Other Titles
The Impact of Electronic Health Records on Nurses and Nursing Care in Low-and Middle-Income Countries: A Scoping Review [Title Slide]
Abstract
Background: Electronic health records (EHR) are increasingly being implemented in low- and middle-income countries (LMIC), a significant shift from paper-based documentation, with goals to enhance clinical decision-making (1-5). However, implementation challenges such as lack of technical skills, funding constraints, and equipment issues exist (2-4). Furthermore, there is a lack of research focused on the impact of EHR implementation on nurses in LMIC, despite the critical role of nursing documentation on care decisions and planning (1-5).
Aims: To map evidence and identify research gaps from primary studies on the impact of electronic health records on nursing care in LMIC from 2015 to 2024.
Methods: This scoping review was guided by the Joanna Briggs Institute guidelines for evidence synthesis (6). A systematic search of MEDLINE, EMBASE, CINAHL, SCOPUS, Web of Science, and WHO Global Index Medicus databases was conducted in May 2024. Data was extracted from included articles and narratively synthesized to identify existing research gaps.
Results: Of 6,122 studies, 41 met inclusion criteria. Most employed quantitative methods but often did not use validated tools or theoretical frameworks. Electronic health records improved documentation, care decision-making, and managerial oversight, but also led to depersonalized care, workflow disruptions, reduced nurse-patient interaction, and technostress. Regional disparities in research output emerged.
Conclusions: The evidence demonstrates that EHR provides both benefits and unintended negative effects for nursing. Significant disparities exist in regional research output, especially from Sub-Saharan Africa, and many studies overlooked the use of theoretical frameworks and validated instruments. These gaps highlight the need for further research, particularly in under-represented regions.
Implication for nursing and/or patient care: The findings offer valuable evidence for nurses and healthcare policymakers aiming to optimize the use of digital healthcare systems, promote equitable access, stimulate further research, provide solutions, and support effective digital transformation in the resource-limited settings of LMIC.
Impact: This review identifies critical gaps in current research on EHR, highlighting both benefits and drawbacks for nursing care. The findings will guide nurses and policy-makers in LMIC to improve digital systems implementation and inform future nursing research and policy development.
Notes
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References:
1) Woldemariam MT, Jimma W. Adoption of electronic health record systems to enhance the quality of healthcare in low-income countries: a systematic review. BMJ Health Care Inform. 2023;30(1):e100704. doi:10.1136/bmjhci-2022-100704
2) Kumar A, Singh P, Singh S. Electronic health records for better health in the lower- and middle-income countries: A landscape study. Libr Hi Tech. 2020;38(4):741-757. doi:10.1108/LHT-09-2019-0179.
3) Bostan S, Johnson OA, Jaspersen LJ, Randell R. Contextual barriers to implementing open-source electronic health record systems for low- and lower-middle-income countries: scoping review. J Med Internet Res. 2024;26:e45242. doi:10.2196/45242
4) Zharima C, Griffiths F, Goudge J. Exploring the barriers and facilitators to implementing electronic health records in a middle-income country: a qualitative study from South Africa. Front Digit Health. 2023;5:1207602. doi:10.3389/fdgth.2023.1207602
5) Mengiste SA, Antypas K, Johannessen MR, Klein J, Kazemi G. Ehealth policy framework in low and lower middle-income countries: A PRISMA systematic review and analysis. BMC Health Serv Res. 2023;23(1):328. doi:10.1186/s12913-023-09325-7
6) Peters MDJ, Marnie C, Tricco AC, et al. Updated methodological guidance for the conduct of scoping reviews. JBI Evidence Implementation. 2021;19(1):3-10. doi:10.1097/XEB.0000000000000277
Sigma Membership
Lambda Pi at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Acute Care, Public and Community Health, Sub-Acute Care, Electronic Health Records, Low-Income Countries, Middle-Income Countries
Recommended Citation
Osman, Wahab; Widger, Kimberley; Harris, Alexandra; Yakong, Vida N.; Chu, Charlene; and Asah-Ofori, Stephanie, "Impact of Electronic Health Records on Nursing in Low-and Middle-Income Countries: A Scoping Review" (2026). International Nursing Research Congress (INRC). 142.
https://www.sigmarepository.org/inrc/2026/presentations_2026/142
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-08-06
Impact of Electronic Health Records on Nursing in Low-and Middle-Income Countries: A Scoping Review
Toronto, Ontario, Canada
Background: Electronic health records (EHR) are increasingly being implemented in low- and middle-income countries (LMIC), a significant shift from paper-based documentation, with goals to enhance clinical decision-making (1-5). However, implementation challenges such as lack of technical skills, funding constraints, and equipment issues exist (2-4). Furthermore, there is a lack of research focused on the impact of EHR implementation on nurses in LMIC, despite the critical role of nursing documentation on care decisions and planning (1-5).
Aims: To map evidence and identify research gaps from primary studies on the impact of electronic health records on nursing care in LMIC from 2015 to 2024.
Methods: This scoping review was guided by the Joanna Briggs Institute guidelines for evidence synthesis (6). A systematic search of MEDLINE, EMBASE, CINAHL, SCOPUS, Web of Science, and WHO Global Index Medicus databases was conducted in May 2024. Data was extracted from included articles and narratively synthesized to identify existing research gaps.
Results: Of 6,122 studies, 41 met inclusion criteria. Most employed quantitative methods but often did not use validated tools or theoretical frameworks. Electronic health records improved documentation, care decision-making, and managerial oversight, but also led to depersonalized care, workflow disruptions, reduced nurse-patient interaction, and technostress. Regional disparities in research output emerged.
Conclusions: The evidence demonstrates that EHR provides both benefits and unintended negative effects for nursing. Significant disparities exist in regional research output, especially from Sub-Saharan Africa, and many studies overlooked the use of theoretical frameworks and validated instruments. These gaps highlight the need for further research, particularly in under-represented regions.
Implication for nursing and/or patient care: The findings offer valuable evidence for nurses and healthcare policymakers aiming to optimize the use of digital healthcare systems, promote equitable access, stimulate further research, provide solutions, and support effective digital transformation in the resource-limited settings of LMIC.
Impact: This review identifies critical gaps in current research on EHR, highlighting both benefits and drawbacks for nursing care. The findings will guide nurses and policy-makers in LMIC to improve digital systems implementation and inform future nursing research and policy development.
Description
Electronic health records (EHR) are being adopted in low- and middle-income countries (LMIC) to enhance care. However, implementation challenges persist. There is a lack of research on nurses’ roles in EHR implementation, despite their key role in care. This scoping review identifies evidence, gaps, and implications for nursing practice and policy in relation to EHR implementation in LMIC.