Towards Electronic Medical Record (EMR) utilization in developing countries: a conceptual model based on systematic literature review

Abstract

BACKGROUND: Paper-based medical records remain prevalent in many developing countries, limiting the accuracy and efficiency of healthcare delivery. Electronic Medical Record (EMR) offer significant potential to improve care quality, yet their adoption faces infrastructural, financial, and contextual challenges in resource-limited settings. METHODS: A systematic review of five databases was conducted to identify studies on EMR design, development, and implementation. Eligible articles underwent qualitative analysis to identify key components and challenges. These findings were synthesized into a conceptual model, using the System Development Life Cycle (SDLC) as a comprehensive Conceptual map to cover all system phases rather than a linear execution plan. RESULT: From 80 eligible studies, qualitative analysis yielded 204 refined codes, synthesized into a three-layered framework (Foundation, Core Cycle, and Optimization) comprising seven conceptual categories: strategic foundations, system architecture, user experience, interoperability standards, implementation processes, ethical considerations, and emerging technologies. Together, these categories outline the key dimensions of EMR system development in resource-limited settings. CONCLUSIONS: The proposed model offers a constructive and iterative approach for EMR implementation in resource-limited settings. By distinguishing between core necessities and optimization features, the framework allows for a flexible, scalable adoption strategy that addresses local infrastructural constraints better than rigid, linear models.