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. 2025 May 12;25(1):181.
doi: 10.1186/s12911-025-02858-3.

Insights into healthcare workers' perceptions of electronic medical record system utilization: a cross-sectional study in Mafeteng district, Lesotho

Tebeli E Sekoai  1 , Astrid Turner  2 , Janine Mitchell  2
Affiliations

Insights into healthcare workers' perceptions of electronic medical record system utilization: a cross-sectional study in Mafeteng district, Lesotho

Tebeli E Sekoai et al. BMC Med Inform Decis Mak. .

Abstract

Background: Electronic medical record (EMR) systems have significantly transformed how healthcare data is created, managed, and utilized, offering improved legibility, accessibility, and support for clinical decision-making compared to paper records. In Lesotho, the system was implemented to enhance patient care, track patients, and generate reports for evidence-based programming. It is imperative to understand how healthcare workers (HCWs) perceive the system as frontline end-users; thus, the aim of the study was to explore HCWs' perceptions of the system, focusing on perceived usefulness (PU) and perceived ease of use (PEU) and factors influencing acceptance and utilization in Mafeteng district.

Methods: A descriptive cross-sectional study design was conducted; 145 healthcare workers from 17 health facilities were invited to participate. The Technology Acceptance Model was incorporated into a self-administered questionnaire. The analysis employed descriptive statistics and the constructs of PU and PEU using Stata/BE 18.0. Multiple regression examined HCWs' perceptions, while verbatim text from participants clarified quantitative findings.

Results: The study had a 49% response rate (n = 71). Most participants were female (70.42%; n = 50), with registered nurse midwives as the most common profession (45.07%; n = 32). A large proportion reported 'good' or 'very good' computer skills (43.66%; n = 31). For PU, 87.32% found the EMR system useful, 83.1% agreed it improves job performance, and 83.1% said it saves time. For PEU, 85.91% found the system easy to use, 81.69% could recover from errors, and 85% could remember task procedures. Network connectivity and electricity supply were cited as barriers to the effective use of the EMR system in health facilities, resulting in interruptions in service delivery. The characteristics of sex and profession had no significant impact on PU and PEU, while both qualification (p = 0.035) and computer skills (p = 0.007) were significant, indicating a positive association with greater PEU of the EMR system.

Conclusion: HCWs in the Mafeteng District exhibited positive attitudes toward the EMR system, recognising its usefulness, ease of use, and efficiency. Sustaining computer literacy and addressing infrastructural challenges could further enhance the successful implementation and adoption of the system, ultimately improving patient care outcomes.

Keywords: Acceptance; EMR system; Ease-of-use; Healthcare workers; Perceptions; Technology acceptance model; Usefulness.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by the University of Pretoria Faculty of Health Sciences Research Ethics Committee (reference number 492/2023). The Ministry of Health (MOH) National Research Ethics Committee of Lesotho (ID237-2023) also approved the study and permission to collect data was obtained from the District Health Management Team of Mafeteng. All methods in this study were carried out according to relevant guidelines and regulations, including compliance to ethical norms and principles of research adopted by the University of Pretoria Faculty of Health Sciences Research Ethics Committee and the MOH National Research Ethics Committee of Lesotho. Participants were duly informed that the study was voluntary and were asked to sign the informed consent form. Consent for publication: Participants were duly informed that the study findings may be published but that measures would be taken to anonymize their role. Competing interests: The authors declare no competing interests.

Figures

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Fig. 1
Stages of the register implementation [Created by the researcher]
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