Electronic health records in patient care: strengths, facilitators, challenges, and future directions—a scoping review

BACKGROUND: Electronic health records are crucial medical informatics elements increasingly utilized in industrialized nations to enhance health care services. Given the significance of electronic health records in improving monitoring and evaluation, along with the necessity to deliver quality, cost-effective, and patient-centered services, this study aims to examine the strengths, limitations, challenges, facilitators, and prerequisites for the implementation and utilization of electronic health records. METHODS: This study was a systematic scoping review conducted in 2023. The protocol of the Joanna Briggs Institute (2015) was employed to design and execute this scoping review, while the model by Levak et al. (2010) served as a guide for its execution. Articles were searched across six major databases, including IS Web of Sciences, PubMed, Scopus, EMBASE, Cochrane, and ProQuest, using a predefined search strategy. Google Scholar was also utilized for supplementary searches. The search period spanned from 2002 to 2022. RESULTS: A total of 37,694 studies were identified across six primary databases. Following evaluation in three stages-title, abstract, and full-text-71 articles were deemed eligible for inclusion in this scoping review. Qualitative analysis and data classification of the selected studies identified four main themes and 31 sub-themes related to the strengths of setting up and utilizing electronic health records. Challenges associated with the launch and implementation of electronic health records were categorized into five main themes and 47 sub-themes, while facilitators and prerequisites for launching and utilizing EHRs were classified into five main themes and 30 sub-themes. It should be noted that some sub-themes were reported in only a single study; therefore, their weight should be interpreted with caution. Finally, a five-stage process was recommended to guide the successful launch and implementation of EHRs. CONCLUSIONS: Healthcare managers and policymakers should comprehensively consider the strengths, limitations, challenges, facilitators, and prerequisites for launching and using electronic health records. Given the relatively limited effectiveness of government incentive policies and financial support, there is a need to assess and revise these policies to enhance the implementation of EHR. Addressing user resistance requires a greater focus on organizational culture.