The perception of primary health care's physicians in adoption of electronic health record-Timor Leste

Abstract

Introduction: Electronic health record becomes the 21st-century innovation trend in developing countries. This digital system provides accurate, real data in real-time access, decreases paper-based documentation, enables access to patient’s previous health status and easy for follow-up, reduces of health status duplication and, allows accessible data sharing among health professionals in the primary health care setting. Purpose: This research aimed to identify and understand the perceptions of primary health care physicians in adopting the electronic health record in the Timor Leste context, specifically to identify benefit, barrier, and satisfaction of this system. Method: A cross-sectional online questionnaire survey was based on the study objectives administered to the medical doctor in primary health care level in Timor Leste who, received an electronic health record training and had an opportunity to utilize in the period between 2015 to 2017. The form was composed of 4 sections (sociodemographic information, benefit, barrier, and satisfaction), rated on a five-point Likert-scale. The samples were calculated by G*Power 3.1.9.4. The reliability was tested by Cronbach’s alpha. The statistical analysis with α= .05, CI= 95%. Result: The online questionnaire was distributed among 193 general physicians with, 84.5% responded rates. Most of the participants had young ages that acknowledge the importance of EHR in the primary health care sector. The majority perceived the most benefit of the EHR: decreased paper-based documentation, facilitated accessibility to patient data recorded previously, provided real-time data access, and reduction on health data duplication. However, barriers remain on the eHealth system indicated by a medical doctor, such as the necessity of frequent revision to technological development, compatibility of web browser, connectivity, and cost in adopting it. Overall, the physician in primary care settings perceived satisfaction toward the digital system. The eHealth was useful, appropriate, and essential for their work area, improved patient safety, elevated quality care, and enabled better communication among health professionals. There were statistically significant differences among ages toward benefit, the ability to use computer toward barrier and place using computer toward satisfaction of EHR usage. The positive slope of the benefit (β= .498; t= 11.361), had a statistically significant predictor on satisfaction on EHR implementation but barrier had negative statistical significance toward satisfaction (β = -.086; t= -1.794). The adjusted (R2= 51.0%). Conclusion: The satisfaction of EHR was influenced by the benefit perceived while utilizing the system and reducing the barrier. Political commitment, financial support, friendly user application, improved quality of internet connection and had a positive attitude toward EHR were crucial for successful implementation.