Electronic Health Records Acceptance and Implementation in Developing Countries: Challenges and Barriers

Context: This literature review mostly emphasizes on the challenges and barriers for acceptance and implementation of electronic health records (EHRs) in developing countries. Although the willingness of developing countries for acceptance and implementation of EHRs is rising, they will face some challenges and barriers which can slow down their progress due to the multidisciplinary and complexity characteristics of EHRs. Some of these challenges and barriers can be seen in the past and present histories of EHRs acceptance process in developed countries too. Familiarity with these challenges and barriers will help developing countries to have better understanding of these problems towards successful EHRs. The main goal of this survey is to study the challenges and barriers of acceptance and implementation of EHRs in the developing countries and how they can overcome such problems.
 
Evidence Acquisition: Two databases, Pub-Med and Scopus with Combination of terms such as Electronic Health Records, Developing Countries, Barriers, Challenges, Acceptance, and Adoption were searched. Totally, 514 articles extracted. Some exclusive criteria such as date of publication (year 2000 and above) and having a close relation to the subject of the study (through abstract) were applied. The result was eight articles from Scopus and 12 articles from Pub-Med. Also, 7 articles were extracted by general search in internet. Also, 11 articles with the same search policies were selected from Journal of Health informatics for Developing Countries (JHIDC) with no exclusion criteria.
 
Results: Developing countries must be fully aware of challenges and barriers in their way towards EHRs. They also need to study the experiences of countries which are successful in acceptance and implementation of EHRs. Developing countries also need to provide infrastructures needed for a successful implementation of EHRs.
 
Conclusions: Despite the positive effects of EHRs in healthcare services, the acceptance rate of EHRs in developing countries and even developed countries is still low. The developing countries are facing many problems in their way toward implementing successful EHRs. Lack of infrastructures in information and communication technology, cost, and cultural resistance are considered as main barriers for developing countries in their approach to accept and implement EHRs.