Barriers to the implementation of large-scale electronic health record systems in primary healthcare centers: a mixed-methods study in Saudi Arabia

The study highlights insufficient connectivity, inadequate technical support, and high turnover in key leadership positions as major contributors to previous implementation failures. Notably, training and ongoing support emerged as critical obstacles, whereas concerns related to privacy and confidentiality were found to be less significant. To ensure successful EHRS adoption, decision-makers must allocate sufficient resources for software selection, infrastructure improvements, workforce training, and continuous technical support. This study fills a research gap by providing evidence-based recommendations for optimizing large-scale EHRS implementation in healthcare settings, particularly in resource-constrained environments.