Currently submitted to: Online Journal of Public Health Informatics
Date Submitted: Apr 27, 2026
Open Peer Review Period: Apr 29, 2026 - Jun 24, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Barriers to the implementation of the electronic health record in public health facilities: A systematic review
ABSTRACT
Background:
Despite the clinical and administrative benefits of Electronic Health Records (EHRs), comprehensive evidence regarding the specific barriers to their implementation within the unique socio-political context of public healthcare systems remains scarce.
Objective:
To identify barriers to the implementation of electronic health records (EHRs) in public health facilities by reviewing previous publications.
Methods:
A systematic review of peer-reviewed articles was conducted. The search was conducted in PubMed, Scopus and Embase. Qualitative and quantitative studies were included that reported barriers from the perspective of health authorities and professionals, excluding incomplete implementations or systems that did not conform to the characteristics of an EHR. Barriers were classified according to the PRISM framework: technical, behavioral, and organizational.
Results:
The search included 161 articles, from which 10 studies published between 2008 and 2022 were selected. Technical difficulties include the need for investment and improvements in infrastructure. Behaviorally, lack of training and resistance to change make adoption difficult. At the organizational level, lack of leadership and funding issues are key obstacles. For successful implementation, it is essential to address these challenges through adequate investment, staff training, and strengthened policies and coordination.
Conclusions:
Barriers have been identified in the process of implementing the EHR within the public sector, which can be considered by governments to speed up the process of adopting this tool.
Citation
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