Confronting The Challenges of Digitalization Electronic Medical Records: A Systematic Review

Evita Kumala Dewi, Ernawaty Ernawaty, Fitri Kurnia Rahayu

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ABSTRACT

 

Electronic Medical Records (EMRs) have the potential to significantly improve healthcare efficiency, quality, and accessibility. However, their implementation faces substantial barriers that hinder widespread adoption. This systematic review aims to identify and analyze key barriers to EMR implementation in healthcare facilities. A systematic literature search was conducted in Scopus, PubMed, CINAHL, and Web of Science for studies published between 2014 and 2024. The study selection process according to PRISMA guidelines. A total of 462 studies were screened, 59 full-text articles were assessed for eligibility, and 14 studies met the inclusion criteria for final analysis. Five major barriers to EMR implementation were identified: (1) usability and system design challenges, (2) training and workforce preparedness, (3) technological and infrastructure constraints, (4) financial and resource limitations, and (5) impact on workflow and patient care. These challenges reflect core strategic management principles, underscoring the need for structured planning, adequate resource allocation, and continuous evaluation. Overcoming barriers to EMR implementation requires improving system usability, enhancing workforce training, investing in infrastructure development, securing sustainable financial resources, and optimizing clinical workflows. A strategic, comprehensive approach is essential to facilitate successful EMR adoption, improve patient care outcomes, and support sustainable healthcare system advancement.

 

Keywords: Barriers, Electronic Medical Records (EMR), Healthcare Facilities, Systematic Review, Implementation Challenges.


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Abdulrahman, M., El-Hassan, O., Redha, M.A.A., Almalki, M., 2024. Adoption Of Electronic Medical Records In Healthcare Facilities In The Emirate Of Dubai. Healthc Inform Res 30, 154–161. Https://Doi.Org/10.4258/Hir.2024.30.2.154

Adedeji, T., Fraser, H., Scott, P., 2022. Implementing Electronic Health Records In Primary Care Using The Theory Of Change: Nigerian Case Study. Jmir Med Inform 10, E33491. Https://Doi.Org/10.2196/33491

Adler-Milstein, J., Jha, A.K., 2017. Hitech Act Drove Large Gains In Hospital Electronic Health Record Adoption. Health Aff (Millwood) 36, 1416–1422. Https://Doi.Org/10.1377/Hlthaff.2016.1651

Ajami, S., Bagheri-Tadi, T., 2013. Barriers For Adopting Electronic Health Records (Ehrs) By Physicians. Acta Inform Med 21, 129–134. Https://Doi.Org/10.5455/Aim.2013.21.129-134

Attafuah, P.Y.A., Abor, P.A., Abuosi, A.A., Nketiah-Amponsah, E., Tenza, I.S., 2022. Satisfied Or Not Satisfied? Electronic Health Records System Implementation In Ghana: Health Leaders’ Perspective. Bmc Med Inform Decis Mak 22, 249. Https://Doi.Org/10.1186/S12911-022-01998-0

Australian Digital Health Agency, 2025. My Health Record Statistics [Www Document]. Url Https://Www.Digitalhealth.Gov.Au/Initiatives-And-Programs/My-Health-Record/Statistics (Accessed 6.4.25).

Ayamolowo, L.B., Irinoye, O.O., Olaniyan, A.S., 2023. Utilization Of Electronic Health Records And Associated Factors Among Nurses In A Faith-Based Teaching Hospital, Ilishan, Nigeria. Jamia Open 6, Ooad059. Https://Doi.Org/10.1093/Jamiaopen/Ooad059

Department Of Health And Social Care, 2024. Build Back Better: Our Plan For Health And Social Care [Www Document]. Gov.Uk. Url Https://Www.Gov.Uk/Government/Publications/Build-Back-Better-Our-Plan-For-Health-And-Social-Care (Accessed 6.4.25).

Dolan, S.B., Wittenauer, R., Shearer, J.C., Njoroge, A., Onyango, P., Owiso, G., Lober, W.B., Liu, S., Puttkammer, N., Rabinowitz, P., 2023. Integration Of A Digital Health Intervention Into Immunization Clinic Workflows In Kenya: Qualitative, Realist Evaluation Of Technology Usability. Jmir Formative Research 7, E39775. Https://Doi.Org/10.2196/39775

Fritz, F., Tilahun, B., Dugas, M., 2015. Success Criteria For Electronic Medical Record Implementations In Low-Resource Settings: A Systematic Review. J Am Med Inform Assoc 22, 479–488. Https://Doi.Org/10.1093/Jamia/Ocu038

Gold, M., Mclauglhin, C., 2016. Assessing Hitech Implementation And Lessons: 5 Years Later. Milbank Q 94, 654–687. Https://Doi.Org/10.1111/1468-0009.12214

