A community-driven communicative approach to adoption of a client record management system

A lesson to be learned from research in information and communication technology for development (ICT4D) is that the best information management system will fail if it is not embraced and competently employed by end users in all stages of workflow, especially those end users with little prior familiarity with computer and database use. Because patient record management systems rely heavily on input from lay practitioners and other less trained staff, they are particularly vulnerable to failure related to end user non-acceptance. This paper presents a case study of a client database system introduced to novice users in a department of social work of a developing country. Factors impacting user acceptance were perceived system utility, congruence with present work practices and cultural appropriateness. We describe an educational intervention that was observed to improve end users´ attitudes toward introduction of the system as well as their ability to integrate it into their work processes. While still in its evaluation phase, we believe this description of the requirements elicitation process and educational intervention represents an important step in the integration and use of patient record management systems in developing communities.