Open-Source Electronic Health Record Systems for Low-Resource Settings: Systematic Review.

Area of Science:

• Health Informatics
• Global Health Technology

Background:

• Information and communication technologies significantly impact healthcare quality, but adoption is limited in low-resource countries due to economic and social barriers.
• Electronic health records (EHRs) are crucial for patient management, yet their implementation in resource-limited regions faces challenges like inadequate infrastructure and staff training.
• The high cost of proprietary EHR software is a major obstacle in low- and middle-income countries, making open-source solutions a promising alternative.

Purpose of the Study:

• To systematically review open-source EHR systems tailored for the unique requirements and constraints of low-resource environments.
• To identify and evaluate the suitability of existing open-source EHR solutions for implementation in settings with limited infrastructure and resources.

Main Methods:

• Conducted a systematic literature review comparing available open-source EHR solutions.
• Collaborated with University of Gondar Hospital, Ethiopia, to define common limitations and essential EHR requirements for low-resource settings.
• Performed an in-depth evaluation of current open-source EHR systems, analyzing their strengths, weaknesses, and alignment with predefined features critical for resource-limited environments.

Main Results:

• Assessed multiple open-source EHR solutions based on 21 key features, including integrated applications, reporting capabilities, interoperability, coding systems, security, patient portal, offline support, and community support.
• Detailed the strengths and weaknesses of each evaluated EHR system concerning their suitability for low-resource settings.
• Presented a comparative analysis of the evaluated open-source EHR systems based on their feature quality and relevance.

Conclusions:

• Open-source, reliable, and flexible EHR systems are in high demand for low-resource settings.
• This study provides a multidimensional evaluation and comparison of five open-source EHR systems, offering informed recommendations for implementers, developers, and healthcare professionals.
• The findings aim to guide decision-making processes for adopting, installing, and maintaining open-source EHR solutions in resource-limited contexts.