Electronic health records post-implementation challenges in selected hospitals: A qualitative study in the Central Region of southern Ghana.

Abstract

Electronic health records (EHRs) are useful tools in healthcare settings but implementation in low and middle-income countries (LMIC) face challenges. To explore post-implementation challenges affecting the deployment of EHRs and their use in selected health facilities in Ghana. Using a qualitative research approach, 21 in-depth interviews were conducted with health workers in two hospitals in the study area in Ghana, in February and June 2020. Purposive sampling was used to select participants. All interviews were audio recorded, transcribed, and coded into themes using QSR Nvivo12 software to aid thematic analyses. Post-implementation challenges were grouped into lack of technological, logistical and managerial support, and inadequate training. Inadequate equipment was the most reported post-implementation challenge that affected EHR use. Unreliable Internet and network connectivity was a source of frustration, which caused staff to develop negative attitudes towards use of the system. Lack of funding stalled implementation of the system and limited its use to critical care units only. It was also the reason replacement of equipment delayed. While EHR post-implementation challenges facing health facilities are surmountable, managerial support, backed with the requisite logistical and technical support is needed. It is not enough to rely on funding; health institutions should prioritise emerging EHR post-implementation challenges in their operating budgets. A national framework is needed to guide effective and sustainable EHR implementation across the country.