| dc.description.abstract | The adoption and utilization of Electronic Health Records can address numerous patient care
difficulties and facilitate a paperless environment in hospitals; nevertheless, their full potential
remains underexploited due to significant interoperability challenges. Patients typically pursue
healthcare services from diverse providers operating inside either affiliated or independent
organizations. In the absence of a consistent linkage across various healthcare providers, patient
medical information becomes fragmented, incomplete, and obsolete. Numerous health
institutions in Kenya have adopted EHRs/EMRs; nonetheless, both the nation and the facilities
that have automated their records suffer from inadequate data convergence due to interoperability
challenges among the various EHR systems. The interoperability of EHRs, a complicated and
challenging undertaking, is predominantly lacking in poor countries. The identified target
audience encounters these problems, along with architectural and technological obstacles, in
facilitating seamless communication across EHRs. The study’s main objective was achieved
through four specific objectives as follows; to establish EMR services available, their utilization,
level of integration in the health sector; to determine the various EMR systems state of
interoperability; to determine the strategies that have been used by successful implementers to
address interoperability challenges and to develop an interoperability model for EMR
implementation. The researcher scrutinized the following frameworks and theories to identify
their weaknesses, and thereby guide the development of the interoperability model for EMR
implementation: the European Interoperability Framework (EIF), Social technical systems theory,
Luhmann's Social Systems Theory and Lopez and Blobel's Interoperability Framework. To
underpin the study, the researcher adopted a pragmatic philosophical standing point to guide the
researcher’s worldview of the research. Further a deductive and inductive approaches were also
adopted for the purpose of triangulation of data. The study population included 229 healthcare
workers from which a sample of 184 respondents were obtained using stratified and simple
random sampling. Key informant interviews and structured questionnaires were used to gather
data. Descriptive and inferential statistics were used to analyze and evaluate the quantitative data,
while thematic analysis was used for analyzing the qualitative data. The findings of the study
indicate technical interoperability (p=0.000<0.05), social interoperability (p=0.006<0.05),
organizational interoperability (p=0.000<0.05) and semantic interoperability (p=0.000<0.05) and
legal interoperability (p=0.002<0.05) were significant predictors. From the results of the study, a
model of Electronic Medical Records End to End Implementation was formulated. The study
concluded that technical, social, organizational, semantic and legal, factors must be addressed to
achieve interoperability of EMR end to end implementation. From the findings it is recommended
that challenges such as privacy concerns, implementation costs issues must also be addressed to
fully harness the benefits of EMR interoperability. The facilities to invest on security measures,
capacity building, compliance to government regulation, technology as strategies to address
interoperability challenges. The model developed is a basis upon which future implementation of
EMR interoperability end to end implementation can be based. | en_US |
