Thesis Report.

ABSTRACT

Background:
Electronic Health Record (EHR) systems are increasingly recognized as important tools
for improving healthcare quality, efficiency, and data management. However,
successful implementation of EHR systems depends largely on the readiness of health
professionals who use them. In Nepal, evidence regarding health workers readiness and
the factors influencing EHR implementation remains limited. This study aimed to
assess the readiness of health professionals and identify associated factors, facilitators,
and barriers for EHR system use in public health facilities of Baglung district.
Methods:
A two stage cross-sectional study was conducted among health professionals working
in public health facilities of Baglung district using sequential explanatory mixed
method design. The quantitative component included 220 health professionals selected
through multistage cluster sampling. Data were collected using a structured
questionnaire and analyzed using complex sample analysis; descriptive statistics and
logistic regression to identify factors associated with EHR readiness. In the qualitative
phase, 20 in-depth interviews were conducted with purposively selected health workers
having a high and low readiness score to explore facilitators and barriers to EHR use.
Thematic analysis was used for qualitative data analysis.
Results:
The study found that 88.66% of health professionals were ready to use the EHR system,
while 11.34% were not ready. More than half of the health workers had received EHR
training (51.36%), while only 20.45% had access to an EHR manual. About 54.55%
reported supportive supervision or monitoring related to EHR implementation within
the last year. Employment level of health worker (AOR=0.28; 95% CI: 0.09-0.81),
ownership of a functional computer (AOR= 34.08; 95% CI: 1.08-1097.45) receipt of
EHR training (AOR= 4.041; 95% CI: 1.22-13.36) and higher level of EHR knowledge
(AOR= 1.18; 95% CI: 1.08-1.29) and improved attitude toward EHR (AOR = 1.37;
95% CI: 1.20–1.57) were significantly associated with readiness. Qualitative findings
revealed facilitators such as perceived system benefits, technical support, andinstitutional support, while barriers included workload challenges, limited training,
language difficulties, and demographic factors.
Conclusion:
Most health professionals in Baglung district were ready to adopt the EHR system.
Positive attitudes toward digital health technologies and supportive organizational
environments play a crucial role in improving readiness. Strengthening training
programs, technical support, and institutional commitment is essential to ensure
effective and sustainable implementation of EHR systems in public health facilities.

Keywords: Electronic Health Record, readiness, health professionals, digital health,
mixed-method study, Nepal.