A qualitative exploration of the early adoption of an electronic medical record system for type 1 diabetes management in Rwanda

Delivering adequate quality care remains a challenge in many low-and middle-income countries (LMICs), especially for people living with type 1 diabetes (T1D), requiring a complex treatment regimen. Digital health solutions, including electronic medical record (EMR) systems, have shown potential to improve delivery and quality of care but still require a successful implementation. To analyze the adoption of a newly implemented EMR system in Rwanda from the perspectives of individuals with T1D, health care providers, and experts. A qualitative study was conducted using the Diffusion of Innovation (DoI) theory to guide the focus of the analysis. A data triangulation strategy was used to gain multi-dimensional insights, involving in-depth interviews and participant observations with T1D individuals, EMR system users, and experts (with varying levels of acquaintance with the EMR system). Experiences of early adoption of the EMR system were explored through thematic analysis guided by the DoI theory. In general, all the participant groups had a positive attitude towards the EMR system, believed to increase the likelihood of a successful implementation. The system was described as user-friendly and improved workflows, data quality, and patient care. The main concerns to successful adoption were related to the maintenance and long-term sustainability of the system. The EMR system showed great potential, was valued by users, and was positively believed to have potential to improve care and outcomes for patients. However, sustainability aspects must not be overlooked when assessing the adoption and use of an EMR system.