Date of Award

11-3-2024

Degree Type

Thesis

Degree Name

MSc in Nursing

First Advisor

Dr. Rafat Jan

Second Advisor

Misbah Zafar

Third Advisor

Khairunnissa Hooda

Department

School of Nursing and Midwifery, Pakistan

Abstract

Background: Efficient management of information is essential in healthcare, where Electronic Health Records are improving patient care through real-time data access. Extensive literature is available on EHR implementation practices to explore its implementation challenges and facilitate with major focus on end users’ perspectives. However, the experiences of core implementation teams that actively participate in these transformative projects remained underexplored.
Purpose: The purpose of this research was to explore the experiences of the core implementation team involved in EHR implementation in low- and middle-income countries (LMICs), especially to identify their challenges, best practices, and strategies they employed to overcome any barriers.
Method: A descriptive exploratory design was used, and semi-structured interviews with key team members were conducted who actively participated in the EHR implementation process at a tertiary care hospital at Nairobi, Kenya.
Findings: The study identified four key themes via Cresswell six step thematic analysis process. Theme one described the overall experience as exciting, rewarding, and a valuable learning experience, with team cohesion being a crucial factor. Theme two mentioned challenges like expertise gaps, technical issues, resource limitations, end user’s training difficulties, and inadequate superuser preparation. Theme three highlighted strategies to overcome these barriers, that include thorough EHR testing, iv responsive training initiatives, an exhaustive support mechanism, and collaboration with stakeholders. Theme four shared lessons learnt and future recommendations that stress the importance of vendor selection, early end-user engagement, offering financial incentives, and effective training strategies.
Conclusion: The study highlights the necessity of thorough assessments and careful selection of EHR vendors to ensure its alignment with local workflows and effective integration with existing legacy systems. It emphasises building internal support systems, including Subject Matter Experts (SMEs) and Superusers and engaging them early in the process to facilitate implementation. Recommendations include adopting structured project management approaches, developing comprehensive resource management plans, thoroughly testing new EHR systems before going live to minimize disruption, and strengthening core teams’ capacity via targeted training. The research also highlights the critical need to integrate health informatics and digital literacy into healthcare education programs in LMICs.

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