar, Gondar, Ethiopia. tesfahunmelese@yahoo.com.
authors.forename: Tesfahun
authors.initials: T
authors.lastname: Yilma
authors.affiliation: Department of Health informatics, University of Gondar, Gondar, Ethiopia. muler.hi@gmail.com.
authors.forename: Mulusew
authors.initials: M
authors.lastname: Andualem
authors.affiliation: Institute of Medical Informatics, University of Münster, Münster, Germany. binyam.tilahun@uni-muenster.de.
authors.forename: Binyam
authors.initials: B
authors.lastname: Tilahun
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003197:Computer Literacy / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D057286:Electronic Health Records; D005002:Ethiopia; D005260:Female; D006284:Health Plan Implementation; D006801:Humans; D008297:Male; D008875:Middle Aged; D010564:Personnel, Hospital / Q000592:standards / Q000706:statistics & numerical data*; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D055815:Young Adult