On the challenge of adopting standard EHR systems in developing countries

Electronic health record (EHR) systems are a popular mechanism for accessing health records in the developed world and have contributed towards improved and cost-effective health care management. However, the development of appropriate and scalable EHR systems in developing countries has been difficult to achieve because of certain limitations inherent in the technological infrastructure. In this paper, we present a comparative study of 19 EHR systems in terms of the security and usability of these systems within the context of the developing world. Our aim was to investigate whether online health services designed for developed countries can be adopted for EHR systems in developing countries. The investigation was based on a number of dimensions such as development environment, system platform, type and access control standards found in the National Institute for Standard and Technology (NIST) and Certification Commission for Health Information Technology (CCHIT). Our research indicates that all the systems evaluated require online access control decisions. Solely relying on an online access control system is limiting, particularly in developing countries where access to the server can be disrupted by a number of disastrous events.