Gold, R., Bunce, A., Cowburn, S., Dambrun, K., Dearing, M., Middendorf, M., Mossman, N., Hollombe, C., Mahr, P., Melgar, G., Davis, J., Gottlieb, L., Cottrell, E., 2018. Adoption Of Social Determinants Of Health Ehr Tools By Community Health Centers. Ann Fam Med 16, 399–407. Https://Doi.Org/10.1370/Afm.2275

Grinspan, Z.M., Banerjee, S., Kaushal, R., Kern, L.M., 2013. Physician Specialty And Variations In Adoption Of Electronic Health Records. Appl Clin Inform 4, 225–240. Https://Doi.Org/10.4338/Aci-2013-02-Ra-0015

Jabali, A.K., Abdulla, F.A., 2023. Electronic Health Records Perception Among Three Healthcare Providers Specialties In Saudi Arabia: A Cross-Sectional Study. Healthc Technol Lett 10, 104–111. Https://Doi.Org/10.1049/Htl2.12052

Jabour, A.M., 2020. The Impact Of Electronic Health Records On The Duration Of Patients’ Visits: Time And Motion Study. Jmir Med Inform 8, E16502. Https://Doi.Org/10.2196/16502

Kiberu, V.M., Mars, M., Scott, R.E., 2017. Barriers And Opportunities To Implementation Of Sustainable E-Health Programmes In Uganda: A Literature Review. Afr J Prim Health Care Fam Med 9, E1–E10. Https://Doi.Org/10.4102/Phcfm.V9i1.1277

Meherali, S., Punjani, N.S., Mevawala, A., 2020. Health Literacy Interventions To Improve Health Outcomes In Low- And Middle-Income Countries. Health Lit Res Pract 4, E251–E266. Https://Doi.Org/10.3928/24748307-20201118-01

Meigs, S.L., Solomon, M., 2016. Electronic Health Record Use A Bitter Pill For Many Physicians. Perspect Health Inf Manag 13, 1d.

Oecd, 2021. Health At A Glance 2021 [Www Document]. Url Https://Www.Oecd.Org/En/Publications/Health-At-A-Glance-2021_Ae3016b9-En.Html (Accessed 6.4.25).

Raut, A., Yarbrough, C., Singh, V., Gauchan, B., Citrin, D., Verma, V., Hawley, J., Schwarz, D., Harsha Bangura, A., Shrestha, B., Schwarz, R., Adhikari, M., Maru, D., 2017. Design And Implementation Of An Affordable, Public Sector Electronic Medical Record In Rural Nepal. J Innov Health Inform 24, 862. Https://Doi.Org/10.14236/Jhi.V24i2.862

Scantlebury, A., Sheard, L., Watt, I., Cairns, P., Wright, J., Adamson, J., 2017. Exploring The Implementation Of An Electronic Record Into A Maternity Unit: A Qualitative Study Using Normalisation Process Theory. Bmc Med Inform Decis Mak 17, 4. Https://Doi.Org/10.1186/S12911-016-0406-0

Slight, S.P., Quinn, C., Avery, A.J., Bates, D.W., Sheikh, A., 2014. A Qualitative Study Identifying The Cost Categories Associated With Electronic Health Record Implementation In The Uk. J Am Med Inform Assoc 21, E226-231. Https://Doi.Org/10.1136/Amiajnl-2013-002404

Tariq, A., Lehnbom, E., Oliver, K., Georgiou, A., Rowe, C., Osmond, T., Westbrook, J., 2014. Design Challenges For Electronic Medication Administration Record Systems In Residential Aged Care Facilities: A Formative Evaluation. Appl Clin Inform 5, 971–987. Https://Doi.Org/10.4338/Aci-2014-08-Ra-0062

Tolera, A., Oljira, L., Dingeta, T., Abera, A., Roba, H.S., 2022. Electronic Medical Record Use And Associated Factors Among Healthcare Professionals At Public Health Facilities In Dire Dawa, Eastern Ethiopia: A Mixed-Method Study. Front Digit Health 4, 935945. Https://Doi.Org/10.3389/Fdgth.2022.935945

World Health Organization, 2016. Global Diffusion Of Ehealth: Making Universal Health Coverage Achievable: Report Of The Third Global Survey On Ehealth. World Health Organization, Geneva.

Zhang, J., Chen, Y., Ashfaq, S., Bell, K., Calvitti, A., Farber, N.J., Gabuzda, M.T., Gray, B., Liu, L., Rick, S., Street, R.L., Zheng, K., Zuest, D., Agha, Z., 2016. Strategizing Ehr Use To Achieve Patient-Centered Care In Exam Rooms: A Qualitative Study On Primary Care Providers. J Am Med Inform Assoc 23, 137–143. Https://Doi.Org/10.1093/Jamia/Ocv142




DOI: https://doi.org/10.33024/mahesa.v6i3.20962

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