Healthcare professionals’ perceptions of a maternal and newborn electronic health record and the role of design in their experiences: a qualitative study

BACKGROUND: Few studies assess the perceptions and experiences of healthcare professionals (HCPs) who use electronic health records (EHRs) within a maternity and newborn care setting. Furthermore, prior research has not specifically focused on the relationship between EHR design and the user experience of HCPs working with these patient groups. OBJECTIVE: To explore the perspectives of HCPs regarding a maternal and newborn EHR and evaluate the role of EHR design in their experiences. METHODS: We carried out semi-structured interviews with 26 HCPs working in a maternity hospital. The Unified Theory of Acceptance and Use of Technology (UTAUT) and a 2025 systematic review informed the topic guide. A framework analysis was conducted. Inductive and deductive coding was conducted, with themes developed based on the grouping of these codes. Themes and codes were then organised using the UTAUT constructs, with design-related themes also classified according to the relevant EHR design category. RESULTS: Within the construct of 'performance expectancy', participants discussed the impact of data entry, user guidance and workflow. In particular, users highlighted the largely positive impact of templates, order bundles and banners, while describing their negative perception of pop-up alerts, time-consuming log-in processes and their inability to open multiple screens. The themes that emerged within the construct of 'effort expectancy' involved searchability and automation. Specifically, participants discussed their desire for search tools, dislike of copy-and-paste functionalities and positive perceptions of auto-population and auto-calculation. The themes that emerged within the construct of 'facilitating conditions' pertained to interoperability-including users' desire for integrated imaging and monitoring-and users' negative experiences with information technology infrastructure. The 'social influence' construct highlighted participants' positive views regarding the organisational priority assigned to the EHR. Interviewees also reported relatively little explicit discussion about their EHR, amongst peers and managers. Yet, participants simultaneously described colleagues as an important source of informal learning, regarding the EHR. DISCUSSION: Users' perceptions of a maternal and newborn EHR can be meaningfully mapped to UTAUT's constructs, thereby providing a roadmap for targeted future interventions. The impact of social influence appears more nuanced in the context of a longstanding EHR, and warrants further research.