Implementation of electronic health record systems in private health facilities: A qualitative study in Ghana

IntroductionElectronic Health Record Systems (EHRS) are transforming healthcare delivery globally, yet their implementation in resource-constrained settings like Ghana remains underexplored. This study evaluated EHRS adoption in private hospitals in Ghana's Suame Municipality, assessing structural readiness, process integration, and outcomes to identify barriers and enablers of successful digital transition.MethodsA qualitative study design was employed, involving semi-structured interviews with 28 purposively selected healthcare workers (clinicians, administrators, IT staff) across four private hospitals. Data were analyzed using Braun and Clarke's thematic analysis to identify patterns in infrastructure, workflow adaptations, and perceived impacts. Theoretical saturation guided sample adequacy.ResultsThree key themes emerged: (1) Structural challenges, including uneven IT infrastructure distribution, staffing gaps (e.g., reliance on single IT personnel), and inadequate training; (2) Process improvements, such as streamlined documentation and claims processing, despite intermittent system failures reverting to paper-based backups; and (3) Mixed outcomes, with reported efficiency gains (e.g., error reduction) offset by policy voids and financial constraints limiting scalability.ConclusionWhile EHRS implementation in Ghana's private sector shows promise in improving workflows, its sustainability is threatened by infrastructural deficits, workforce capacity gaps, and unclear governance. The study recommends public-private partnerships for financing and hybrid paper-digital systems to mitigate disruptions.