Implementation of electronic health records in Iran: a scoping review of barriers and operational solutions

Despite the emphasis on overhead documents and general social security policies, the process of implementing the Electronic Health Records (EHR) in the Iranian health system has not yet been fully implemented. The purpose of this study is to identify and explain operational barriers and solutions for the implementation of EHR in the Iranian health system.

This study was a scoping review, using the Arkesy and O'Malley framework in 6 steps including identifying research questions, identifying related studies, selecting/screening studies, data area/division of data, summarizing, reporting results, practical guidance and recommendations. Iranian databases including SID, Magiran, irandoc, and English -language databases including PubMed, Scopus, Web of Science, ProQuest and Google scholar were searched. Selected articles were analyzed using Maxqda software (version 10).

After screening, 32 articles were selected. Operational barriers and solutions were classified into three levels of macro (policy and health management), Messo (centers of health services) and micro (health service providers). Desirable management and leadership, providing the necessary standards, community-building, preparing processes, training before implementation of the project, employee participation in implementation of the plan, and government financial support were among the most important operational strategies for EHR implementation in Iran.

The implementation of EHR in the Iranian health system faces obstacles that need to be taken in coordinated and simultaneously at the level of health policy and management levels, providing centers and health service providers to improve efficiency and effectiveness.