The Role of SmartCare Electronic Health Records System in the Delivery of Health Services: Case of First-Level Hospitals in Lusaka District, Zambia

The digitization of healthcare through Electronic Health Records (EHRs) has transformed medical service delivery globally thus leading to improved efficiency, data accuracy, and patient care. However, developing countries like Zambia face significant implementation challenges, including skills challnges, infrastructure gaps and policy limitations. This study examines the implementation of Zambia's SmartCare Electronic Health Record (EHR) system in first-level hospitals of Lusaka District, focusing on registry personnel's experiences, policy frameworks, service delivery impacts, and implementation challenges. The study employed a qualitative research design, exploiting a purposive sampling method to select 30 registry personnel across five hospitals in Lusaka. Data was collected from 25 registry personnel through in-depth interviews and analysed using thematic analysis. The findings reveal that all twenty-five participants emphasized that the SmartCare system was usefull, was user-friendly and its ability to streamline data capture and retrieval made work enjoyable and much easier. However, findings also revealed a concerning gap in policy awareness among registry staff, which potentially compromise data governance and system interoperability. The study further established that while SmartCare has significantly improved efficiency in patient record management, reducing paperwork and enhancing data accessibility, substantial barriers hinder its optimal utilization. Key challenges include system failures (reported by all participants), erratic power supply, inadequate training and therefore limited skills,, insufficient computer resources, and inconsistent distribution of SmartCare cards.