Using the Diffusion-of-Innovation Theory to Examine Factors Influencing the Implementation of an Electronic Medical Record in Obstetrics

Objectives: The objectives of the present study were to assess the perceptions of physicians and midwives towards an Obstetric Electronic Medical Record and to apply the diffusion-of-innovation theory to the examination of factors that are perceived by users as influencing the implementation of Electronic Medical Records.Patients and methodsType of study: This is a mixed study, after the implementation of an Electronic Medical Record (EMR). Study location:  Dakar, Senegal.Methodology: We designed an online questionnaire that was sent to all users of the software. The questionnaire included three parts: a section collecting the socio-demographic and professional characteristics of the participants, a section in relation to the usage of the software, the impact on the organization, the advantages, and limits, and finally the last section where the users reported their degree of satisfaction as well as the extent to which they would be willing to recommend the software-based upon their experience. The questionnaire was completely anonymized and accessible to physicians wishing to take the survey. Their consent was first requested.Results: A total of 51 physicians (85%) agreed to participate in this study among the 60 who were approached. Of the respondents, 62.7% were women and the average age and experience were 32.3 years and 22.1 months, respectively. Overall, the software was perceived as being simple to use, intuitive, and designed for an obstetrician. On the contrary, some physicians reported some drawbacks. Those were mainly the time needed to type in the information especially when they were on duty with a heavy workflow, lack of sufficient computers, and some bugs. More than half of the participants agree that there is no need to be young to use optimally the software. However, an ideal user should be open-minded and be able to cope with change. On a 0-10-scale, participants acknowledged that they were satisfied with the software, it impacted positively their department’s organization and they were willing to recommend the software; all medians above 8.Conclusion: Identifying the determinants of the adoption of the electronic medical record is crucial for its successful implementation and dissemination. User responses will help to adjust implementation strategies to promote better integration of this technology into medical practices beyond our facility.