Success Factors for Electronic Medical Records System in the Sri Lankan Public Sector Hospitals: Qualitative Study

The Electronic Medical Records (EMR) system is the foundation for digital health care. The implementation is complex due to many stakeholders and requires heavy investments. Many EMR implementation failures are evident locally and globally. Although globally accepted success factors exist, research has proven that the EMR success factors are context-based. Hence, it has become a significant management need to identify success factors in each information system. EMR systems have existed in Sri Lanka for over 18 years; however, limited Sri Lankan literature exists on EMR success factors. This study aimed to bridge this gap and investigate success factors based on the perspectives of EMR users and management to develop an EMR success evaluation model. The in-depth semi-structured interviews were used as the data collection method. Twenty-five participants were selected based on purposive sampling, and face-to-face interviews were conducted at their work settings. Thematic analysis was used to analyse and interpret qualitative data. This study's findings revealed three new success factors: the change management process, a change champion with efficient leadership skills and financial resources, which are unique to the Sri Lankan public sector context. Further, it was found that the current EMR solution is reasonable and provides the required EMR functionalities for clinical decision making. Therefore, this study concludes that the EMR success depends not merely on the EMR solution but on socio-technical factors, combining technology, people, and processes. This finding is useful for EMR strategic managers in the public health sector to successfully manage future EMR implementations. Furthermore, this study proposes an EMR success evaluation model for the Sri Lankan context, adapted from DeLone and McLean’s Information System Success Model, to facilitate quantitative investigations of information system success. Future research could explore the perspectives of health administrators to validate key success factors and further investigate data governance and strategic use of data for better patience care.