Methods and Challenges in Evaluating Electronic Health Record Systems: A Systematic Literature Review

Abstract

Systems due to their ability to increase the accessibility of clinical information, support data-driven decision-making, and potentially improve patient care quality and safety. However, EHR system evaluation remains highly complex due to the dynamic interaction between technical, organizational, and human factors. This article presents a systematic literature review aimed at identifying, classifying, and synthesizing EHR evaluation methods used in various healthcare contexts, while also uncovering key challenges in their implementation and assessment processes. Following PRISMA guidelines, this study examined scholarly articles published between 2013 and 2023 and indexed in reputable academic databases. The review reveals a wide variety of EHR evaluation approaches, including usability testing, system performance measurement, cost-benefit analysis, and qualitative methods such as user satisfaction surveys, in-depth interviews, and ethnographic studies. However, various challenges remain, including limited interoperability, data privacy and security issues, deficiencies in methodological rigor, clinical user resistance, and ethical dilemmas in health information management. Furthermore, the lack of a standardized evaluation framework further complicates comprehensive and ongoing assessment efforts. This study emphasizes the need to develop an integrated, multidisciplinary, and ethically sound EHR evaluation model to ensure optimal system benefits while minimizing future implementation risks.

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