Hospitals' Readiness to Implement Sustainable SmartCare Systems in Addis Ababa, Ethiopia

The frequent failures of electronic health systems and lack of successful scale-up beyond pilot phase have been a concern for the implementation of electronic health systems in resource-constrained settings. Despite the challenges, developing countries have increasingly been implementing an electronic medical record system to improve patient care and clinical services. In this multiple case study research, we assess the readiness of ten hospitals in Addis Ababa, Ethiopia to implement sustainable electronic medical record system also known as SmartCare. SmartCare is an integrated electronic medical record system with various models to be used in different departments of a health facility. The assessment adopts a conceptual framework for sustainable eHealth implementation that addresses the technological, social, organizational and economic factors of electronic health systems implementation. Technological readiness, social readiness, organizational readiness, and economic readiness are evaluated to learn hospitals readiness to implement sustainable SmartCare systems. Sustainable eHealth implementation index is computed from the four factors to evaluate the readiness level of a healthcare organization to implement sustainable eHealth technology. The economic readiness is the lowest of all other factors which highlight the impact of economic factors on the implementation of sustainable SmartCare in Ethiopia. The commitment of top management to support successful SmartCare system in Ethiopia is demonstrated with a high organizational readiness level in most (80%) hospitals. The four categories are closely interrelated that weakness in the level of readiness in one category may affect other categories. This research project supports the effort of sustainable Smartcare implementation in Ethiopia by identifying the possible gaps in the implementation of sustainable SmartCare systems.