2. Language is not uniform across all health
institutions across the country
Adopt or develop a standard vocabulary
Identify local terms and associate them with
standard terms
Health care providers should be educated on:
• Benefits of using standard terminology for clinical
decision making support
• Health record documentation
3. Health data should be:
• Accurate and valid to the original source
• Complete
• Reliable
• Legible
• Accessible
• Current and timeless
Assure that EHR can improve quality, accuracy, and
availability of health records
Develop standard procedures for data input, storage,
and management
4. Resistance to computer technology usually
because of lack of computer literacy
Resistance to system change because of cultural
background
Introduction of a basic computer skills course for
personnel (health care providers, clerical staff,
etc.)
Consider culture of the personnel when
designing the EHR
Gradual introduction of EHR into the institution
5. Developers have to understand clinical data
and how health professionals use that data in
decision making
Lack of perceived benefits for users
Have personnel be involved in the discussion,
development, and implementation of EHR
6. International experts hired to develop systems
eventually leave when project is finished
Available staff but skills and knowledge not
adequate for tasks given
Lack of trained and educated staff because of
limited teaching programs
Recruit experts to teach appropriate skills
• Medical terminology
• Computer programming
Form developer communities for online discussion
and consultation
7. Availability of electricity
Availability of space for equipment
• Clean, dust-free, temperature regulated area
Availability of IT infrastructure
• Telecommunications give access to off-site data
Review present environmental conditions
Take into account environmental limitations
when designing EHR
Address limitations before implementation
Design contingency plan during disasters
8. Perceived high costs of computers and computer
systems
Must be self-supporting
• Funding is limited and healthcare costs are increasing
• Philanthropic and research funding are depleted eventually
Identify specific needs of the local healthcare
institution
Compare current systems costs plus perceived costs
against estimated benefits of the proposed system
Plan alternative ways to generate funds
Support from local public and private stakeholders
can help shoulder costs
9. Health care providers worry of not being able
to access information at all times
The community worries of data not being
maintained in a secure environment
• Leaked personal information leads to social stigma
Create data back-up system
Update local laws concerning EHR
Create password security and secure
workstations
Limit and monitor access of system
10. 1) Electronic Health Records: Manual for DevelopingCountries. (2006).
World Health OrganizationWestern Pacific Region. Retrieved from
World Health OrganizationWestern Pacific Region website:
http://www.wpro.who.int/publications/docs/EHRmanual.pdf.
2) S.P. Sood, et al. Electronic Medical Records: A Review Comparing the
Challenges in Developed and DevelopingCountries. (2008). Proceedings
of the 41st Hawaii InternationalConference on System Sciences.
Retrieved from Institute of Electrical and Electronics Engineers
Computer Society website:
https://www.computer.org/csdl/proceedings/hicss/2008/3075/00/307502
48.pdf.
3) W.M.Tierney, et al. Experience Implementing Electronic Health Records
inThree EastAfrican Countries. (2010). Stud HealthTechnol
Inform;160(1):371-375. Retrieved from ReserchGate website:
http://www.researchgate.net/publication/46273445_Experience_implem
enting_electronic_health_records_in_three_East_African_countries.