Challenges to Electronic Health Record Implementation Grouped According to Level of National Development and Stage of Implementation Scoping Review.

Abstract

Background Electronic health records (EHRs) have the potential to improve the quality of care; however, barriers to implementation have limited the full utilisation of such technology. The objective is to identify the barriers to implementation (EHR) and countries faced by such barriers and to classify the barriers according to the level of income of a country and the stage of implementation. Methods The literature body was used to identify barriers to EHR implementation using peer-reviewed research papers from different countries and facilities published in English from 2020 to 2024. Results Twenty articles were used to identify a number of barriers to EHR implementation. The analysis showed that countries face barriers mostly depending on their income level and the stage of EHR implementation. Low-income countries face mostly input barriers such as a lack of hardware and skills, poor internet connections and power interruptions, while high-income countries face mostly output barriers such as a lack of data security, poor health profession-patient relations and poor privacy. Lower- and upper-middle-income countries face mostly operational barriers, which include data incompatibility, more documentation and more time needed. Furthermore, low-income counties, middle-income countries and high-income countries face mostly invention, innovation and diffusion barriers, respectively. Conclusion High-income countries have successfully implemented most EHRs, as evidenced by their stage of implementation. Low-income countries and middle-income countries should make use of documented cases and develop solutions to barriers they are facing or they are likely to face.